Leading article: Sleepy doctors make dangerous mistakes

YOUR LIFE may one day be in tired hands. According to a poll by the Association of Surgeons, nearly three-quarters of consultant general surgeons are working excessive hours. Of course, a survey by such an interested party, and the special pleading that accompanies it, have to be treated with caution. However, the impression of an overstretched profession is one that is generally recognised and deserves attention.

The news comes after the high-profile revelations about the competence of the Bristol heart surgeons and the new allegations about surgery at the Royal Brompton hospital. These were particular phenomena that deserve separate enquiry and analysis. But events do seem to be combining, and conspiring to erode public confidence in this most vital of professions. Too many of us are beginning to feel that, should we find ourselves on the operating table, we could be exposed to unnecessary risk.

The most straightforward answer to the problem is to increase the number of consultant general surgeons. This is acknowledged by the Secretary of State for Health, Frank Dobson. However, Mr Dobson is also sensible to point out that "you could have all the money in the world, but you still need trained doctors and it takes a long time to train them". In the meantime, there is the strongest case for much tighter regulation of the number of hours that surgeons - and other medical staff, from junior doctors to ambulance drivers - are permitted to work at a stretch. Naturally, such professionals have an ethical obligation to respond to clinical need. But there is an overriding public interest in ensuring that such responses are made only by the alert and competent. It may mean longer waiting lists, but we should no more permit the weary to wield the scalpel than the drunk or the doped.