QUALMS are certain to be expressed about the scheme to have ambulance staff standing in for doctors in East Lancashire hospitals at weekends.

For while the aim is to lighten the workload of taxed junior doctors, having paramedics on overtime shifts taking over their "routine tasks" must inevitably reduce the level of medical skills available to patients.

No-one doubts the enthusiasm and abilities of the ambulance personnel - as is testified by the high standing of their service with the public - but it remains indisputable that their talents are not those of doctors. And despite the reassurances of health bosses that the paramedics' role on the wards will be restricted to tasks for which they have been trained, the outcome must be a dilution of standards of patient care, even if little or no risk is involved.

It has to be accepted that health trusts have an obligation to reduce the long hours worked by junior doctors and that squeezed financial resources and the general shortage of junior doctors hinder that duty.

But we fear that, for all its good intentions, this scheme to draft paramedics to the wards in the doctors' stead may infringe a higher obligation - that of the patient always coming first.

Sick people in hospital have a right, surely, to the fullest medical help available, but with this plan. we are concerned that some in Blackburn may get something less than that.

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