European paediatrics--unity with diversity?

The 900 consultant paediatricians in Britain might occasionally pause to reflect that they have about 30 000 paediatrician colleagues within the European Community (EC). The total number in greater Europe between Lisbon and the Urals must approach six figures. The geographic and political map of the continent has radically changed during the last year and it is likely that colleagues working in the wider Europe will wish to develop links with British paediatricians and these will involve education and medical practice. However measured the national political approach to association and integration the professional pressure is likely to be strong-and British paediatricians should welcome it. 1992/3 Nothing apocalyptic is likely to happen on 1 January 1993 as free movement of doctors within the EC already exists. The Single European Act merely commits the EC to establish a single market by the end of 1992. However the dominant influence of the market may challenge some UK practices such as the limiting of patient access to specialists by insisting on referral from primary care. The defence of free consumer choice is becoming an imperative and this could have enormous organisational and financial consequences, not only for those doctors practising in countries where they are remunerated by item of service payments. European Council directives in 1975 laid down the rules for member states for mutual recognition of qualifying degrees and diplomas both for undergraduates and postgraduates and in general practice harmonisation of training is almost complete. Trainee doctors from the EC are classified in the UK for medical manpower purposes as career doctors and a steadily increasing number of juniors from the continent are occupying training posts in paediatrics in the UK. Many have already tasted medical life as undergraduates on elective secondments and some British universities are participating in the Erasmus scheme of undergraduate exchange with mutual recognition of specialty courses, and a similar scheme (TEMPUS) has been established with some Eastern European countries. So why do more European paediatricians not apply for posts here, especially as unemployment is a familiar feature of medical life in some European coun-tries? The answers are not known but likely barriers are language, earnings, and differences in practice-not to mention the climate. Of course there has traditionally been close exchange of doctors at all levels between the UK and the Republic of Ireland. Clinical practice We recognise great differences in our professional practice and customs throughout Europe. …