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DOCTORS ON THE SICK

13-11-2007

As the government's disastrous junior doctors recruitment scheme unfolded earlier this year, Birmingham neurologist Dr David Nicholl gave us a unique inside view. Now, in this shocking expose, he warns there's worse to come.

This year has been the most disastrous year in the 60 year history of the NHS for junior doctors.

The chaos of the failed computer system, MTAS, combined with the new recruitment system MMC (Modernising Medical Careers) to cause untold misery and uncertainty for thousands.

However, if 2007 was bad, it is now clear that 2008 will be even worse because no one has been counting the numbers properly for the number of hospital consultants and GPs that are needed in the UK.

Don't take my word for it, the Royal College of Physicians in a report last month stated that the "MTAS ‘crisis' was essentially about a computer and selection failure plus, more importantly, the painfully obvious fact that there are insufficient training posts for all our young doctors - whether English-qualified or those with the highly skilled migrant status (HSMP).

And it will get steadily worse...consider that the present medical students are "already moving towards an insufficient number of training posts".

Since then, the situation has become even worse.

Less than two months before the jobs are advertised for 2008, recruitment plans have been thrown into disarray by an Appeal Court decision last week that the government had acted illegally in trying to exclude overseas doctors from this process.

I reported in February how this decision was morally reprehensible and had put doctors under such stress that one had committed suicide. We now know that the Government had broken the law.

Given that the Department of Health had been hoping it would win this case to protect the interests of UK graduates for 2008, it is now clear - given that the number of qualified medical students is increasing with each year and that the number of applicants from overseas this year represented 28% of the 34,000 applicants - that the process will be even more chaotic next year.

Don't get me wrong, the Appeal Court decision was the correct decision, but it is clear that those who were responsible for this complete failure of workforce planning need to be held to account as their failure will lead to untold misery, unemployment and cost millions of pounds of taxpayers money.

Put simply, why on earth did we build these new Medical Schools (Peninsula Medical School, Brighton & Sussex Medical School, Warwick, Keele and Hull) plus expand the places at existing medical schools without actually working out how many doctors we needed?

When I qualified at Birmingham in 1989, there were just under 160 medical students, this year the number will be just short of 400, at a cost of approximately 250,000 to train.

Incredibly, in the last 10 years, the number of medical students have been increased by 76%.

Imagine if the government trained too many Air Force pilots but didn't have enough aircraft for them to fly, the uproar that there would be. My advice to any medical student is to consider taking US board entrance exams (so that you can emigrate) or think about a career in military medicine as there is a shortage of military doctors, as there is no longer a guarantee of a job with the NHS.

I am in charge of postgraduate training for neurology for the West Midlands and we have more neurology trainees than any other region in the country outside of London. Yet, as I reported earlier this year, I will have no training posts to offer for at least another year.

When Tony Blair came to power in 1997, it was clear that significant investment was required in the NHS, and indeed waiting times have fallen and access to hospital specialists has improved hugely.

On 16th June 2000, the former Health Secretary, Alan Milburn said "The government is considering a further increase in medical school intake to ensure that we have the number of trained doctors the NHS will need in the future".

However, in the fight to improve waiting times, no Health Minister, it seems, has planned for what that the number of doctors this country needs should be.

Earlier this year, on Channel 4 news, I accused 2 government ministers of misleading the public over the precise figures of unemployed doctors. Patricia Hewitt and Lord Hunt are now no longer at the Department of Health and no-one has managed to answer my allegations.

In the summer, in another Channel 4 news interview, the Chief Medical Officer, Sir Liam Donaldson, was unable to give a figure for the number of doctors likely to be unemployed. If the people at the top don't know the figures, isn't it time they went?

That I feel this is especially so when one sees the crass incompetence of those who designed this mess. By way of example, look at the last slide in this presentation from one of the designers of the ill-fated MTAS system- "fully protected" indeed!

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