The government has reneged on its pledge to provide more flexible working in the NHS, says the Medical Women's Federation in Postgraduate Medical Journal. Nearly 70% of medical students are women, and by 2012 male doctors will be outnumbered by women.
But despite its pledges in 2000, made in the government's blueprint for the NHS - the NHS Plan - and the policy commitment made by the pay negotiating body NHS Employers in the same year, there are now fewer flexible posts than ever before, say the authors.
Drs Helen Goodyer and Finola Lynch argue that flexible working has been under threat since the new junior doctors' pay deal in 2000. This has made flexible working "unaffordable to trusts," they write. And it has generated widespread ill feeling towards flexible trainees who are now perceived as grossly overpaid for the hours they put in.
The structure of the pay deal meant that flexible post trainees were being paid more than most full time junior doctors and consultants during the first five years after qualifying. The government has pumped in a further £7 million a year to support flexible training.
But a new pay deal hammered out between NHS Employers and the British Medical Association in 2005 has only served to increase the confusion and ill feeling around pay bands for flexible training posts, say the authors.
In 2005 it was anticipated that the number of flexible training posts would double by 2010, but the body responsible for fostering more flexible working practice lost its responsibility for hospital and general practice. Local funding for flexible training has dried up, and recruitment to these posts has been frozen this year as trusts struggle to meet their debts.
Training posts are in a state of flux as a result of reforms, and the impending implementation of the European Working Time Directive will cut the hours doctors can legally work, so it is more important than ever to create flexible working, say the authors. "The principles and polices needed to create a cultural and practical shift in working practices are there. What is missing is the will (and consequently the funding) to achieve it," write the authors.
"This approach is both short sighted and unforgivable at a time of profound change in UK medical training," the say, adding: "Nothing less than a cultural revolution is required within the NHS."