Counting the Cost of a Medical Training Disaster

Delivering his New Year message on Thursday 27 December 2007, the leader of the BMA in Scotland warned that failing to address the problems facing recruitment to medical training could wreak havoc with the future of patient care.

In 2007, changes to specialist medical training recruitment led to a catalogue of disasters leaving junior doctors disillusioned and demoralised. In March this year, hundreds of Scottish doctors took to the streets of Glasgow to protest at the reforms, calling for them to be delayed until the problems could be resolved.

Dr Peter Terry, Chairman of the British Medical Association (BMA) in Scotland, said:

“Despite repeated warnings from the medical profession about the flaws in the system, the UK Government pressed ahead with an untested and poorly thought out application process. This badly implemented system has let our junior doctors down and cost the NHS dear. As well as the financial implications, the UK has lost a great many talented doctors and, for those trapped in the system, morale is at rock bottom. Trust in the Westminster government has been lost and doctors feel they have been let down by those who should be inspiring and leading them.

“Much of the blame for this year’s debacle lies at the door of the UK Government but certain aspects of implementation were devolved to Scotland and where that happened, things were improved. Here, there was a greater willingness by the service and the administration to work in partnership with the profession to overcome the problems. This approach rescued the situation for many junior doctors but still came at a major cost to the NHS. In order to overcome problems with the application and selection process, every single applicant to Scotland was interviewed. This resulted in thousands of interviews conducted by consultants who had to be freed from their clinical and teaching duties in order to fulfil this commitment. In the single specialty of general medicine, it was estimated that this cost the equivalent of 560 consultant days out of service.

“In 2008 we begin with a clean slate and I am determined that we will do all we can to prevent a repeat of this dreadful situation. The online application system has been scrapped, as have UK-wide recruitment processes (with the exception of general practice). Junior doctors who meet the person specifications can make as many applications as they desire to posts throughout the UK, with each country managing its own system.

“Even now, however, doctors throughout the profession are voicing concerns that the 2008 recruitment process will be even worse than 2007. Some anticipate thousands of applicants for limited posts and consultants fear that the short-listing processes will be unable to cope.

“So how can we be sure that we are getting the best people for the job? An independent review, led by Sir John Tooke, is currently underway to determine the future for medical training, but in the meantime we have a duty to protect the interests of those doctors who find themselves stuck in this system. In Scotland we will work in partnership to take a critical look at the proposals but our determination is to do what is best for Scottish doctors and NHS Scotland.”

Commenting on priorities for other groups of doctors in 2008, Dr Terry added:

“2008 will be a testing time for many groups of doctors in the NHS. GPs face a difficult time with the current round of contract negotiations and staff and associate specialists are still seeking agreement on the details for their new contract.

“The BMA in Scotland is proud of the way that doctors, managers and politicians worked together to overcome some of the challenges we faced in 2007, and we have high expectations for the new Scottish Government in 2008. I hope that Health Secretary Nicola Sturgeon maintains her commitment to work with the profession to address the many challenges facing our profession in the coming year and to do what is in the best interests of the Scottish health service. If not we risk losing excellent doctors from NHS Scotland to the detriment of our patients.”9

Source-BMA
LIN/M