Tuesday

The NHS messes up the hiring of junior doctors

Belatedly, I want to mention the extraordinary mess the government has made of the hiring of junior doctors. It has been well covered in the Telegraph.
It should not come as a surprise that the NHS has completely mucked up this business. The government is a bad administrator. It is also in a monopoly position. This kind of disaster is the sort of thing that governments operating monopolies go in for – although this does rank among the most cack-handed foul-ups that even a government monopoly has managed.
The dislocation the NHS has brought upon itself and the misery endured by doctors are appalling. The only possible silver lining is that perhaps more in the medical profession will come to view the NHS as a failed idea. Already there are far more who take that view than there were a decade ago.
Here is part of a letter printed there which was written by a doctor:
These last few weeks have been the final straw for many of us. We have been subjected to the most unfair and least meritocratic selection process ever seen, MTAS [medical training application service] via MMC [modernising medical careers].
Here is a link to several letters.
We have had to sum up our years of work and experience in several politically correct short answer questions, on which we are then judged. Examinations, experience and references are all but ignored in the pursuit of vague waffle. Shame on those who are behind this scheme. Many a tear will be shed this week by many brilliant young doctors who have had their hopes and dreams crushed in a quite barbaric fashion. Many of us will emigrate and many of us will leave the profession; I hope those behind the scheme are proud of these achievements.

Here is the beginning of an excellent article on it by Dr Max Pemberton:

The sight of people breaking down in tears is not uncommon on wards.
But on wards this week there have been scenes never witnessed before — scores of people bursting into tears, inconsolable and scared.
As I walked on to a ward there were huddles of people attempting to console others; nurses with outstretched arms, consultants with kind words, people shaking their heads in disbelief and hugging each other. They aren’t patients though. They are doctors.
This week saw the results of the new Government initiative Modernising Medical Careers (MMC), which has been branded by those caught up in this chaotic reshuffle as “Massive Medical Cull”.
All junior doctors in the country have had their contracts of employment terminated from August and been forced to reapply for their jobs through MTAS (Medical Training Application Service), an online, Kafkaesque application service.
From the beginning the process has been fraught with technical glitches, delays and conflicting information.
In my hospital, over half of the doctors I work with have not been selected. Most have been training in excess of 10 years, many of them have already obtained further degrees in their field of work and yet are now deemed surplus to requirements. They face an uncertain future.
Others face the prospect of relocating to another part of the country, selling their homes and uprooting their families, or attempting to retrain in another speciality. Many are considering taking their skills abroad, more still are considering jobs in the City or industry.

The full article is here.
Here is the beginning of the main story:

Thousands of young doctors have been left without jobs because a new NHS training system has gone “disastrously wrong”, it was disclosed yesterday.
Patricia Hewitt is preparing for further NHS closures
As much as £2 billion has been spent on the training of up to 8,000 doctors who find themselves without a new job under a Government initiative.
Such is the fury at the scheme, called Modernising Medical Careers (MMC), that doctors have renamed it “Massive Medical Cull”.
It costs £250,000 to train a doctor and the “shambles” is said to be blighting the careers of dedicated young men and women who may now leave the NHS. Many are also saddled with debts of more than £40,000 after funding their training.
The Daily Telegraph has been inundated with letters and emails from despairing doctors and their parents who “feel like crying”.
This comes a day after this newspaper reported that three out of four trusts were restricting patients’ treatment because of the NHS financial crisis.

There was also an article by Bill Deedes, who writes from the perspective of someone who remembers Aneurin Bevan and the introduction of the NHS. When Deedes, who is actually somewhat on the left of the Tory party, starts suggesting the NHS is an idea whose time has gone, then there surely is a change in the air:

A district nurse who occasionally attends to my needs brought sad tidings. Six nurses she had trained to carry out her invaluable duties were leaving the nursing service: there is not enough money to pay them.
At my time of life, you get a view of what is going wrong with the National Health Service, and why we shall not be able to continue on the present lines for much longer.
A vast, unwieldy organisation is outstripping our taxable resources and fraying the golden thread of selfless service that runs through the NHS. We need, for a start, to think back to 1945, when Aneurin Bevan, Labour’s minister for health, began to shape the service.
I had returned from the war to work on this newspaper for £18 a week – and lived comfortably. The Daily Telegraph itself was less comfortable. Imported newsprint, which cost foreign exchange, was severely rationed. We ran a four-page newspaper most days, six pages a couple of times a week.
My circumstances and this newspaper’s have improved since then; indeed, they have been transformed. Bevan’s National Health Service stays much as he left it. That is the fatal flaw.
Those in the Labour Party who worship the memory of Bevan – and he was a wonderfully talented politician – also worship what they see as his memorial, a free health service for all.
In fact it was never this. Bevan flounced out of the Attlee government because Hugh Gaitskell insisted on some payment for spectacles and dentistry.
“A desiccated calculating machine,” Bevan called him. But it is an article of Labour faith: nothing in Bevan’s legacy must be touched. This is nonsense.
The NHS is crying out for a new source of money and it is best raised by encouraging personal health insurance.
When I last looked at Australia’s health service, half the population had taken out health insurance, encouraged by tax concessions on insurance premiums. It is probably more now.
Ah yes, it means a two-tier system which is anathema to Labour stalwarts.
But if, as you find in Australia, the tier for those without insurance enjoys more reliable care than our NHS because there are fewer queuing up for a free service, what is wrong with that?
Yes, people will resent any charge on what has once been free for all.
But unless we can swallow our political prejudices and move on, we shall assuredly destroy a wonderful medical service. Nurses are leaving this country to find work overseas.

  1. Why are British doctors and nurses paid more than their eqivalents on the Continent?
  2. The decline of home visits by doctors
  3. How many households have private medical insurance?
  4. Doctors and managers in the NHS are gagged by the government
  5. How much for removing moles in Malta?
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One Response to The NHS messes up the hiring of junior doctors

  1. David Yates says:

    The current chaos surrounding training appointments for junior doctors has been virtually ignored by the BBC – another example of the bias that James talks of. I complained but was told that it been reported online & was dealt with on Today on Radio 4. On the six o’ clock news – not a trace that I saw. When did we last see 12,000 doctors marching on Parliament – barely noticed by the BBC

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