MTAS: National Poll rejects single interviews, and calls for Consultant boycott
From Mmc
An open letter was sent today to Consultants, on behalf of: Prof Morris Brown (Cambridge), Dr Mei Nortley (London), Dr Helen Wise (Wessex) , Dr Sarah Spencer (Bridgend, Wales), Dr Chris Allen (Cambridge), Dr Gordon Caldwell (Worthing), and many other concerned consultant and junior doctor colleagues in the UK. One of the authors has asked me to post it here.
Dear Colleague
We are privileged to be invited by the Junior Doctors to write a brief letter to all our Consultant colleagues on the subject of MMC/MTAS. Probably most doctors wish this would go away, either because its consequences will destroy careers, or because the topic has become repetitive and tedious. To the latter group we apologise for adding to your inbox.
- Support for Consultant boycott
Many of you find yourselves in the position, at once enviable and difficult, of having more say now over the fate of the Juniors than the DoH mandarins and quangos who have ridden roughshod over just process and individual rights. This opportunity arises because MTAS cannot proceed without the collaboration of Consultants in the round 1b interviews. Some of you will be well aware of the flaws and injustices of MTAS, and just need to know your views are shared by the majority of colleagues. We have conducted an online poll at http://www.cai.cam.ac.uk/people/mjb14/ which shows that 81% of 813 Consultants and 85% of 2422 Juniors want a Consultant boycott. These percentages are in line with several Trusts who have balloted their staff locally.
- Objections to a boycott, and their resolution
We would like to address next those Consultants who, while fully aware of the wrongs of MTAS, are uncertain about a boycott. The main concerns are the need to staff hospitals in August, the feasible alternatives to single interviews, the time spent already on the appointments process, and the legality of a boycott.
- 1st August changeover
This date is not written in tablets of stone, and is indeed recognised to be an undesirable date for national handover. In our poll, 80% of both seniorities would like doctors to stay in their current post. The main downside is a delayed start for the new FY1s, who should be compensated; but at least they have a future ahead of them, whilst 10,000 FY2s and SHOs unsuccessful in their single MTAS interview face a permanent end to their career in hospital medicine.
- Feasible alternatives to single interviews
Several alternatives to MTAS for this year have been proposed, as listed at http://www.cai.cam.ac.uk/people/mjb14/. These include partial reversion to Deanery-specific appointments, and appointment to temporary posts this year. The permutations include a rescue plan from the Royal College of Surgeons ( England ) whose President has dissociated his College from the recommendations of the Review Body. In our poll, only 15% voted for the MTAS single interviews, with other doctors preferring either a reversion to Deanery appointments or appointments limited this year to temporary posts.
- Wasted interview time
Regarding the need to salvage the thousands of hours already spent, there are several answers. We have been told that the only audit of MTAS as a selection tool found selection of the top 20% to be valid, and we have proposed that posts are indeed offered to 20% of applicants without unnecessary repetition of work. However, it is the consequences of a mistake, not the time taken to make the mistake, which determines the importance of rectifying the error; most Consultants will recognise that their wasted hours of interviews are nothing compared to the wasted years of Juniors whom MTAS will discard.
- Legality
It is implausible that thousands of Consultants carrying out the democratic will of the majority, as measured by our poll, will be accused of breach of contract.
- Why the Review Body proposal (of single interviews) is wrong
Finally, we address Consultants who have successfully resisted the news stories of MMC/MTAS and would like a short resume of why the majority of doctors reject the solution proposed last month by the Review Body. The outstanding problem with this solution is that in England, about one half of doctors will have only one chance of success, because the now discarded and discredited short-listing procedure rejected all (or all but one) of their initial choices, and these applicants are limited to one interview in the impending round 1b of interviews. The other half of applicants can count the scores from any interviews already attended, and one further interview, giving them up to four times the chance of being appointed.
The DoH and Secretary of State have claimed that the interview process will be the same for remaining interviews as before, but this is widely considered impossible, given the huge variety of process – for instance, some committees allowed, whilst others refused, the use of candidates' CVs. In Scotland , Wales and N. Ireland, all applicants will be allowed four interviews, in contrast to the Russian Roulette of the one-strike-and-you're-out approach in England .
The two larger Royal Colleges represented on the Review Body are the Chairman's – RCPE – and RCSEng. The President of RCSEng has dissociated his College from the recommendations. The interests of most English doctors were not, we feel, well represented.
- Why Consultant action is urgent
The week-long shut-down of the MTAS computer due to leaks of confidential information has added to both the agony of applicants awaiting news of interviews and to the incredulity that this untried system will deliver matching of applicants and posts – with sensitivity to the needs of partners and families – by 1 st August. Channel4 News has reported that "Hundreds of junior doctors in Scotland have had details of interviews lost in the latest IT chaos to hit the NHS". Their full report can be viewed at http://www.channel4.com/news/articles/politics/domestic_politics/nhs+hit+by+further+it+chaos/497572
We believe that the spiralling debacle of MTAS and our poll results will embolden Consultants to follow those in Trusts and specialties who have already declared themselves against further participation in MTAS interviews. The sooner this happens, the sooner Deaneries can activate their contingency plans for a temporary solution, and a revised date for the August changeover can be set, thus preventing any further harm to our service to patients
- MMC
Although a new Review to consider MMC as well as MTAS has now been announced, our poll found that only 10% of doctors thought MMC an advantage over Calman for SpRs, and 25% for SHOs. There are numerous features of MMC which need radical rethinking, such as the requirement for doctors to commit to their specialty and location of training within two years of qualification. We believe the recent intransigence over revisions to MTAS make it essential to halt any MMC appointments before a thorough Review is complete. Otherwise we will be told it is too late or illegal to make major changes.
Further poll findings, broken down by specialty, grade and location, will be published soon at http://www.cai.cam.ac.uk/people/mjb14/ , and we hope you will add to those views already expressed.
We thank you for reading this letter, and for listening to the heartfelt wishes of the Junior doctors that Consultants support their cause by staying away from round 1b interviews and, preferably, inform their deanery of this decision.
