We're training doctors for Australia
From Mmc
We're training doctors for Australia
Back in November last year, I rang a doctor at the John Radcliffe in Oxford to ask him about Patricia Hewitt's lunatic sound bite. (Mixed-sex wards. She said there weren't any. Or many.)
Wearily, he said it was a tiny problem for the NHS. "The biggest problem we face is losing a whole generation of junior doctors in 2007 to MMC/MTAS." To what? "Look it up," he said. "Modernising Medical Careers - haven't time to explain - but we're going to lose a great young surgeon we really want to keep. He has to apply into a computer black hole that could send him anywhere in the UK. The fact that we want him here counts for nothing."
I looked up MMC online, but soon drowned in a swamp of chatter about old-style SHO competences being commensurate with new-style ST3 competences.
Gulp. I know a bit more about it now. The wretched and fallible system of online, anonymised, mass-application forms (accompanied by the usual crashing that you expect from any website run by gov.uk) has left thousands of highly qualified and experienced junior doctors with nowhere to go after July 31. For example, none of the senior house officers currently working at the premier intensive care unit at St Thomas' Hospital has been short-listed for any interviews.
After a panel of surgeons in Birmingham withdrew in a paddy from the current round of interviews, health minister Lord Hunt was scrambled to the Today programme to say hastily that he had ordered "a review" of the system. He was questioned hard and he fudged and blethered mightily. He said that the appointment of doctors "had to be a competitive process". He insisted that the new system was working well "in large parts of the country". Ouch. Makes it sound like Iraq.
It's not a competitive process; it's a lottery. The short-listers know nothing about the applicants except what they have "scored" on the online application form. They don't know that Dr A has been working at St Elsewhere, while Dr B has been on the London "golden circuit", is in receipt of glittering prizes, was top of his year, is a member of the Royal College of Surgeons or that the consultant he is currently working for would give his eyeteeth to keep him right here on the kidney ward at Guys. You're only allowed to apply for four jobs (out of 30,000 posts - why?). One interview might be in Cardiff and another in Dundee - on the same day. (In Britain? You'd need to borrow a helicopter.)
Worse (for the doctors), neither Dr A nor Dr B know anything about the jobs they're applying for. They have to accept an offer before they know what county it's in, what the job description is, what the hours are or the salary scale (it can vary by 30 per cent). A proportion of the 22,000 places are fixed-term specialist-training appointments anyway. These jobs will provide the NHS with manpower, but they won't lead to career progression, since they're not official "training" posts.
There's a widely held assumption that applications were sifted initially not by humans, but via an electronic crawler picking out keywords - touchy-feely kinds of buzzwords. That's a bit worrying. I once put a column of mine through an electronic crawler that claimed to determine whether the writer was male or female. In seconds, it pinged back saying: "This writer is male. Are we correct?" I clicked NO. It pinged back: "Hey, you are one butch dame!" Ho, ho - very satirical. I sent the link to my journalist daughter to test the piece she was working on. She emailed back: "Says I'm a man, too. Don't think it works too well: the piece was all about shampoos."
I did the test as a joke; 22,000 NHS doctors had to do this for real in February - crafting their 150-word answers after coming off-shift in A&E and settling into another white night of online form-filling and wondering if each word was a) point-scoring, or b) useless. The truth is that half of them didn't even know their 150 words needed to be point-scoring. They didn't know it was an engineered, rather Orwellian game, got up by the NHS manager-class to be "accessible" and promote "equality of opportunity". They know now.
Though these doctors are called "junior", they are the workhorses of the NHS: The ones you see at 3am; the ones who (in the words of one of the thousands of commentators to this paper's website) "treat you, make decisions, resuscitate, thrombolyse, dialyse and often operate on you". Some of the comments on the Telegraph website are bracing and cheering: "Please come to Canada! We'd love you all!"; "Ontario needs as many doctors as it can get."; "We're desperate for doctors in Western Australia."; "Queensland is crying out for doctors." Yes - well. Doctors cost £250,000 each to train - training that you and I have been paying for this past decade. Jolly nice to know they're so valued in Australasia, Canada and America, but -give me strength.
Finally, if you'll forgive a Kinnockian flourish, I warn you not to fall ill in the period between now and April 13, when the interviews will be going on. Or May, when the "second round" of applicants is hoping against dread hope. Or August, when the successful applicants will turn up at their "chosen" hospitals to start the next phase of their career. Some of them will be doctors who'd hoped to specialise in radiology, but have had to settle for something else instead. Poor them; poor you.
Still, as Lord Hunt says, the system will still be working well "in large parts of the country". He must have meant Western Australia.
