03 April 07 RCS statement

From Mmc

I have attempted over recent weeks to keep you fully informed and up to date as discussions have proceeded about the debacle caused by the MTAS arrangements and the steps that have been taken by the review group with a view to resolving this.

This is a very complex issue. It has been clear from the outset that the arrangements have broadly served general practice well while the position with hospital medicine has been much less satisfactory. Across various specialties and in some deaneries, there has been recognition that good candidates have been selected for, and performed well in, interviews. Elsewhere, however, it has been clear that well qualified and experienced candidates have not been identified. The prevailing view in surgery is that the arrangements are seriously flawed. Our survey of Fellows and Members, with about 80% of respondents considering MTAS so fundamentally flawed that it is incapable of continued operation and should be abandoned for 2007 with a return to the deanery appointment processes that were in place last year, was a significant indicator. The recent ASIT meeting in Belfast, where I could gauge the views of a significant number of trainees, reconfirmed this widespread dissatisfaction. There was some feeling that an extension of choice to applicants, to be interviewed for two or more of their MTAS selections, would improve matters but there remain grave logistical concerns that this is impractical. The Scottish Executive announced on 30 March 2007 that “eligible junior doctors applying for specialty training jobs will be offered interviews for all posts applied to in Scotland”. It has been particularly unhelpful that a lack of coherent and consistent thinking amongst ministers and officials in Edinburgh, Cardiff and London has led to an utterly inequitable situation where trainees in parts of the United Kingdom appear to have been offered multiple interviews against their preferred choices while others will not, or cannot, be treated on a similar basis.

There will be a further meeting of the review group tomorrow and I will attend once more to outline my grave concerns about the general situation and these recent developments and to assess whether there is any prospect of finding a satisfactory solution. I have to say that I am not optimistic and I assure you that I will dissociate myself from these negotiations if I see no recognition of the gravity of the situation generally, and particularly for surgery. There must be adequate transitional arrangements put in place to support those able trainees who fail to be appointed at this stage. I will not see a generation of highly qualified, experienced and committed surgical trainees exposed to the vagaries of an untested and clearly flawed system, effectively participating in a professional lottery.

I will write to all of you again following this meeting tomorrow. Having acted until now in what I believe to have been the best interests of everyone, given the range of opinions I have heard and the practical constraints of which I have been conscious, I am not prepared to leave you, and those who share your concerns, in further uncertainty. If there is no significant and expeditious move tomorrow towards a satisfactory solution, I and my colleagues on Council will seek, independently if necessary, a resolution of this situation that meets now your reasonable expectations and ensures for the longer term our patients’ absolute right to the safest and highest-quality care.

Bernard Ribeiro CBE