25 May Email to members re withdraing from review
From Mmc
To all Members and Fellows of The Royal College of Surgeons of England
Dear Colleague
I am writing to let you see the text of a letter that I have sent to Professor Neil Douglas this afternoon formally withdrawing from the Review Group. I very much regret that, despite all of our best efforts, I have no alternative but to pursue this course of action. This has been taken because of the lack of progress in establishing sufficient numbers of extra training posts for the transitional period.
Professor Neil Douglas
President of the Royal College of Physicians of Edinburgh
9 Queen Street
Edinburgh EH2 1JQ
Friday, 25 May 2007
Dear Neil
Review of MTAS and MMC
I am writing with regret to inform you that I am withdrawing from the current and ongoing discussions about the selection and appointment arrangements for junior doctors’ training.
Over my period of two years as President of this College, there have been two particular matters that have been of central concern. First, I have repeatedly, and at length, emphasised to Ministers and policy officials at the Department of Health (DH) the essential need to make adequate transitional arrangements for a large number of well- trained, experienced and committed senior house officers who are in danger of being lost to the NHS. Their career prospects and their opportunity to contribute to the care of the next generation of surgical patients are being severely compromised.
At my first scheduled meeting with Patricia Hewitt, Secretary of State for Health, on 11 October 2005, I made her aware of the difficulties that would arise in 2007 with unprecedented competition for a limited number of national training numbers between the first doctors to complete foundation training and 3,500 or more senior house officers with some years of surgical experience. I put to her the possible solution of expanding progressively national training numbers for a fixed period of time. This would safeguard the future for this group of trainees and enable pump priming of consultant expansion over coming years to underpin DH’s plans for service delivery. Patricia Hewitt acknowledged that there was a major problem and stated she had no wish to see trained doctors out of work or without a reasonable opportunity of progressing in their chosen specialty. She was happy to seek a solution to this impending problem.
At the time of writing, almost two years after first raising my concerns, there is still no recognition whatsoever by DH of the scale of this problem or its profound implications, far less the prospect of an acceptable solution in terms of a temporary expansion of national training numbers. Only a few days ago, DH appeared to indicate that there would be a significant expansion of surgical training posts at ST3 level with an assurance from Postgraduate Deans that such training would meet the required standards. However, following yesterday’s meeting of the Review Group, DH has again failed to confirm a specific commitment to surgery. The announcement of 200 additional training posts, unspecified in terms of medical specialty or location, can at best be described as obfuscation. There has been in my view a scandalous failure of duty to address this issue. We have all, as taxpayers, rightly invested in training this talented generation of young surgeons. It is my duty to ensure that this is not squandered.
My second concern relates to the arrangements for selection of junior doctors into run- through surgical training programmes. Surgery has unique requirements in terms of recruitment - the criteria for selection include diagnostic skills, clinical judgement and manual dexterity. It is neither practical, nor indeed safe, to select junior doctors with a view to a career in surgery without the opportunity of assessing whether they have the full mix of professional skills required. The view within surgery, amongst consultants and trainees and across all specialties, is that selection must take place at ST3 level when trainees have had two years to acquire basic skills under supervision in the operating theatre. This is essential to ensure that the next generation of specialist trainees will be able to provide a safe service for patients. I am dismayed that DH has sought clinical engagement on this issue of selection and again failed to accept unequivocal professional advice.
It is with the greatest reluctance, therefore, that I am dissociating myself and my College from any further involvement in the Review Group that you have been chairing.
Yours sincerely
Mr Bernard Ribeiro CBE
President
The Royal College of Surgeons of England
