Dr Andrew Murrison
From Mmc
20 April 07
Dr. Murrison: To ask the Secretary of State for Health how much has been paid to the Work Psychology Partnership in connection with the medical training application service. [128713]
Ms Rosie Winterton: There is a contract in place between the Department and Work Psychology Partnership for the sum of £92,950 excluding VAT. Work Psychology Partnership are contracted to provide advice and tools to support the recruitment and selection into specialty training programmes, for which the Medical Training Application Service facilitates applications.
Dr. Murrison: To ask the Secretary of State for Health how much has been spent on the Medical Training Application Service (MTAS); and how much has been allocated to MTAS for 2007-08. [128715]
Ms Rosie Winterton: The cost of the Medical Training Application Service (including set up costs) is £1.9 million in 2006-07. The budgets for 2007-08 have not yet been agreed.
08 March 07
Dr. Andrew Murrison (Westbury) (Con): On a point of order, Mr. Speaker. Yesterday the Secretary of State for Health announced that there would be a review of the unfolding disaster that is “Modernising Medical Careers”. What indication have you had that the Secretary of State will come to the House to explain her plans, and to tell us why she has supervised so much of the chaos that has been inflicted on junior doctors and our national health service?
Mr. Speaker: I think that the Secretary of State for Health will somehow or other hear of the hon. Gentleman's concern.
16 March 07
Professor Neil Douglas
President
Royal College of Physicians of Edinburgh
Dear Professor Douglas,
Modernising Medical Careers
We welcome the government’s forced decision to conduct a review of Modernising Medical Careers (MMC) and the online application system Medical Training Application Service (MTAS). It has been prompted by pressure from the Opposition and by the refusal of consultants across the country to engage with a scheme that is so obviously flawed.
The Shadow Secretary of State for Health, Andrew Lansley CBE MP, raised our concerns about MMC in December 2005. We note that the BMA petitioned ministers to delay MTAS last summer as it became clear that the scheme was unworkable. The Opposition has consistently pressed the government as its plans evolved and consider therefore that we are well placed to contribute to the post mortem that you have been asked to lead.
The government’s intention is to move from a consultant-led to a consultant-run service. We understand that this has the broad approval of the medical profession. To achieve this MMC promotes competency-based training for juniors that will reach consultant status sooner. It is hoped that it will eschew wastefulness in the course of young doctors’ training. However, we fear that narrowly specialist consultants will emerge from the process with less practical experience and confidence than their predecessors.
We understand that more than 30,000 doctors are applying for 22,000 training posts. There is some confusion over this as the latest Department of Health figures cite 18,000 training posts heightening our concern for the basis on which the government has reached its recruitment target.
We suspect that the government has established too few training posts and would ask your review group to determine whether this is the case and what scope exists to re-designate non-career grade positions as training posts to meet the commitment given in December by the then minister Lord Warner that junior doctors should be confident of a training job. You will have noted that the last exchange on MMC between Andrew Lansley and the minister Andy Burnham in the Commons on 13 March failed to extract the promise of the extra posts implied in Lord Warner’s undertaking.
Ministers need to be explicit about the future they envisage for the several thousand doctors that will not, as matters stand, end up with a training job. They need to say why, in the consultant-run service they are committed to, so many young UK graduates should, contrary to their aspirations, be destined for non-career grades. They also need to say what assessment they have made of the proportion of unsuccessful applicants that will leave the UK or leave medicine. There has to be a mechanism for providing doctors that have applied unsuccessfully through MTAS with constructive feedback.
MTAS is the latest in a string of centrally driven IT disasters to bedevil the NHS. Doctors have written to us in large numbers to report that it has crashed frequently, sent out the wrong appointments and appointments that clash, been accessible to non-authorised personnel and been capable of having personal data amended by unauthorised third parties. MTAS invites plagiarism and creative writing in the composition of the on-line vignettes that it depends on. It has evidently involved a massive investment in time and effort by juniors and consultant staff. Inevitably, there have been opportunity costs for NHS service delivery.
We trust that your review will investigate the personal testimony that is readily available from practitioners and formalise it in a way that can be used constructively in revising MTAS. You will have no shortage of feedback from doctors but we stand ready to provide you with comment that we have received in the form of hundreds of e.mails and letters if it would be helpful and having gained the permission of those that have contacted to us.
MTAS has meant that the safety-critical attributes of language proficiency and communication skills cannot be reliably tested until the interview stage. It has improved the chances of EEA practitioners succeeding at the expense of UK trained doctors.
The NHS has historically relied on doctors from outside the EEA. Many are in the UK on the Highly Skilled Migrant Programme (HSMP) and came to this country in the expectation of a string of training positions. However, overseas doctors cannot be employed if there is an EEA graduate that meets the basic criteria for the job. Clearly our Treaty obligations are to the disadvantage of doctors that have served the NHS well over many years. Furthermore, it is difficult to see how the arrangements are to the benefit of patients.
We understand that a substantial number of overseas doctors have been admitted to the first round but that guidance for the second round is still awaited. We invite you to obtain clarification of the status of overseas doctors as soon as possible and to ask why they have been subjected to so much avoidable stress and uncertainty.
MTAS is untried and unproven. Its scoring of applicants in the pursuit of ‘fairness’ is completely hopeless with only 25% of marks available for actual clinical or academic achievement. The balance depends on questions that are, in the view of many of the doctors that have contacted us, variously platitudinous, pious or woolly.
It is hard to see how MTAS can discriminate between good and bad candidates, the criteria that will be of interest to our constituents. Your review should determine the extent to which MTAS has marginalised suitable candidates at the expense of the unsuitable.
MTAS was clearly unfit for the purpose of underpinning MMC. However, the process currently underway could not be re-run without disadvantaging doctors that have already been through the first round. We recommend a root and branch review of MTAS before it is used again. If this cannot be achieved, the default position is conventional shortlisting with CVs and references followed by interview.
If ministers decide to persist with a re-vamped version of MTAS we would strongly recommend that it is piloted.
We would ask the review group to call on ministers to account for the wastefulness that their failed experiment has involved at a time of substantial financial pressure on frontline NHS services.
We note that the Multi Professional Education and Training Levy (MPET) has been raided to address NHS deficits. This crisis management seems to us to be short-sighted and we are inclined to revert to ring-fencing for items like training that need the security of a long term, reliable revenue stream. We invite you to reflect on this and comment in your report.
Yours sincerely,
Dr Andrew Murrison MP
