Doctors' training debacle and the destruction of a profession ( letter)
From Mmc
16 March 07
Doctors' training debacle and the destruction of a profession
Sir - It is important that everyone realise that the failure of the new absurd and inappropriate method for appointing junior doctors to suitable training posts is not an isolated or unpredicted event, but the result of unrelenting government intervention designed to destroy the independence of the medical profession.
The medical profession has been independent and self-regulating since the 15th century. In modern times, it continued to supervise the quality of postgraduate training, approve training programmes and examine the suitability of trainees for medical practice, while the General Medical Council undertook the task of self-regulation.
Independence and self-regulation have long been an anathema to politicians who believe that they should control everything. Serious attempts to destroy the medical profession's independence began in the 1990s, when many hospital trusts sought to abolish the statutory requirement that all NHS consultants should have a college certificate of completion of training and be on the Specialist Register.
This was successfully resisted, but recently the Government established a quango - the Post-Graduate Medical Training Board - to replace the colleges' specialist training boards. It gave this board the power to overrule college examiners and recommend that candidates deemed unsuitable by the colleges be placed on the Specialist Register.
The Post-Graduate Medical Training Board is the source of the present debacle. It has changed the college training programmes to meet NHS needs (replacing quality with quantity). It has ignored the destructive effect of the EU Working Time Directive on the quality of training, and it has produced a common training schedule inappropriate for many specialities. It appointed a group of deans and educationists to devise the Medical Training Application Service.
The selection system invented by this group has failed. The previous selection system that produced top-class NHS consultants has been destroyed.
I could give many other examples of interference with standards and the undermining of professional independence by the Government.
Some groups of consultants and (I am pleased to note) the Royal College of Surgeons and the BMA have at last had the guts to rebel. This rebellion must continue until the politicians' many attempts to destroy the medical profession's independence stop.
Doctors know best how to train doctors, assess their competence and treat their patients. If the medical profession fails to regain its independence, doctors will become a poorly trained, inadequately tested group of government-controlled lackeys. And who will suffer? The patients.
Professor Sir Norman Browse, Former Chairman, Joint Consultants Committee, Former President, Royal College of Surgeons of England, Alderney, Channel Islands
