Email to members and letter to Secretary of State

From Mmc

"Dear Colleague,

I am acutely aware that the completion of the first round interviews of junior doctor posts now underway (so called round 1b) is causing not only a huge and unwelcome workload for physicians but also concerns as to whether they are doing the right thing in cooperating with what is widely agreed to be a flawed MTAS process. College Council has just met again and confirmed that the basis on which we are now continuing to encourage consultant participation is first and foremost for patients – to ensure that doctors will be in post on 1st August. Secondly, we believe that much of the anguish of our trainees and hard work of our consultants should not be wasted and that the compromise arrangements being worked out by the Review Group have some merit as an interim measure. Finally, we believe this gives us the best chance of true engagement for a radical overhaul not just of the appointments system but also of the training programmes for next year and beyond.

But this cooperation has to be subject to an agreement that our professional advice will not be ignored or sidelined in the future. I attach below an open letter that I have sent to the Secretary of State for Health, Patricia Hewitt in which this is made quite plain. It would be extremely helpful if you would share this letter with your trainees.

I hope you will support this approach.

Kind regards,

Yours sincerely

Professor Ian Gilmore MD PRCP President Royal College of Physicians

The Rt Hon Patricia Hewitt MP
Secretary of State for Health
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NS

17th May 2007

Dear Secretary of State,

I am writing to all consultant physicians in the UK today, encouraging them to continue interviewing our young doctors for posts to start in August. Throughout recent weeks we have supported, and continue to support, the review group under the chairmanship of Professor Neil Douglas. However, Council has asked me to set down the reasons for this and the implications for further engagement with the Department of Health on training and other issues.

The basis on which we are now continuing to encourage consultant participation is first and foremost for patients – to ensure that doctors will be in post on 1st August. Secondly, we believe that much of the anguish of our trainees and hard work of our consultants should not be wasted and that the compromise arrangements being worked out by the Review Group are the best interim measure. Finally, we believe this gives us the best chance of true engagement for a radical overhaul not just of the appointments system but also of the training programmes for next year. MMC, in the rush to deliver it, became gradually but irretrievably inflexible and quite unsuitable for the aims and aspirations of our highly trained medical graduate workforce. We do not believe that every doctor can succeed in pursuing the speciality of his or her choice, but shoe-horning individuals into one career track on one day in their life will not produce a satisfied and motivated medical workforce for the patients of the future.

As you are aware, the failure of MTAS, the application system into the new ‘MMC’ training programmes has been one of the most negative and destructive events in medical training in recent years and has damaged confidence in those bodies involved. Among those are the Royal Colleges, whose statutory responsibility for training doctors was taken away and transferred to PMETB but who are still perceived by many junior and senior doctors to have failed to intervene – indeed been complicit – in the failures of the last few months. We have been deeply damaged by insistence that “The Royal Colleges’ agreed to these changes”. As responsible professionals we have worked with the Department of Health in its wish to train a medical workforce in a way it perceives as appropriate for the NHS for which it has responsibility. We have however repeatedly expressed concerns and caveats that have gone largely unheeded. There has been consultation but little true listening

And so RCP cooperation in encouraging consultant physicians to complete the arduous task of interviewing for a system in which many now have doubtful faith is conditional – conditional on full and meaningful input into what follows. We welcome and support the independent review being undertaken under the chairmanship of Sir John Tooke, but must be at the centre of its implementation. Our concerns must be heeded and not dismissed as professional self-interest. We must be recognised by the Department of Health as an important part of the solution – not of the problem. Colleges must be allowed to use their acknowledged expertise in the detailed setting and delivery of standards of training without undue interference from the statutory regulator that has been put in place.

We believe that the recent sad episode now gives a genuine opportunity to revisit not just the selection process but also the training programmes themselves. But the whole profession must work with the Department of Health to make these programmes fit for purpose – and this will happen only with full and meaningful involvement of the Royal College of Physicians. As we work to improve standards of care, we depend critically on the support of physicians throughout the country who are working hard for their patients, and we cannot risk this trust between physician and College being damaged again by apparent complicity about healthcare changes over which we have had little influence. There is now an opportunity for the Department to demonstrate the benefits of real clinical engagement with physicians to improve the quality and delivery of care for patients.

I look forward to your agreement that we can move on from this difficult time, in a genuine partnership with the Department of Health, to establish a training scheme for our young doctors of which we can all be proud.

Yours sincerely,

Professor Ian Gilmore MD, PRCP President Royal College of Physicians"