Hewitt is not what the doctors ordered
From Mmc
Hewitt is not what the doctors ordered
By Vicki Woods Last Updated: 12:01am BST 05/05/2007
I knew the Secretary of State for Health would be on Question Time on Thursday night, so I was braced (as was she) for the inevitable question about the MMC/MTAS scandal. It is a scandal, and it's ongoing and I doubt that Patricia Hewitt is the woman to fix it.
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I think everyone knows by now, even those without a weeping junior doctor in the family, that MMC stands for Modernising Medical Careers and MTAS stands for Medical Training Application Service online. But I prefer the junior doctors' own monickers: "Murdering My Career" via "Medical Transportation to Australia."
The much-trumpeted, whizzy new online application system that was supposed to pop 30,000 junior doctors into place on the next rung of their career ladder turned out to be a badly planned, badly executed, computer quiz. It managed to ensure (for one example) that four highly trained junior doctors who ran the intensive-care department at St Thomas' Hospital in London were left without a single interview between them for a training place anywhere in Britain.
The question for Hewitt was: "Like the Prime Minister, is it now time for the health secretary to resign?" William Hague answered first and said, with plodding gallantry, that he wished her well. Tim Collins, formerly Colonel Collins of the Heroic Eve-of-Battle Speech, said that unfortunately the NHS didn't work any more and should be changed or reformed or broken up or something.
The Secretary of State said that if a minister was responsible for a "major policy blunder", then of course they should go, and smiled kindly through the rowdy yells of "Go, go, go". She obviously had a form of words ready that would prove she was not herself such a minister, nor was she herself responsible for a major policy blunder. I listened hard for what she could possibly say: if it wasn't a policy blunder, what was it? And if she wasn't the responsible minister, who was?
Well, she wriggled out in the way that government always wriggles out: by blaming the professionals. "Everyone in the medical profession" had agreed, "after years of discussion", that a major reform of the training system was needed. "Not just for junior doctors themselves, the workhorses of the NHS, working quite outrageously long hours, but also for the sake of patients, so that more senior, better-trained doctors would do more of their care and we would go on raising the safety standards of the NHS."
She named the begetters of MMC as "the Royal Colleges, the BMA, and the junior doctors themselves". Since junior doctors themselves were never consulted at any point, all the junior doctors in the audience screamed and roared "No, no, NO!"
She proceeded blithely: "The IT system has simply not worked," thus neatly throwing the blame on to nameless IT providers, rather than her department. And then she rather brilliantly threw the ball right back at the people she said were responsible for the whole MMC/MTAS debacle in the first place. The professionals.
"When it became apparent that the IT system had not worked," she said, "and I had the medical Royal Colleges and the BMA come and say Look, we've got to change this and we've got to sort it out - WE'VE got to change this. And I said, Absolutely right!" So it's the Royal Colleges and the BMA who are pursuing the NHS medical training reform policy for her! It's the BMA and the Royal Colleges who are now, in Patsy's view, responsible for the placement of all our medicins sans occupations into training jobs. I think the truth is almost the opposite of what she says.
New Labour dislikes the professional classes, especially grandee professionals. The entire thrust of Patricia Hewitt's personnel reforms since 2000 has been skewed towards wresting control of the medical profession OUT of the hands of the hospital consultants and the Royal Colleges.
I think the whole idea of Modernising Medical Careers in the first place was to slot a few more people called Dave and Pete and Mandy into the sort of glittering top-notch jobs that were previously filled by people called Charles and Jeremy and Harry (and not Mandy; not even Amanda).
New Labour dislikes the professional classes almost as much as Old Labour did. Always ready to knock judges for cock-ups in sentencing policy; always ready to throw young princes to the desert breeze when Basra gets sticky ("it's a matter for the military"). But at least you knew where you were with Old Labour.
I laughed out loud when I read Alice Thompson on Thursday about the government's dislike of country matters. An MP told her that farmers going bust wholesale was "Payback for what Margaret Thatcher did to the miners". I heard the same thing during the 700 hours of wasted time on the foxhunting Bill. John Mann, the MP for Bassetlaw (Lab), was on the Week in Westminster last week saying trenchantly that there used to be "closed shops in all industries in the past".
He could well understand why doctors "wanted to keep their very rarified closed shop going" and I think "rarified" in this context definitely means "peopled by chaps called Jeremy". Professionals who work in public services are OK in NewLab's eyes so long as they're hard-working family types: hard-working teachers, hard-working nurses are always being praised up by secretaries of state. Hard-working professors at Oxbridge colleges are more problematical (they should be increasing state-school access).
Anyway, you should remember my advice about not getting ill in August. Patsy will no doubt be gone, but what she has wrought (with the help of the professionals) will remain. August is the month for the MMC/MTAS changeover of all junior doctors everywhere in the country. Also the month when consultants go on their summer holidays. Also the month when undertakers are traditionally rushed off their feet. "After, Christmas and New Year, it's always the busiest time of the year," says my local undertaker.
"Funerals always stacked back to back in August." You should heed him; he's a professional.
