Training overhaul blamed for junior doctors fiasco
From Mmc
Training overhaul blamed for junior doctors fiasco
Sara Gaines and agencies Monday October 8, 2007
Changes to junior doctors' training were rushed and officials failed to heed warnings of impending problems, a report (pdf) into the fiasco concluded today.
Thousands of junior doctors found themselves unable to continue their training as problems with the new Modernising Medical Careers (MMC) system became apparent earlier this year.
An independent inquiry today blamed weak leadership and policy development at the Department of Health, as well as doctors' leaders and medical royal colleges.
Professor Sir John Tooke, who headed the inquiry, pointed to a string of failures in implementing MMC, which is designed to speed up the time it takes to become a consultant.
Under the new system, junior doctors had to apply online for specialist posts through the medical training application service (Mtas). Appointments to specialist posts are critical for young doctors because they can lead to consultant posts.
Risks over Mtas were recognised as early as 2005, the inquiry found, but there were repeated assurances that the system was on schedule and deliverable. In the event, the computer system proved badly flawed and repeatedly broke down.
Another problem arose as 32,649 applicants competed for 23,247 posts. It emerged that 10,000 doctors had come from abroad to take up medical posts, which had not been allowed for in NHS plans.
Some of the best candidates were not offered any interviews and trainees complained that the system did not allow them to set out their skills and experience.
Mtas was later abandoned by ministers amid calls for former health secretary Patricia Hewitt to resign.
The inquiry report recommends major changes to MMC, to better encourage or reward "striving for excellence" and offer trainees flexibility in their careers. If adopted, they would give doctors longer to decide which specialism to follow and would involve face-to-face interviews rather than just relying on a computer system to pick the best candidates.
Sir John said the "open door policy" of admitting doctors from other countries needed to be resolved urgently by the government.
"The highly skilled migrant programme added 10,000 to the number of applicants we received in last round. We are simply saying this has to be reconciled with the issue of self-sufficiency," he said.
The British Medical Association (BMA) welcomed the draft report. It plans to survey its members on the recommendations and hold a conference on the future of medical training.
"Any future system has to be properly piloted. It must be driven by input from the medical profession, and the interests of patients, rather than a short-term political agenda. Better workforce planning will be crucial," said Ram Moorthy, chairman of the BMA junior doctors committee.
Dr Hamish Meldrum, head of the BMA, also called for greater clarity on doctors' immigration status.
"The immigration status of overseas doctors during the recruitment process this year was extremely vague, creating the possibility of discrimination," he said.
"Overseas medical students have come to the UK on the understanding that they'd be able to train and work in the NHS. They've often made personal and financial sacrifices to come here. It would be hugely unfair to deny them opportunities to work in the NHS."
