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Sir, The junior doctors saga has been in and out of the news for so long that neutral observers could be forgiven for believing the official reassurances that all, bar a few computer glitches, is now resolved. This, of course, is the view that the Secretary of State would like to be believed. More surprising has been the mood of resignation among the institutions charged with defending the interests of patients and training of doctors.
The reality, however, is that more than three months after submitting their compulsorily inane and now discredited online applications, not a single doctor has yet been appointed. Yet hospitals across the land have about 30,000 vacancies to fill by August 1 using a computerised selection system that has so far failed every task. The Secretary of State has apologised for the distress to doctors, but not yet to patients when 10,000 doctors disappear in August. She has said she would take personal responsibility only for a policy blunder. What counts as blunder if not her department’s investment in another high-profile IT disaster? If not sanctioning a change to medical careers without adequate piloting, validation and consultation? As for the Chief Medical Officer (CMO), not a word of apology, advice or leadership has been heard. Yet he continues to pull the strings of those trying to save his creation.
An independent review body was established by the Department of Health (DoH) to resolve the chaos of February, when a third of applications were randomly rejected. Instead of rapidly suspending an appointments system whose shortlisting procedure had failed, the review has wasted months while time runs out on the junior doctors’ current contracts. The review has become top-heavy with DoH apparatchiks. On the same day as we called for a democratic ballot (letter, April 4), the CMO took his seat at the table. Within hours came the decree that doctors who have trained for ten years would be limited (in England) to just one interview – with odds in many specialties of 10 to 1 against success. Doctors are used to stiff competition. But a “one strike and you’re out” opportunity to use ten years of training would scarcely be fair competition, even if interviews were ideal. Yet these too are a fiasco, some committees having allowed use of CVs, some banning them altogether. Meanwhile, the latest MTAS computer shambles has left many committees guessing whom, when and where they should meet, with no previous paperwork available.
We have put forward several alternatives to the single interview. These were accepted as feasible in a private meeting we had with DoH members of the review body, and are similar to the unilateral rescue plan of the College of Surgeons. We have balloted 3,500 doctors and will publish this week results showing 75 per cent rejection of the single interview, 85 per cent support for a consultant boycott of these and a postponement of the unnecessary August 1 meltdown. Ninety per cent expressed no confidence in the Secretary of State and CMO. The will of the majority should be heard.
MORRIS BROWN, Professor of Clinical Pharmacology, University of Cambridge
NICK BOON, President-Elect, British Cardiovascular Society
NICK BROOKS, President, British Cardiovascular Society
EDWIN CHILVERS, Professor of Respiratory Medicine, University of Cambridge
ASHLEY GROSSMAN, Professor of Endocrinology, Queen Mary, University of London
ALISTAIR HALL, Professor of Clinical Cardiology, University of Leeds
GEORGE HART, Professor of Medicine, University of Liverpool
TONY HEAGERTY, Professor of Medicine, University of Manchester
HUMPHREY HODGSON, Vice-Dean, Royal Free and University College School of Medicine
RICHARD HUGHES, Professor of Neurology, Kings College London
KAY-TEE KHAW, Professor of Clinical Gerontology, University of Cambridge
JOHN LAZARUS, Professor of Clinical Endocrinology, University of Cardiff
JOHN MONSON, Professor of Surgery, University of Hull
STEPHEN O'RAHILLY, Professor of Clinical Biochemistry, University of Cambridge
NEIL SCOLDING, Professor of Neurology, University of Bristol
ROY TAYLOR, Professsor of Medicine & Metabolism, University of Newcastle
HUGH WATKINS, Professor of Cardiology, University of Oxford
NICK WRIGHT, Warden, Queen Mary College, London
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