Nigel Hawkes: Commentary
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Is this a resignation issue? It is getting perilously close.
When ministers are forced to backtrack not once but twice or three times, finally conceding the very points made from the start by their critics, their position is fatally weakened. Had Lord Warner, the minister who could most plausibly be blamed for the junior doctor appointment system, not chosen to retire at the end of last year, he would be on his way any day now. His absence leaves Patricia Hewitt, the Health Secretary, rather exposed.
She may not be directly culpable for the failings of the application system, but she is culpable for the political error of not seeing early enough that this was an issue that could not be finessed. At every stage she has been a yard off the pace. Today’s court action by RemedyUK is the key. If the court rules that doctors’ reasonable expectations of fairness were not met, then she will face another retreat. If, on the other hand, it finds for her, she will be home clear – winged but still defiantly flapping.
Scotland, Northern Ireland and Wales can offer doctors four interviews, but apparently England cannot. After ten years’ training, their futures are to hang on a banal application form, dodgy computer software and a single interview. Small wonder they are angry.
And what will happen if, through the misguided workings of the application system, thousands of overseas doctors are appointed to posts while thousands of expensively trained British doctors are not? The political consequences would be huge.
Law firms would never tolerate their trainees being selected in such a way: nor would newspapers, or any properly run business. Will hospitals really put up with the wrong doctors being imposed on them for the next five years?
It is symptomatic of the arrogance of NHS management that such a “Year Zero” approach was ever adopted. In the attempt to undermine the old boy network that, it claims, characterised the old interview system, the department came up with something infinitely more sinister. And where were the defenders of medical professionalism? The royal colleges were silent, the Postgraduate Medical Education Training Board denied responsibility, and the British Medical Association equivocated. Not my problem, guv.
It is no surprise that so many doctors despair of their profession when there are so few prepared to defend it.
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