Nigel Hawkes, Health Editor
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Leading doctors have called for the abandonment of a new system for selecting candidates for higher training and asked consultants to boycott the process. In a letter to The Times, 23 of the top specialists in the country say the system is in chaos and that it is folly for senior doctors to continue struggling to keep it afloat.
They say that the review launched by the Department of Health into the Medical Training and Application Service (MTAS) in an attempt to rescue it is legally questionable and has made things worse by restricting young doctors to just a single interview.
“This is the week for grass-roots democracy to act,” say the 23, led by Morris Brown, Professor of Clinical Pharmacology at Cambridge.
“MTAS cannot progress without participation by individual consultants in interviews.
“We hope they will say no, that individual trusts will ballot their consultants, and that medical directors and chief executives, putting patient care first, will say no.”
MTAS has been in meltdown for the past month as a result of failures in the computer-based system for selecting junior doctors for higher training. Last Friday the architect of the new training system, Professor Alan Crockard, resigned, blaming others for the failures.
Doctors complain that the computer system that produces shortlists for posts has failed to reflect the candidates’ ability or, in some cases, to produce shortlists at all. Candidates of high academic attainment and proven record have not been offered a single interview.
The appointments are critically important to young doctors, mostly in their mid-twenties and with six to eight years of medical training. They are competing for training posts that will lead on to qualification for consultant posts.
Today’s letter to The Times urges an immediate return to the old regionally based appointments system, led by the same expert doctors who will be responsible for the specialist training.
“This solution is still feasible,” it says. “It will minimise the adverse impact of the hugely expensive and ill-consid-ered reorganisation on patient care, while providing much-needed breathing space for careful planning and validation of new training and appointment processes.”
Among the signatories of the letter are the professors of medicine at Liverpool and Man-chester universities (George Hart and Tony Heagerty), the Vice-Dean at the Royal Free and University Hospital in London, (Humphrey Hodgson), Professor Stephen O’Rahilly FRS from Cambridge, and Nick Wright, Warden of Queen Mary College in London.
Patricia Hewitt, the Health Secretary, was forced to apologise yesterday to doctors affected by the failure of MTAS. She conceded that implementa-tion was “nowhere near what it should have been”. She told Radio 4’s Today programme: “That is exactly why junior doctors have been caused this absolutely needless anxiety and distress and I am very sorry indeed that that has happened. We are now sorting it out.” But Ms Hewitt insisted that the new training scheme, called Modernising Medical Careers (MMC), was sound.
However, the signatories of the letter say that MMC imposes premature choices and expects doctors to hand over five years of their lives “without being told the detailed specification or location of the training or mentorship they will receive”. Ms Hewitt admitted only that the shortlisting process did not work.
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This debacle is not surprising, given the incompetence of Hewitt and her lapdogs. She should resign.
Dr Timothy Chan, Swansea, UK
I honestly do not think that the public understand junior doctors disiullusionment.
All they ask for is this: to be free from unneeded, unwanted and miscalculated political schemes that make headlines but distort patient care e.g National Project for IT, Choose and Book.....and now MMC/ MTAS.
It's a shame that doctors are too busy explaining choices of chemotherapy, talking to bereaved relatives and recovering from making stressful decsions to resist this nonsense.
When you daily deal with life and death it takes a lot to shift you. MMC/MTAS has single-handedly destroyed all goodwill in the NHS and it's future. If you want a doctor, he/ she'll probably be the one in tears, wondering why they bother when they get treated like this.
Paul , London, UK
If I had been in another profession, my union would have been up in arms about the whole MTAS debacle. There may even have been strikes. My friends and I (all doctors) discussed the issue this evening. We came to the conclusion that consultants within the NHS could have voiced there concerns over the application process sooner. It was only after their input was required for MTAS, i.e. their physical involvement, that the consultants started to realise what a shambles the process is.
Oh and one last thing... Ms Hewitt really should have the curtesey to resign.
Honey, Birmingham, England
Not only is MTAS a complete disaster, just wait until August 1st 2007 when ALL these new trainee specialists take up their new jobs at once. They wont be able to provide patients with a service because they will be going through mandatory induction and training programmes.
All I can suggest is don't be ill and need hospital treatment at the beginning of August 2007 because the hospitals will be in a state of chaos!
Philip Whitehurst, Wolverhampton, UK
My wife works in the local Hospital as an SHO. The teams are constantly understaffed and a day when she ends on time is a rare event. A few weekends back she worked from 9 AM - 11.30 / 12.00 on the Friday, Saturday and Sunday and then back to work for a full week Monday to Friday. You would make mistakes on a checkout doing those shifts - but this is with peoples lives!
With this background, the Health Secretary launch MMC. With no pilot and no support from the grass roots, they went ahead with a scheme that local Drs said was madness. Moral in the NHS was already at an all time low - now the attitude is what is the point. Australia has suddenly become a potential destination for many of our best Dr's.
The new specialists will be trained up in less time than consultants and will in effect replace the grade - they will be paid less and will be less experienced.
You could not have found a better way to destroy what morale was left among junior Dr's in the NHS.
Mike , Southampton, Hampshire
Not only have doctors been decieved about the fairness of the recruitment process but also about the number of jobs available. The numbers published by MTAS was actually 32000 doctors applying for 18500 jobs, of which some do not even allow progression to become a consultant. And who will suffer? It will not just be the doctors, it will be the patients.
Francesca Rannard, London, UK
I am pleased that Ms Hewitt has apologised, belatedly admitting the fiasco that is of her making in conjunction with cronies in the medical profession (and I have yet to hear apologies from the denizens of the Royal Colleges who went along with this mad scheme).
This episode tells us much about the way that politicians work. I repeatedly heard Patsy's Health Ministers telling us that the system was fine, when it was clear to all of us in the profession that this was not true. Their first response was reflex denial and lies. Would a resignation or two not be appropriate?
There is a danger that the focus now will be all about the process of selection, whereas most of my colleagues believe firmly that the whole premise of MMC is flawed.
Dr David Niblett, Bedford, England
Now Ms. Hewitt put that in your pipe and smoke it!
Alan Logue, Portrush, Northern Ireland
Patricia Hewitt has consistently hidden the real objective of MMC, which is to reduce doctors in training by 8000 by August. This is due to Gordon Brown's "streamlining" of hospitals, which means closing many of them. That is why they think we need fewer doctors. They are both guilty of deception. We must not vote for polititians who deceive us and certainly not for those who make life worse for us.
Alan Clarke, Liss, UK
One of my american doctor friends tells me the US is flooded with UK applicants unwilling to wait for promotion taking up residencies over there.
What a waste paying to train doctors over here and then leaving them no promotion path.
Gareth Webber, Swanley, Kent, UK
Whilst an apology is most welcome from the health secretary, the uncertainty goes on. Whilst we are promised an interview of our 1st choice specialty almost 2 weeks ago now, we are yet to be given any information about when we can submit our first choice or what time scale we can expect to be interviewed. I love my job, i love going to work each day and meeting the challenges that each day brings but this whole proceess is driven me to tears. It is heartbreaking....
Catherine Roughley, farnborough, hampshire