Health Secretary Jeremy Hunt is to announce an expansion in training places from 6,000 to 7,500 a year.
He believes increasing the number of home-grown doctors will be essential given the ageing population……..
…There is widespread agreement that the NHS is facing a crisis when it comes to doctor shortages. It is one of the underlying reasons why the dispute between the government and junior doctors has been so bitter.
So news that the number of training places is to increase by 25% is certainly being welcomed by many. But whether it is enough is another matter.
The health service employs more than 150,000 doctors – a quarter more than it did a decade ago. But even that has not been sufficient – vacancy rates are said to be running at close to 10%.
This is despite huge numbers being recruited from abroad. In fact, the numbers registering to work in the NHS from outside the UK has been outstripping those graduating from medical school in recent years.
The future, of course, is fraught with difficulties. The impact of Brexit on EU doctors is uncertain, there are large numbers due to retire – a figure of 13,500 in the next five years has been suggested – and then there is the not insignificant numbers who leave the NHS for other countries or opportunities.
More doctors in training doesn’t necessarily translate to more doctors in the NHS.
Many in the professions will say “too little too late”, but NHSreality lauds the good news, and worries about the 10 year interval before these doctors emerge as full working people. Meanwhile we advocate adverse selection so that a good proportion come from schools spread all over the country, that medical students are predominately graduates, that the gender bias is corrected so that there are equal numbers of men and women, and the training is “virtualised” so that Medical Students live in a community for the 4/5 years of postgrad training, and their subsequent 2 Foundation years (F1&F2) to “register”. Has the new PM been reading NHSreality? Why are we only now looking at the numbers, and communication skills, and nobody has yet mentioned the ethics of pinching doctors from other countries.. Chris Smyth reports 4th October “Doctors must pay back thousands if they quit NHS early”, but this is a restraint of trade, and against the European Convention of Human Rights. NHSreality agrees with the principle but it is a loss of liberty…
Letter responses in The Times 5th October are additional comment:
Sir, The promise by the health secretary to create an extra 1,500 training places at medical schools (Oct 4) is to be welcomed for the long term, but it raises further issues. The uptake of places will be slow unless action is taken to improve doctors’ working and training conditions. Students are unlikely to sign up to a training scheme that commits them to pay back fees if they prematurely leave an NHS that is currently offering such a poor training environment.
Creating a culture that helps to value, attract and retain junior staff in the UK is far more likely to succeed than enforced measures. Moreover, valuing the contributions of doctors from overseas will be vital for the next 10 to 12 years at the very least. We must explicitly recognise this.
Although the prospect of extra doctors is a step in the right direction, it does not solve the immediate problems facing an under-resourced NHS that has crippling shortages of staff in its emergency departments. Action is needed in the short, as well as the long, term.
Dr Tajek B Hassan
President, Royal College of Emergency Medicine
Sir, I trust Mr Hunt has done the maths on his proposal to train 1,500 more doctors each year. Has he taken into account the fact that almost 70 per cent of medical students are female and that a significant proportion of them will choose to work part-time (or not at all once they are married with a family)? Will he be asking for those who choose to work part-time for reimbursement (pro rata) of the cost of their training?
He also needs to understand that hundreds of young British-trained doctors are going abroad to get a better training than exists in the NHS. Having done so, they then find it hard to return to the UK due to the protracted rules around accreditation.
Dr Andrew Cairns, GP
Sir, Jeremy Hunt’s announcement that an additional 1,500 doctors a year will be in training by 2018 is welcome news. But as medical training takes a minimum of seven years, 2025 is a long way off. Meanwhile, preventing the avoidable attrition of staff leaving now would help. For the 55,000 NHS workers from the EU, Mr Hunt’s assertion that “we want EU nationals who are already here to be able to stay post-Brexit” still falls short of a firm government commitment.
Compared to the OECD and EU average, the UK has fewer doctors, nurses and beds per head of population. The National Audit Office estimated that the NHS in England was 28,000 nurses short.
The NHS is in the midst of an unprecedented funding squeeze, with pay increases stuck at 1 per cent since 2009. A key way forward is to increase productivity, at pace, which more than anything needs motivated staff to achieve. The junior doctors’ dispute may be drawing to a close, but an imposed settlement damages already fragile morale.
Dr Jennifer Dixon
CEO, Health Foundation