We are creating a “caste” of doctors – by neglect. Neglecting to change our electoral system is equally crass..

Not everyone wants to be a doctor. It needs some intelligence, memory, staying power and determination, as well as all round education and communication skills. This is why “graduate” entrants are better bets for the state’s investment. If it costs £250,000 to train a doctor, then we as taxpayers want the best value from our investment.

Currently the drop out rate and the emigration rate are high. Preventing nurses and doctors from the EU from coming here will make the short term skills crisis worse.

There is a new advert in the media, for a medical school in Malta with training and exams run by Barts and the London Hospitals trust.

Studying in Malta.

This is basically a second private medical school for UK provision. The first was at Buckingham, and there is competition for places. Costs and overheads will be cheaper in Malta… With 11 applicants for every 2 places in the UK Medical Schools, there should be plenty of aspirants.

So who will apply? I have no idea of the fees, but lets assume that it will be in the order of £250,000 over 5 years, and add to that travel and accommodation, say £10,000 per annum. The total is a minimum of £300,000. This opportunity is a beginning for what goes on in the Indian subcontinent, where most training places are private. Doctors in the UK from the Indian subcontinent are more likely to be privately trained than not. They are also more likely to come from affluent families who have invested in their children’s education for the long term.

If all 9 failed applicants went to private medical school, and remember that their careers officers all recommended and supported their applications, there would eventually be the same excess of private doctors in the UK. If the government is tempted to reduce the places it funds because of oversupply, then the caste system gets worse.

The short-termism of governments in a first past the post electoral system is now evident to everyone in the UK. (Particularly those who have died early as a result of system failures) But the politicians and the media collude to be against any form of PR (proportional representation) Fair voting systems mean everyone feels they have a chance to influence power.

The protest vote at Brexit referendum was because we don’t have PR. The referendum on PR was ill timed, and mismanaged by Mr Clegg and colleagues, but now there is a real feeling that the time for PR is here. It is present in Scotland and Wales, and could easily be applied to change the House of Lords, and reduce it’s overheads. Would we like GP education to be privatised in the same way?

Don’t be led by the media ring in your nose: vote Liberal for a longer term view, and Proportional Representation. (which form is another debate).

Image result for maltese falcon cartoon







This entry was posted in A Personal View, Medical Education, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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