Читать книгу In Stitches - Nick Edwards, Dr. Nick Edwards - Страница 15

A few weeks ago doctors organised a march against what the government is doing to junior doctors’ training. I have never seen so many placid, conservative, non-volatile people on a demonstration before. They were campaigning against a programme called MMC – Modernising Medical Careers (otherwise known by some as demoralizing/mangling/mismanaging medical careers). It certainly has benefits in terms of organising doctors’ training from when they finish their ‘foundation jobs’ (the first jobs they get after qualifying). In A&E it has the added benefit of ensuring that every junior A&E doctor works for a time in anaesthetics and intensive care – jobs that are often hard to come by but that can teach you vital skills.

However, its implementation is what is really pissing off a vast number of doctors, damaging morale and, in the future, may damage patient care. Again, the intention was sensible enough – streamline doctors’ training and try and make job opportunities fairer – but the implementation is farcical. Instead of bringing it in gradually, there has been a most ridiculous attempt to transfer a cohort of doctors from the old scheme to the new one at the same time as implementing the new training scheme for the very junior doctors. As a result 30 000 doctors are applying for 22 000 jobs.

It is the way that they are being forced to apply which is outrageous. The ‘system’ consists of a computer-based questionnaire that assesses your ability to write politically correct crap in 150 words. Doctors with experience, exams, research and wisdom are losing out to others who have been on a course on how to fill out the application form.

The lucky ones who are offered interviews are faced by senior doctors who have not seen their CVs and who have had to mark 600 applicants’ forms in a weekend – but only one question on the form – and so they cannot possibly get an idea of the candidates. The lucky ones get jobs, but often in different parts of the country from where they live and where their kids go to school. They only get told about their jobs at short notice, then have to scramble to find somewhere new to live and somewhere to send their kids to school.

I know of so many doctors whose current contract is finishing in August and then do not know what they will do. Individually, it is upsetting; these doctors, who have debts from medical school and haven’t hit high earnings yet, are left with the threat of no job and no future in the NHS. Collectively, it is a disaster; it costs £250 000 to train a doctor – we are losing thousands of doctors and that is millions and millions of pounds that we as the tax payers have wasted.

Tragically, no-one seems bothered. There is a campaign group (http://www.remedyuk.net) and a few Internet blogs that have taken a big interest such as http://www.nhsblogdoc. blogspot.com, http://www.drrant.net, http://www.thelostdo ctor.blogspot.com and http://www.drgrumble.blogspot.com. However, the national media has not seemed that concerned about the plight of the country’s junior doctors and the fact that many of them are leaving the NHS at our expense.

How did this happen? I think it is government arrogance. They thought they knew best. They ignored the advice of the British Medical Association, which was to ‘slow down, take stock and do this sensibly’. They rushed it through and now, despite a last-minute review, we are faced with this disastrous outcome. They then had the audacity to blame the senior doctors (via the Royal Colleges) who were the very ones urging caution against this whole system.

I know the politicians have said that doctors need to live in the real world and not expect a job for life and should expect competition for popular jobs. That is completely fair and in the past it was totally wrong that some doctors were helped by an ‘old boys’ network’. However it is the utter lack of care that the system shows for its employees that is upsetting. No other group of workers would accept such a shambolic arrangement: where thousands of junior doctors have had their contracts expire in August and then have to apply for new jobs where they can’t show their CVs, don’t know where they will work or what their pay or conditions will be. Then if they are lucky and get a new job, they will only have a couple of weeks notice to uproot themselves and their families before they start their new jobs – remember, this is not just happening to people just out of medical school, but to doctors in their mid thirties who have up to eight years experience and who have roots and families which they need to consider as well. The only people smiling at this mess are the employment lawyers who could be in for a windfall. Oh, and the Australian health service, which is getting loads of very good, well-trained doctors at the British tax payers’ expense. No wonder the application system called MTAS (Medical Training Application System) has been nicknamed Migrating To Australia Soon.

P.S. Since this was written a review group have looked at how to try and improve everything. They are hatching a last-minute plan to try and save the government’s blushes, and thousands of junior doctors’ livelihoods. I wish them luck – they’ll need it.