Monday, March 05, 2007

The Prime Minister's Office response.

An e petition to stop 'Modernising Medical Careers' was sent to the Government in January 2007 having been signed by 2,712 people. The Government have since responsed to the petition as below:

"The Government are aware of the calls to defer implementation of the new specialty training programmes. However, the view of the four UK Health Departments is that, as we are on target to deliver, this would not be helpful and would actually cause greater uncertainty for trainees.
The petition suggests that there will be a lack of specialty training posts....Of course, as entry is competitive not every trainee can be guaranteed a post and not everyone will be able to get into the specialty they want in the location they want, but this has always been the case. However, the number of training places announced represents a significant increase in training opportunities.
It is inevitable that reform on this scale will prompt some concern but we hope this response goes some way to reassuring you about these important changes."

It is unclear was meant by 'a signifcant increase in training opportunites' and I am aware of many doctors who seem to have missed out on further training posts. In a letter in the Independent newspaper today, Dr Liz Tate (SHO psychiatrist) wrote:

"When the results [from the MMC] were in, the scale of the disaster became apparent...Junior doctors have suddenly seen how little they are valued by the Government. Doctors with homes, partners and families are now faced with the choice of becoming unemployed or relocating their entire household to take up a job they don't even want.

Contrary to what the public are sometimes led to believe, most doctors want to work, enjoy their job and are committed to their specialities and their patients. This new system of job allocation favours no one. At best, the Government will create a generation of demoralised and demotivated doctors, doing jobs they hate in areas miles from their families and friends. At worst, doctors will leave the country for the open-armed invitations of Australia and New Zealand, or leave medicine altogether."

I continue to fully support the junior doctors and I very much value their hard work and dedicated commitment.


Anonymous said...

This is great Michelle. It's time more doctors stood up for their profession.

Dr Michelle Tempest said...

Thanks for that rc! Lets hope lots of doctors support the march. Michelle

QUASAR9 said...

Hi Michelle,
Welcome to the real world.
Most people (including) doctors have to do jobs they don't necessarily like, and beavailable to move where the job takes them - because the bills have to be paid.

Contrary to Myth, doctors are human first and careers second, and patients (or clients) needs come low down their priority list.

Just as in a mechanics life a dentist's beamer (bmw) is just a job they do for money - and they'll charge the dentist as much as they can.
Just as in a roofer's life, the doctor's or dentist's roof is just another roof with tiles needing replacing, but if they can sell the dentist a new roof - smiles all around?
Just as in a plumber's life, the doctors's plumbing is just another job needs doing.

What goes round comes round
Except we expect higher standards and more guarantees from the work carried out by our BMW mechanic, roofer or plumber.

But I agree, the government hasn't the balls to take on the BMA, GPs, doctors, surgeons or specialists, yet will trod on junior doctors, nurses and other hospital staff - because they are more expendable?

How come every European country seems to have a surplus of doctors looking for jobs in the uk - how come we are importing doctors from Africa and the 'ole' empire - and they don't come cheap ...
And our doctors want to go to New Zealand and Australia or the US - don't they train doctors?
Or is the truth the size of houses with pools they can purchase, a rarerity or luxury in the uk - even among the highest earning doctors.

Sure some doctors want to heal and cure people or even do a good job.
But that is no longer the majority. The majority want a high reward and highly paid job, with no accountability to man or beast.

Dr Michelle Tempest said...

quasar9 - thanks for your comments. Medicine is more than just paying the bills - it is a vocation. As for junior doctors being expendable, I think the Government will learn at their peril, that the junior doctors are the engine of every hospital and without them and their 24 hour rotas, the hospital could not and would not function. It may also sound a cliche, but doctors went into to medicine because they wanted to help people...all be it, I agree they are also human - Although, I think at the moment they don't feel as if they are being treated very humanely. Michelle

Raedwald said...

As a layman (or rather as one in a profession other than healing) I tend to believe that doctors went into medicine as a vocation until reasonably recently - the 80s maybe. I think many still do.

I also think that we lost something valuable with the general de-professionalising that started perhaps in the 70s. Oh, while we can all subscribe to lofty ideals about professionals not being any better persons than the humblest of their clients, it came as a considerable shock to some doctors of the older generation to be addressed as 'mate'. Or 'love'.

Now the internet has made everyone an expert, and some central soviet planning bureau decides how many plumbers, doctors, lawyers or gas fitters the state produces. Smart kids surf the cash wave. Now I fear the number entering the old 'vocational' professions primarily for the lure of lucre is increasing as the old social and professional distinctions are blurring - as the value of status declines, material reward takes its place.

Midwife with a Knife said...

q9: I don't think you have any idea of the training and harship one puts up with to become a doctor. If I were just looking for easy cash, I would have done something different (IT maybe, or plumbing). Instead, I went into medicine because I wanted to take care of patients. Admittedly, I have no complaints. I have US$170,000 in student loans, but I feel like its' worth it in order to spend my life doing something that I love and that I believe in.

Yeah, people do sometimes need to go where the jobs are. In fact, I have done my training in places I would never have picked to live, because that's where the U.S residency match sent me.

I'm ok with all of that.

But what's happening in in Britian is that docs are being asked to make all of the sacrifices involved in medical training (and trust me, there are many), and then they're having the rug pulled out from them after they've already made those sacrifices. It seems like once someone's made the sacrifices, and already obtained a job, the government should not treat them so shabbily. Especially since we're talking about physicians who make very little money (especially when calculated per hour), and really ask very little other than to not have their lives shattered so incredibly callously.

I have to admit, I'm constantly stunned that the BMA and the British people have allowed this to happen. It would serve them right for all doctors to leave the country and then lets see how they feel?

And again, if it were about money, there are far easier ways to make money than medicine.

simon said...

The problems with Australia are largely in the rural/bush areas.

We have plenty of student and OS doctors who want to work but only in the cities, and probably for the reasons of:- beaches/schools/lifestyle/career/$$ etc.

We have a huge shortage of doctors in rural areas because:-

Rural doctors have huge areas to cover,and have a wider range of health issues, both physical and mental.

The role of the GP out west is lower paying, and requires 24 hour "on call" duties. They are usually a "one man band"
This also means less income.

The hostpital facilities are usually behind that of the cities. So too are country towns and their facilities. It can be a lonely existance.

(But perhaps its real doctoring, not just seeing one patient every 15 minutes as a money machine)
As far as our health standards are concerned. They are the same as the standards in Britain as too is the training. So British trained doctors would feel at home here.

TryingTimes said...

This government will ignore the wishes of fewer than 3,000 petitioners in the same way it will ignore the wishes of almost one million marchers through London and similarly ignore 1.5 million e-petitoners.

We do not have "listen to the people" democracy in the UK and anyone who believes otherwise is deluded - we have 'issue management'.

There are a large number of doctors who sit in parliament and they have issues - that's what we're seeing the product of.

In the near future there will be wholesale reform of two areas: medical training and oversight.

The GMC (clients of mine) and the BMA will become fringe organisations while the regulatory powers will pass to the leity.

This new 'feature' will include social services/ofsted-style validations, targets and - dare I say it - performance indicators.


Anonymous said...

I really feel for our junior doctors too.

Newmania said...

It seems to me that if we paid Doctors less than the absurd amounts they currently recieve we could afford more of them ? No ?

I do not supoprt Doctors , I think they operate as Union and are entirely swivvle eyed about their worth. They should be more appeciative of the fact that the rest of us pay for their training and paid a lot less. They seem to despise the people they treat and whose taxes fund their increasingly glamorous lifestyles. Many of find the sight of expensive sports cars outside run down NHS surgeries disgusting .It is not a vocation more than any other job it is part of the flight to the proffessions and the last places you can avoid commercial competition whilst recieving large rewards

Cut their deal .Then there would be less people wishing to be Doctor and we could employ more . Its the classic greedy Union problem and obviious to all but the happy recipients

By the way that is by no means the end of my complaint about Doctors and their misguided belief that they know best about everything . theyu infest left leaning consultative bodies that have driven ever more illiberal legislation inflicted on a population they clearly regard as naughty children rather than adults and citizens .

It may also sound a cliche, but doctors went into to medicine because they wanted to help people...all be it, I agree they are also human

..and that is not a cliche its a damned lie and I am sick to death of hearing it. Do you seriously suppose that the medical profession is inhabited by people of higher moral standards than any other ,Its a laughable suggestion and somewhat insulting.

It is quite simple, Doctors rewards can be cut in half and there would be no shortage . We could quite simply attract the staff at a fraction of cost and if theis inlvolved resourcing internationally well its about time this applallingly wasteful system we have started to faintly measure up to the private sector that funds it .

All in all the whining is a sad joke and I would not overestimate the amount of suppprt you have in the country . You have little.

QUASAR9 said...

Hi midwife with a knife

$170,000 student debt
And how much is your mortgage?
I rest my case, on this post and the previous one on stress at work
Debt is not work related stress. Debt is debt related stress. Work is what you get paid for, and use to pay off debt.

However I should still expect to get paid! - whether the patient dies or not, whether the patient is left with a limp or not, whether the patient...

I wrote a 'consultative' reply, but it got lost.
In the meantime newmania covers some of the points.

Anonymous said...

Contained in Newmania's rant against doctors (what do you have against us?) there are some valid points: I believe the negotiators for recent contracts have let greed get in the way of professional integrity, so that we are now very well paid at the expense of our personal and professional freedom. I think it is unbelievable that in this country patients are not allowed to choose their own doctor, and have no real choice over the hospital they are treated at either. I agree it is anomalous that we restrict the entry to medical school so as to keep the number of doctors down below a "competitive" level. This does create an environment where mediocrity can flourish and be rewarded and I think it is shameful that it was allowed to happen.

On the other hand it is sad that he doesn't believe doctors go into medicine because they have a genuine vocation. No-one is claiming that doctors have any higher moral standing than anyone else-that claim cam from within his own fevered imagination. At the same time very few people go into medicine without a genuine wish to improve life for others. Newmania can choose to believe that or not but I have no doubt that it is true.

My take on this disaster is not that there will be winners and losers-that is true in any field and less so in medicine as has been pointed out than in other less protected careers. The real point is that this selection process does not discriminate between good candidates and bad ones, so we have no guarantee that the hospital consultants of the future will continue to be the best of the applicants.

Newmania may not like doctors, but I bet if he were to get ill he would rather be treated by a specialist selected for training as superior to other applicants (by a fair and meritocratic process) than one randomly selected from a pool of wannabes

Anonymous said...

Hi Michelle,

I am stunned and saddened by some of the "anti-doctor" comments that have been posted here. It is true that GPs (who are fully trained and on the GP register by the way) have a very good deal but no so the hospital doctors. We have been subjected to appauling on-call rotas and pay cuts rather than the "dreams of averice" that certain posters seem to think of when discussing our salaries. I am frankly fed up with MMC. It has forced me, my wfe and new baby to leave a unit and an area that we love and move half-way across the country for fear that the dorr with shut in our faces if we stay. I have been lucky to be shortlisted in a number of places but still have no idea even if these interviews are going to take place!!
The government are trying to fit round pegs into square holes getting LATs and other registrar level doctors to enter their all-new ST system. It is obviously unworkable and is proving to be such.
OK rant over. Thanks.


Dr Michelle Tempest said...

Well I am pleased to see that this post has created such a debate. Overall, I don't think doctor bashing helps with considering the future of training. Everyone, patients or doctors, should all want medical professionals to be trained and trained well. Currently British training is globally respected, and I for one, want it to stay that way.
Thanks again for your comments. Michelle

Anonymous said...

And "they" are trying to get rid of womens choice now. See and sign the petition on:
Thanks, An angry mum who wants to have a choice