Editorials

Planning the United Kingdom's medical workforce

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7148.1846 (Published 20 June 1998) Cite this as: BMJ 1998;316:1846

On present assumptions UK medical school intake needs to increase

  1. Michael Goldacre, Reader in public health
  1. University of Oxford, Institute of Health Sciences, Oxford OX3 7LF

    Without an appropriate workforce, health service delivery will fail. The function of medical workforce planning is to ensure, so far as possible, that the right numbers of doctors, in the right specialties and grades, are in the right places. Traditionally national policy in the United Kingdom has been to provide an adequate supply of doctors while avoiding overproduction and unemployment. The policy has also been to train enough doctors for self sufficiency without reliance on net immigration. The main mechanisms for achieving these policies have been through fixing quotas for the number of places in medical schools and through a variety of mechanisms to control the number of NHS medical posts in each grade, specialty, and location.

    Several factors tend to increase the demand for health care and for doctors. Population size and structure, notably its ageing, is reasonably straightforward to estimate. Advances in medical knowledge and technology are less predictable. They increase the scope for treatment and increase specialisation, which, in turn, tends to increase the range and number of specialists. Hitherto, technological advances in medicine have generally increased, rather than reduced, costs and the need for medical staff. Public expectations to meet needs and improve quality of care, fuelled by professional aspirations, media …

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