Education And Debate Modernising the NHS

Challenges to the health services: the professions

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7248.1533 (Published 03 June 2000) Cite this as: BMJ 2000;320:1533
  1. Isobel Allen, professor of health and social policy (i.allen@psi.org.uk)
  1. Policy Studies Institute, London NW1 3SR

    This is the fourth in a series of seven articles

    “There is the challenge for the professions to strip out unnecessary demarcations, introduce more flexible training and working practices and ensure that doctors do not use time dealing with patients who could be treated safely by other health care staff.” This was the third of five challenges to the health service set out by the prime minister on 22 March, followed up by the secretary of state for health on 23 March with the announcement of six modernisation action teams to focus on the challenges. This announcement expanded on the reference to more flexibility and removing demarcations by adding “in the context of major expansion of the health care workforce.”

    The challenge to the professions has been made. What are the most important things that would make a difference?

    Summary points

    Professionals are ready to change—and have already done so

    NHS organisations need to listen to their staff, who know where systems go wrong

    More flexible working and training are long overdue, together with proper training for multidisciplinary working

    Innovation needs to be encouraged—and entrepreneurial clinicians supported

    Preparing to act on the challenge

    The first thing is for the government to recognise the extent to which members of the professions are ready to take on the challenge. The profile of the medical profession has changed radically in the past 10 years. Women now account for more than 50% of doctors leaving medical schools 1 and represent an increasing proportion of doctors under the age of 40, particularly in general practice. Younger doctors are much more like their contemporaries outside medicine in terms of education and aspirations than their older counterparts were.2 They deplore the traditional resistance to change of the medical profession. They want flexibility within their careers which will help them to lead a “normal life.” …

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