Robbing Peter to pay Paul

BMJ 2007; 334 doi: (Published 22 February 2007) Cite this as: BMJ 2007;334:388
  1. Lisa Hitchen
  1. London

    Junior doctors are seeing cuts in study leave and cancelled courses as trusts and strategic health authorities raid education budgets to balance their books. Lisa Hitchen reports

    As the end of the financial year looms, UK doctors are worried that strategic health authorities (SHAs) and primary care organisations will use education and training money to reduce their health service deficits.

    “There is a commitment for the NHS to balance its books by April. We are very much hoping they won't take [money] from the education budgets,” said Andrew Rowland, vice chairman of the BMA's Junior Doctors Committee.

    Education and training budgets are vulnerable not only because of deficits in the NHS but also because the money that the Department of Health gives for educating and training doctors is no longer ring fenced.

    Until April 2006, the cash given to strategic health authorities for education and training had to be spent on just that—education and training—although some manipulation did occur. Last year, however, that protection was removed.

    The House of Commons health committee drew attention to the vulnerability of these budgets last December, saying, “There is an immediate danger of funding distributed by the Department of Health for education and training purposes ¼ being used for other purposes by the SHAs” (BMJ 2006;333:1236).

    Funding for education and training comes from two levies: the service increment for teaching (SIFT) for undergraduate teaching and the medical and dental education levy (MADEL) for postgraduate teaching. Together with another levy for non-medical staff they make up what is known as the multiprofessional education and training levy (MPET).

    Money from SIFT is not payment for teaching as such but is designed to allow for the extra costs to the NHS of having students present when patients are seen by …

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