Hunt aims for fully home grown doctor workforce
BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5399 (Published 04 October 2016) Cite this as: BMJ 2016;355:i5399
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Mr Hunt's aims will not be fulfilled tomorrow. Nor in the next ten years.
Unless he makes it clear that NON-UK doctors already employed by the NHS will not be expelled, these doctors would be well-advised to seek employment elsewhere - now, rather than after they receive expulsion orders.
There is more than a grain of truth in Dr Saripanidis's response.
Until the home market is flooded by home grown doctors (if ever), Mr Hunt might consider offering ten year contracts to doctors trained in old established medical schools across the Channel. In the 1980s too we were short of doctors, specially in orthopaedics. We recruited doctors from the Netherlands, Belgium and Germany. They fitted in very well.
Mr Hunt has a leaky bucket ( the NHS). As he attempts to fill it from the slow stream of UK medical schools, the holes at the bottom undo his attempts. Will he learn to love his existing doctors? Then they might love us enough to stay with us.
Competing interests: No competing interests
Polly Toynbee wonders today in the Guardian "The puzzle is why anyone would insult the one third of NHS doctors born abroad by suggesting they are only “interim”, as May said. [...] As ministers refuse to guarantee the right for EU staff to stay, NHS doctors and nurses feel insecure and unwelcome – and many may slip away. Ed Smith, chair of NHS Improvement, the regulator, writes in the Telegraph warning of the risk to patients if overseas staff are made to feel “demoralised and diminished”. Simon Stevens, head of NHS England recently wrote: “It should be completely uncontroversial to provide early reassurance to international NHS employees about their continued welcome in this country"".
There is nothing wrong with increasing the capacity for the training of new doctors, but underneath these promises of self-sufficiency, there lies, once again, thinly disguised, the blaming of outsiders for the country's ills. Blaming of outsiders has been the populist theme of the Tory conference, in which Home Secretary Amber Rudd, for instance, said she wanted to" name and shame" businesses which are failing to take on British workers.
This government's 1930s style systematic foreigner-bashing is simply intolerable. We, foreign doctors, have served the NHS well for many years. That the NHS would collapse without us is not a matter of opinion, it is simply a fact. Britain needs us much more than it needs its xenophobic press and its fickle politicians. I hope the BMA will make this clear.
Competing interests: No competing interests
The announcement was made by Jeremy Hunt, the Secretary of State for Health. In a recent court case a lawyer acting on his behalf successfully argued that when he says something he does not necessarily mean it.
References
https://hansard.parliament.uk/commons/2016-04-18/debates/1604186000002/J...
https://www.bma.org.uk/news/2016/september/hunt-irrationaly-imposed-cont...
http://www.gponline.com/junior-doctors-lose-high-court-case-against-heal...
https://www.theguardian.com/politics/2016/apr/18/jeremy-hunt-ramps-up-rh...
Competing interests: No competing interests
The UK will become the first Country in History to reject brain drain, not based on solid long term economic calculations but instead on vague chauvinistic slogans.
Tens of billions are spent by other European Countries in order to educate/train/recruit/employ high quality medical doctors.
Rejecting the best of them who wish to work in NHS hospitals means that UK taxpayers must eventually pay all those necessary billions, through increased taxation.
Unless, of course, it is decided to frenetically train tens of thousands of nurses into "physician assistants" and assign them all GP tasks.
If the same Nationalistic principles apply for all other professional groups active in the UK, future tax burden will rise to unbearable levels.
Competing interests: No competing interests
Re: Hunt aims for fully home grown doctor workforce
Jeremy Hunt's announcement at the Conservative party conference about medical school places does not represent a dramatic increase in the number of medical students (and therefore junior doctors) by any stretch of the imagination.
It is a replacement of the perceived losses that will be attributed to less international graduates working in the U.K, post Brexit.
It is staggering that it has taken the Secretary of State for Health, Jeremy Hunt, 4 years in that position and 6 years of a Conservative government to concede that the NHS is not self-sufficient in producing the correct number of doctors. This is a stunning own goal.
In addition, there is no guarantee that this will mean more 'domestic' doctors if the removal of the cap also applies to international students wishing to study at UK medical schools. Students that are expected to pay in excess of £35 000 a year, for the privilege. It is therefore absurd to suggest, as the Secretary of State does, that they do not pay their fare share. They do pay for clinical placements, with increasing fees on a yearly basis. We should be concerned that an additional levy from these students would make them more attractive to universities which would have the opposite effect than what's desired from the policy.
In any case, having only doctors trained in the UK will be bad for medicine and bad for patient care. Medicine is an international community of learning which thrives on the interchange of experience and knowledge. It thrives on British doctors being able to go abroad and serve communities and, more importantly for patients in the NHS, it thrives on overseas doctors being able to bring their experience from abroad over here.
Training more doctors is a welcome move but it should not be seen as an alternative to recruiting highly skilled and expert overseas staff. To simply close our borders would be terrible for patient care. Without international doctors, putting it simply, the NHS would not be able to cope.
Let us also address the fallacy that medical graduates cost £220 000 to train. £220 000 is what hospitals receive per student, broadly speaking, via Service Increment for Teaching. In many places, how that money is spent is not known. Not all of it is directly related to education and some is siphoned off for service delivery so it is poor judgement to use it to justify an arbitrary minimum number of years service.
The GMC must now ask whether the significant increase in medical students on wards and in theatres, is safe. Clinical placements remain saturated within the context of the current cap, so this is a difficulty which cannot be ignored.
The underlying principle is that this year, there were more vacancies going into the foundation programme than ever before. Progression into specialty training is poor.
Retaining the current workforce has to be the priority.
We can have more doctors if we make the NHS attractive for those that currently work in it.
And, finally, translating more medical students into more doctors means that the government need to make a parallel commitment to increasing the number of foundation posts to prevent medical unemployment and a loss to the taxpayer.
Harrison Carter and Charlie Bell
BMA UK Medical Student Committee Co-chairs
hcarter@bma.org.uk
@harrydecarter
Competing interests: A member of an organisation with expressed concern about this policy.