The butterfly is a flying flower, The flower a tethered butterfly

Saturday, 26 January 2008

Workforce? Or .... force works?!

“Force is all-conquering, but its victories are short-lived.”

I am still waiting for the first part of the HSC's fifth session attended by 'Douglas.'It is not on the government site yet, not even as audio!

The second part of the session was attended by the workforce planners, Anne and Moira (Because I am friendly like that :) and Sian Thomas of NHS employers.

Remember, when Professor Liz Paice attended the third session and
gave her evidence, she said that '2007 was the one opportunity that will never happen again' or something else meaning the same. If you bear that in mind while listening to the 3 ladies in the fifth session, the future of postgraduate education becomes clear, if the current policy is left to continue.

Was 2007 a disaster in workforce planning? No, said the planners and all the three ladies agree with the CMO's earlier evidence (session 1.) It was the IMGs, not us, says Anne and Moira. Sian mentions the 'good' things about MMC but agrees with the CMO that the IMGs were the problem and adds that it was due to high volume of applicants and the lack of a transition period and a big bang approach caused the 2007 mess.S ian then said that continuing with round one was what the employers said they wanted because there were only a few weeks to August 1st when doctors had to be in posts for the 'sake of the patients', hence, it was the right thing to do to continue with the deeply flawed round 1.

I don't think so Sian, there were around 5 months left till August first! Round 1 could've been easily scapped and a fairer way to select introduced! My proof, round 2 was introduced and managed in three weeks! Therefore, the quality of the recruits was never really a priority! Why?! .... but, forget about this for now ....

There were hardly any cuts to educational budgets said Anne, except for a year in London where study leave money was affected, actually more money was invested to ease the 'bulge' to help transition. The workforce ladies think 'Doctors' aspirations need to be looked at.' Moira then goes on , with lots of 'employee circular' jargon about her 'effective workforce planning' using words like 'positive', 'flexible', 'quality, effective, robust, full co
nsultation, exactly what we should be doing .... etc. A load of dressed up to 'mock' hot air!

Moira on commissioning the trainees evaded the question, using lots of jargon ending with the words 'positive step!' ...
:-) Sian evaded a few questions herself using the same technique! The 'dence' use of jargon worked and the panel did not enquire further when questions were evaded! Of particular note, was when Sian spoke about international competition post CCT .. It was just left at that! Amazing. Again, when she said that 70% of medics are now female. Very good! Said Richard, the panel member ... No quizzing on why this is, nothing!

Sian talks from the point of view of her 500 or so employers It was very clear they were mainly after a cheap workforce in the future, regardless of the dire consequences on patients. All three women 'firmly' believe this is the way to go! Cheap, cheaper and cheapest! ... cut training numbers further, cut training times further! EWTD implications on the hours does not mean more training or training posts, it just means more nurses doing doctor' jobs, says Moira and agrees the rest!

With less training because of the EWTD, it simply means you have to re-evaluate the doctors at CCT level and classify them accordingly on the 'level escalator', or so implies Sian. Redefine the doctor's role, she adds but I don't think she means it the way Professor Tooke meant. I think what she wants is to 'downgrade' them! Afterall, the system for appointing consultants no longer guarantees a job at the end of training! But Sian wants more! She wants international competition for post CCT, even 4 years after graduation, at the end of core training! For the sake of the patients Sian? I don't think so! This is break neck competition! It's all about money! All about cheap, cheaper and cheapest!

It's about completely 'disarming' doctors! Forcing the medical profession into submission! ... It's WAR!

Can you now guess how the session will proceed to the end? The workforce planning ladies intend to wriggle out of responsibility and through the use of unfamiliar to the panel jargon entwined with carefully chosen 'positive' words. They will be evade answers when they it suits them. They will also make bad news look pretty!' Pchycobable, used on an investigative 'government' panel! Oh, please! I tell you, these ladies would have no trouble filling the 'white boxes of MTAS!' As for the above, I don't believe you ladies! Your ways have now prepared and put me in the mood for the remainder of the session! From this point, I could even have predicted your answers to the remaining questions! I knew you were going to also blame it on the seniors and their organisations, on the medical profession! No consensus, hey! Fiona sums up the session brilliantly below

Let's now go back to Prof Liz Paice and the 'one' opportunity of 2007 and see why she said so.

Here is the future of medical training in Britain:

Training posts will reduce year by year

Possible protection for the Brits till the end of core training for the lucky ones with training numbers

The rest will be forced into trust grade service or just leave medicine

Cut throat competition for jobs post core training

More and more doctors forced into trust service or leave medicine

Of those lucky to get jobs post core training, proceed to gain CCT

Again, cut throat competition for 'specialist' level posts based on the 'new' definition of the doctor's role, the way 'employers' see it and not the medical profession

Not much difference between CCT, trust grade or, indeed, quactitioners at this level either in expertise, money wise and, of course, 'standing' wise

Work in teams of bring them in, churn them out for safety

Select a handful to train to real consultant level ... no power, you're the flying consultant .. nice and placid ... and does 'exactly' what s/he is told!

Bye bye profession, hello levels escalator!

Welcome to Unison doctors!

“There are only two forces in the world, the sword and the spirit. In the long run the sword will always be conquered by the spirit.”


David L. Cox said...

Your points are very well made Sam. The 5th HS Committee meeting was disappointing to me, in that I've yet to hear Rubin's excuses for his patronising letter. I wonder when that will appear?

As far as the second part is concerned this was an appalling example of apparatchik mumbo-jumbo for the main part. You have touched on many of the worrying bits however. Bright women, evading many of the real points and trying to pin blame anywhere except on the MMC, its designers and its apologists, including themselves! That their thoughts on Tooke were aired was almost insulting!

Training budgets were 'not reduced' but did include the costs of the temporary 'Patsy' jobs, which were clearly planning on the hoof! The kind of work force planning that one would not have believed could possibly have come from a system with such erudite work force planning managers as these! Never mind, it was clearly valuable training and real value for money for the taxpayer!

I had one point that particularly annoyed me.In discussion of the effect of EWTD on posts one of the paticipants (Sian Thomas?) said that she didn't think more training places should be generated just to meet the enforced reduced hours!

The choice clearly is to develop training with quality at least at the current level, and therefore employ more trainee doctors, or to lengthen the training time for those lucky enough to have places, or (and reading between the lines the preferred option), dumb down the training! Therein lies the rub!

I trust that RemedyUK and should they have awakened yet, the BMA, were taking sufficient notice.

Sam said...

'That their thoughts on Tooke were aired was almost insulting!'

They were David, the planners meant it; they want to discredit him. Moira and Anne don't approve of Sir Tooke's recommendation to set up a new body to be in charge of doctor's training and ring fence the money for same because that will make them out of a job, right? Of course, Sir Tooke would not have recommended this had he not found solid evidence to justify his decision, remember, the Telegraph once had an article on this, that Patsy raided doctors' training to the tune of 135 million to balance her books. Why didn't the panel ask about this? Surely Moira and Anne are aware of it.

'I trust that RemedyUK and should they have awakened yetthe BMA, were taking sufficient notice.'

I am sure both are very aware David, the thing is, is it too late?

See, this is why we musn't waste energy on blame anymore. Best concentrate on raising awarness amongst doctors. Hopefully, they can then affect change. By the way, Remedy has an article on its front page called 'reclaiming our profession' So, let's hope .. :)

David L. Cox said...

Good points Sam. I come from business background where incompetence meets its correct rewards - the dole queue - and find it difficult to excuse such when it is carried out on the public (ie mine and your's) purse! So far to me, few involved warrant continued employment, especially all concerned with work force planning, which has been a disaster inflicted on juniors for years! Let us not forget the 2005 round when single SHO jobs were attracting 1500 applicants!

Planning? What planning? My continued correspondence with the DoH atthe time was like talking to the wall - just standard set answers, with absolutely no indication of any joined up thinking at all. I don't think much has changed, or will change until major heads roll.

I wonder where the Rubin, Douglas and Wright session is? Is the fact that it is missing significant?

Sam said...

'I wonder where the Rubin, Douglas and Wright session is? Is the fact that it is missing significant?'

Maybe it takes a few days to put the full video on the site., so, let's wait and see. I want to know what they said too David, I suppose, everybody does.

I also have a feeling the HSC's report may come out 'After' the Secretary State for Health speaks at the end of February as promised.