“Who in the world am I? Ah, that's the great puzzle.”
The DoH agreed unconditionally to some of the recommendations and kept some on hold, either for Darzi to decide upon or for the government to give more consideration 'sometime' in the future. Why will Darzi be given this extra task is unclear, since Darzi would seek the help of his advisers who can not possibly be any better than the totally independent Sir Tooke anyway! Can Darzi achieve an overall 87% agreement from across the medical profession?
Sir Tooke did not comment on this particular bit in his response but, you could tell from he wasn't really impressed by the government's response even after meeting with The Secretary of State to discuss same despite being given 'some' open ended assurances, including:
"deal fairly and effectively with the bulge in would-be specialist trainees"
How? No mention. But, if Remedy is stating there will only be 300 more posts, how is this fair and effective for 12,000 affected doctors? The government's response does not explain what it intends to do to ensure that those doctors will be dealt with effectively and fairly. Of course, the Lords are meeting today to consider the government's appeal against Bapio's win but even if it wins at The Lords, what other measures are in place to ensure fairness? None mentioned.
Prof Ian Gilmore commented:
"The profession remains extremely anxious about resolving the considerable residual issues from the disaster of the implementation of MMC and MTAS in 2007. There is an impatience to move on with these crucial Inquiry recommendations, some of which are now subject to further process. All are agreed that through these changes, the ultimate goal is to improve standards of patient care."
While The Royal College of Surgeons said:
"The college also supports the measures put in place to rescue those trainees who have been caught up in MTAS, but the numbers of training places and extra posts is paltry. Surgical trainees this year are facing competition ratios far in excess of ten to one which means that many of those who would have gone on to specialist training in previous years now face the untimely end of their surgical careers, a huge loss to the NHS. This College has warned successive Secretaries of State about the scale of the problem and this is too little, too late."
So, why didn't anybody do anything about this then? Like stop the flaw of IMGs when the problem of increased competition was known as far back as ' successive Secretaries of State?' What will become of all those trainees midway through their training?
In section 5 'workforce planning' of the response, the government elaborates on its ongoing efforts to give priority to the Brits before considering IMGs but will this alone help? ... not unless there are currently 9 IMGs of the 10 applicants per surgical post on offer, for example. Which is not the case, so, even if you give all the available posts to the Brits, there will still be a large percentage of disappointed excellent trainees! Apart from the trust grade, what other alternatives are there for the disappointed doctors?
"The Inquiry noted the need for consistent policies for the workforce and for those policies to embrace a long-term vision for its size and structure. The vision should be linked to service objectives and to the other roles doctors undertake, including those in management, education and research and overseas work."
Does this mean the government, with regard to doctors, encourages the brain drain out of Britain?
As for redefining the role of the doctor, well, this was vague and extremely open ended:
"Current trends in the health system, including changing demand patterns, more care delivered closer to home, the introduction of new technologies and increasing managerial complexity, will require changes to the ways in which clinicians deliver healthcare in the future."
Oh, look! The Auzies have a problem with their increase in medical school intake and specialty training numbers too! ...
“I am looking at you,
You at him,
How to solve This puzzle--
You, he, and I?”
We would strongly advise that you consult your supervising consultant or clinical tutor before taking such as step. Current projections indicate that opportunities to enter training at ST3 level and above will be severely limited in 2009."
You will be asked to state your preferences from a list of ST3 programmes available in your local deanery. Your deanery will assess your skills, consider your preferences and allocate you to one of these ST3 programmes.
The post you are offered may or may not be your preferred option. You should accept this offer provisionally and then consider the opportunity to apply for other ST3 posts that will be advertised as part of the national open competition in phase 2.”
Not too bad then, opportunity for the 'trapped' however small since there aren't many jobs to go round anyway ... How about some more ST3 posts ... please :-)
The London Deanery extends the ST3 application deadline because ....
"the person specification for Trauma & Orthopaedics ST3 on the London Deanery website differed from the national person specification on the MMC website. In particular, “4 Months A&E experience” was included in the essential criteria in the “Career Progression” section of the person specification on the London Deanery website. The person specification on the London Deanery website has been withdrawn and the shortlisting scoresheet has been amended to reflect the national person specification.
And the BMA has kindly given guidance and referred applicants to the London Deanery re:
22/2/08 Information for London KSS run-through trainees:
Click Here for the Link
Well, they're only 'human' after all ....aren't they? ...
“I might not this believe
Without the sensible and true avouch
Of mine own eyes.”