New doctor recruitment scheme threatens NHS care
by Simon Creer
More than 10,000 junior doctors face unemployment and NHS patient care is at risk after a new recruitment scheme was introduced this year. The new Medical Training Application Service (MTAS), an online system designed to centralise recruitment has caused serious unease amongst doctors and exposed a shortfall in the number of posts available.
The new system was introduced under the guidance of Modernising Medical Careers (MMC) a body described by their own website as being "devised to improve the quality of patient care through better education and training of doctors." MTAS required all junior doctors to complete one online application form and submit them at the same time countrywide. When the site went live in January 2007 it received over 30,000 applicants for approximately 18,500 posts.
Problems with Doctor Recruitment
The problem, however, goes beyond a shortfall in available posts. The application process itself is seen by many as inherently flawed. Applicants were faced with a single form within which to record all their information. One doctor in Yorkshire who preferred to remain anonymous asked; "How can they rate people on short interviews and a set of generic question?"
He went on to say "the application process turned us into lapdogs fetching balls that the MMC threw. If you collected the balls and answered the questions in the generic way they wanted then you would get a job." He claimed the process was updated to remove bias from selection but he argued; "Is bias really a problem? Surely a consultant is capable of making an informed choice having had contact with doctors and decided which they want and why."
RemedyUK, a non-partisan voice for doctors claims; "after progressing so far in training they [doctors] will have been caught out by poorly planned transitional arrangements between old and new systems." In all likelihood it is not only doctors that will be caught out. Patients may face serious staff shortages and a downturn in the quality of care they receive from the NHS as the start date for these posts draws near.
RemedyUK explains "All junior doctors will now be synchronised to change over on the same day. If the consultant happens to be away not one single member of a given team will have any knowledge of any patients." This changeover is scheduled for August 1 and 2. Channel 4 News reported on May 1 that "patients face being turned away from operating theatres as the NHS struggle to cope with the chaos surrounding further training of juniors," and, "hospitals are drawing up plans to cancel leave and operations." RemedyUK also points out "there is no single body that takes responsibility of forecasting and implementing employment numbers."
Further problems with the MTAS site regarding security protocol on April 26 have resulted in the extended closure of the application process, which remained offline at the time of writing.
As interview deadlines draw near there is still little information on the whether available posts will be filled by August. A message to all on the MTAS site says; "we remain committed to ensuring that interviews go ahead." RemedyUK say; "alternative arrangements are uncertain and people do not know if they have interviews. There is no doubt burden of care will rest with consultants."
The Yorkshire medic believes, "The NHS will really suffer and there is serious potential for detrimental care. Overall this will affect the faith patients have in public health care because it displays massive amounts of disorganisation."
Options for Junior Doctors
Applicants are being offered three alternatives firstly to seek work abroad which will not count toward their training or to seek voluntary work which is obviously unpaid and is not classed as training. The third option is to re-sit the previous year and potentially face the process for a second time next year.
At this point advice for patients is thin on the ground as the system is in the grip of uncertainty. Doctors are obliged to provide emergency cover when and where it is needed but with a system in chaos this will be a fire-fighting operation rather than a systematised solution. Patients should keep themselves apprised of the situation and keep in contact with their hospital if they are due to be admitted in the months of July and August.
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