I was chairing my first meeting of the BMA’s junior doctors committee last week, when a copy of the Daily Telegraph was thrust under my nose. The article came as no great surprise as we had issued a press release highlighting the rota gap problem based on Department of Health figures we uncovered from 2008 recruitment. The figure was a 5% shortfall (or around 3,000 junior doctors in the UK).
What was surprising was the response from the DoH. Whilst I expected a public rebuttal, it came as a shock, as I’m sure it did to all junior doctors who read the article, to be told that: “The latest feedback from SHAs suggests the total numbers of vacancies for junior doctors in August this year was 1,055 which is only around 2% of posts.”
Given that this apparent reduction in rota gaps came at a time when most hospitals were trying desperately to prepare for the introduction the European Working Time Directive such a large drop seems almost miraculous.
Last year the DoH stated in a document on the WTD that: “Patient safety can be put at risk if critical rotas cannot be filled and in extreme circumstances, specific services may be need to be closed.” This suggests they are, or at least were, aware of the seriousness of the problem.
In the same document they acknowledged the reasons behind for the problem were Modernising Medical Careers and the changes to the immigration system. It is all there on page 9.
Yet their view is seems somewhat different now, according to their unnamed spokesman in the Daily Telegraph: “It is not true to say that as international recruitment has been stopped there will be gaps in rotas.”
They go on to dismiss our concerns about rota gaps: “The BMA are using old data…”
Has the rota gaps problem gone away? Dr Alan Axford, Hywel Dda NHS Trust’s medical director thought not when he took the unprecedented step of publicly highlighting the rota gap problems in West Wales in July. In Northern Ireland, the Erne and Tyrone County hospitals have suspended some gynaecological services due to a shortage of junior doctors and in Scotland it was recently reported that 23% paediatric trainees were on maternity leave.
The fact is that hospitals rely on junior doctors working extra unpaid hours to prop up our healthcare system. This is not a suitable or sustainable way to solve the problem. The DoH needs to stop hiding behind statistics and pretending the problem has gone away. We work on these rotas - we know it hasn’t.
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