Hospital Dr News

Review to create cheap, low quality consultants

A junior doctor’s petition to halt controversial government proposals to reform postgraduate training has ignited opposition from thousands of doctors who may previously have been unaware of the planned changes.

The petition has attracted more than 5,250 signatures and the number is increasing every day. This compares with only 382 responses received by the official Shape of Training review consultation.

The petition was launched by orthopaedic registrar Dr Ben Dean to raise awareness of the reforms because he fears they could be detrimental to patient safety.

Dean says: “There is a significant lack of awareness of the Shape of Training review amongst doctors and a significant reason for this is the recent history of doctors being ignored by the policy making powers-that-be, precisely as happened during the implementation of MMC (Modernising Medical Careers).”

The Shape of Training Review makes 19 recommendations. The two that have attracted most controversy are proposals for a shorter period of more generalised medical training for each specialism and moving the point that doctors are registered with the GMC to the end of medical school.

In addition to launching the petition, Dean has challenged the transparency of the review and Government attempts to influence it. He recently won an 18-month Freedom of Information court battle with the GMC to reveal minutes of undocumented meetings between senior civil servants, politicians and the report’s chairman, Professor David Greenaway, vice chancellor of Nottingham University.

The GMC, which provided the secretariat for the review, was forced to publish the details of meetings with ministers and officials which took place during the review’s call for evidence in 2013. Some of the minutes are only single word jottings.

The notes of one meeting said the report would provide “an opportunity for ministers to be radical”. Minutes from another noted that: “Ministers (are) setting strategic direction and feeling happy”.

Dean said a reasonable interpretation was that the review was a way introducing a cheaper, lower quality, type of consultant grade to deliver seven day services. “There is a lot of circumstantial evidence that can add to that impression and the idea hasn’t been adequately rebutted by the GMC and the Department of Health (DH),” he said.

He requested the notes of the meetings because the review’s recommendations to shorten postgraduate medical training to between four and six years and move the point of GMC registration, were inconsistent with the review’s aims of maintaining high quality training.

“There appears to be a whiff of predetermination throughout the review in the way specific models and approaches were proposed very, very early before they had even finished gathering and analysing the evidence. The review has significant methodological flaws in my opinion. They are proposing major structural reform of postgraduate education based on scanty or poor quality evidence,” he said.

A DH spokesman said: “There was nothing other than routine engagement with Sir David Greenaway’s independent report from anyone at the Department of Health. What’s more, no decision has been taken to shorten consultant training or change doctors’ registration – any changes would only take place if they were in the best interests of patients and following appropriate consultation.”

Meanwhile Health Education England (HEE) has launched an engagement exercise to discuss the recommendation that full GMC registration should move to the point of graduation from medical school. It will run for six weeks from mid-February until the end of March.

The DH says there is no timeline for implementation of the review. “HEE’s engagement exercise will form the basis of the future consultation should a future government wish to take it up. This would then require primary legislation,” said the spokesman.

GMC Chief Executive Niall Dickson, said: “There are recommendations made in the review that could require changes to postgraduate training and everyone accepts that more work needs to be done to understand the benefits and impact of such changes.”

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One Response to “Review to create cheap, low quality consultants”

  1. Malcolm Morrison says:

    Welldone Ben Dean! Glad to see the orthpods are ‘leading the charge’ ! (So says a retired bone-cruncher!)

    I wonder how many doctors are aware of this report? It seems to have ‘crept in under the radar’.

    However, I agree with the ‘general principles’ of the recommendations; but, as usual, “the devil is in the detail”! It needs widespread debate before such ‘radical’ changes are introduced.

    One such detail: It talks about ‘women’s health, child health and mental health’ – no mention of ‘men’s health’! (Is this being ‘sexist’?!) No mention of ‘adult health’. No mention of ‘surgery’!!!

    I call on ALL doctors to debate this – lead by Hospital Doctor!

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