Posts Tagged ‘Recruitment’

Legal challenge over juniors’ employment rights

By Francesca Robinson - 30th December 2009 1:24 pm

A legal challenge has been issued to the government over decisions it has made which deprive junior doctors of key labour protection rights.

Lawyers employed by the campaign group Remedy are questioning the propriety of a consultation carried out earlier this year on whether to exempt deaneries from employment agency legislation.

Remedy has opposed the move because it claims that it deprives juniors of key employment protection rights.

Abuses include failing to inform junior doctors seeking work through deaneries of which rotation jobs they will be assigned to when they apply; being forced to ’stick or twist’ on jobs; and not knowing where they will be two weeks before a job starts.

Remedy’s lawyers have sent a legal ‘letter before action’ to Lord Mandelson, the business secretary, in a bid to persuade him to withdraw his decision and to start the consultation process again.

They have highlighted the way the Department for BIS justified the exemption on “potential consequences” and “evidence” - the details of which were not revealed.  

They argue that the consultation came to the conclusion that the only group who could be affected by the proposed changes to the law would be the deaneries themselves. They also point out that there was no consideration of the impact this action would have on the doctor.

Remedy’s head of policy Richard Marks said: “In the short term this legal action will delay any changes which will be to the benefit of those currently going through the system. But our long-term aim is to campaign for better and fairer controls of the ways that deaneries conduct recruitment.

 “We want to see the levels of protection for doctors increased, not reduced. The distant promise of a code of conduct with very uncertain powers is simply not good enough.”

In return for exempting deaneries from employment legislation the Department for BIS has proposed establishing a code of conduct to govern future recruitment and training arrangements for junior doctors.

 But Dr Shree Datta, chair of the BMA’s junior doctors’ committee said they were concerned about how much teeth the code would have and whether it would be enforceable. 

“We will await with interest the progress that Remedy make on this issue. Meanwhile were are putting pressure on deaneries to make sure they are aware of the feeling among junior doctors on this issue,” she said.

A Department for Business spokesperson said: “I can confirm that we have received a letter from Remedy and are in the process of considering it.”

Read a blog on the issue.

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Encouragement will widen professional access

By Liz Denny, medical student in Liverpool and the BMA's lead on accessibility - 18th December 2009 1:34 pm

There will be many of you who will approach yet another report about equality and widening access to medicine in the same way that I approach the Peter Andre and Katie Price circus.

I don’t understand it, I don’t care about it and frankly I wouldn’t be that fussed if a gigantic foot dropped down on top of it.

I sympathise with this reaction as in recent months we have been deluged with reports, pronouncements and initiatives on this topic, not least from Alan Milburn’s summer report on widening access to the professions. Unfortunately much of this has been wrapped in the overbearing language of political correctness which makes you want to pull your hair out.

But, buried beneath this mountain of political spin lies a couple of serious points. It is true, as the BMA’s new report into the make up of medical school demonstrates, that as a profession we have an appalling track record of recruiting students from low income backgrounds.

Just one in seven medical students comes from this group, despite the government pouring £392 million into widening participation schemes in recent years. The glut of spending has resulted in an increase from the lowest groups of just 1.7% since 2003. Not exactly time for the party hats and the cava.

I imagine though that many of you again would have been left unmoved by this last paragraph, possibly because you suspect that what is coming next is a call for positive discrimination. Certainly our report suggests this view is filtering through to students, with a rising rate of applicants refusing to answer questions about their social status, possibly due to a fear they could end up being penalised if they are judged to be too wealthy.

Well, this isn’t what the BMA or I believe in. Positive discrimination is as unfair as it sounds - there is nothing positive about discriminating against anyone.

What instead needs to happen is for us to remove the barriers holding back low income students. Many of these lie at school level, well before application forms are even filled in.

Pupils from low income areas receive worse grades than their counterparts in more affluent districts and, perhaps linked to this fact, many automatically think a career in medicine isn’t for them. Another issue may lie in the career advice students get, as there is evidence of an inconsistency in the quality of these services.

Certainly, in my own experience, I didn’t feel I got much encouragement to go for medicine despite my grades. There of course other barriers, not least the increasing cost of a medical degree which all politicians appear to have genetic pre-disposition to ignore - despite medical students now facing a £37,000 debt bill after graduation.

To tackle these problems we don’t need phony positive discrimination schemes. We need to look at the school system and how it interacts with medical schools, especially in terms of career advice services. We need no more increases in tuition fees and someone in Whitehall to wake up to the debt problem that threatens to bury the ambitions of thousands of students with the brains but not the wallet to get into medical school. And we also need a proactive set of mentoring schemes - an area the BMA is looking to work on - aimed at raising the sights of children so that they believe a career in medicine is within their reach.

Tackling the under representation of low income students is therefore not a flag to be raised in the cause of political correctness. It is about something more real, more practical and more important - making sure we get the best talent into our hospitals and that everyone gets the chance to fulfil their potential.

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“Only the wealthy can enter the profession”

By Mike Broad - 16th December 2009 2:25 pm

Medicine continues to be a closed shop to students from low income families, a BMA report finds.

The study, called Equality and diversity in UK medical schools, reveals that only one in seven successful applicants are from the lowest economic groups, despite them making up nearly half of the UK population.

In the past five years, there has been an increase of just 1.7% in students coming from low income backgrounds, despite £392 million being poured into widening access schemes across the higher education system since 2001.

Professor Bhupinder Sandhu, chair of the BMA’s equal opportunity committee, said: “Medical schools are still not recruiting enough students from low income backgrounds. There is evidence of a drastic gap in acceptance rates. Fifty eight per cent of applicants from the top socio-economic group obtained a place at medical school, but only 39% of applicants from the lowest group were successful - a gap of 19%.

“A combination of complex problems lies at the heart of this failure. There are clear underlying issues within education at school level, not just in the poor academic performance amongst low income students, but also in low aspirations, with many seemingly feeling a career in medicine is simply unattainable.”

The report finds, however, that medicine does attract a higher proportion of ethnic minority students when compared to the general university population, although there are large differences in acceptance rates between different ethnic groups. And women made up 56% of all accepted applicants to UK medical schools.

The study analysed the latest figures from 2008 on successful applications to UK medical schools from the Universities and Colleges Admissions Service.

Dr Vivienne Nathanson, head of science and ethics at the BMA, is concerned that lower income applicants could be further deterred by mounting levels of student debt, which are set to hit £37,000 for medical students.

She said: “The chancellor’s recent announcement of a scheme aimed at helping low income students gain exposure of medicine may help to address the fact that many do not feel a medical career is a possible career option.

“But this will not in itself solve this problem. The government must look at the cost of the medical degree and how we address the failings in our school system.”

Read the full report.

Read a blog on the issue.

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Record numbers of junior doctor vacancies

By Francesca Robinson - 13th November 2009 9:04 am

Evidence of a worsening junior doctor recruitment crisis following the introduction of the European Working Time Directive has come to light this week.  

Jobs4medical, an online recruitment service, announced that it has a record number of doctor vacancies on its site.

It is currently advertising 7,500 locum and permanent doctors’ positions, which also includes consultants and GPs.

The highest number of vacancies posted on the site for secondary care are in accident and emergency followed by paediatrics and psychiatry.

Vicky Scott, operations manager at Jobs4Medical, said: “We have seen a huge increase this year in doctors’ positions. We are getting feedback from recruiters that it’s very difficult to recruit doctors into these roles. We are finding that the movement isn’t there in the market that there was a year ago or maybe even eight months ago. It has got worse since August.”

Across Cumbria there are currently between 16 and 20 specialist junior doctor vacancies. Recruiters from the North Cumbria University Trust recently travelled to India in a bid to recruit 10 new juniors.

In an interview on Radio Cumbria junior doctor committee chair Dr Shree Datta said: “There are shortages throughout UK and we need to look at why…there are these shortages. What it means is that junior docs on the shop floor working harder than they otherwise would be. Tired doctors are not the best doctors.”

Reports are also coming in of the way that recruitment problems are beginning to impact on services. Hospital managers in Wales recently decided that adult brain surgery will be permanently centralised in Cardiff because of the nationwide shortage of junior doctors.

Dr Richard Lewis, Welsh secretary of the BMA, said the shortage of middle grade and junior doctors in Wales could be contributing to the higher number of complaints about medical staff.

Complaints about hospital services have risen by 15%. Among these two-thirds were about inpatient and outpatient care and another one in 10 about accident and emergency. More than half concerned medical staff.

“We have a shortage of junior and middle-grade doctors and that undoubtedly puts pressure on those staff who are trying to deliver a good service,” he said. “But when we have an under-doctored workforce, there will be increasing pressure on the ability of services to deliver.”

Rural and outlying areas are having the greatest struggle to fill posts. NHS managers in Scotland are currently relying on temporary cover to maintain their complement of junior doctors at Caithness General Hospital. Since August the hospital has been unable to fill three of the nine permanent posts. 

A BMA spokesman commented: “Clearly the problem is getting worse. The trouble is much of the evidence is currently anecdotal. It’s an evolving picture because there is a problem with the quality of the data because, for example, there are issues with junior doctors working more hours and falsifying their hours because they want access to training. 

“It is difficult to get a handle on the exact impact the EWTD is having but clearly the shortage of junior doctors is going to be putting pressure on the system particularly where there are recruitment problems already.”

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Shortage of juniors puts rotas under pressure

By Mike Broad - 25th September 2009 2:10 pm

Juniors’ rotas are under pressure because of ongoing staff shortages, the BMA claims.

The BMA junior doctors committee says Department of Health data suggests the NHS was short of almost 3,000 juniors at the end of 2008.

The problem has got worse due to the mishandling of overseas doctors and inadequate preparations prior to the implementation of the 48-hour week which came into force for junior doctors in August.

There is no accurate census of junior doctor staff rotas, but the Department of Health estimated that there was a 5% shortfall in junior doctors at the end of the recruitment process in 2008. This equates to 2,914 junior doctors.

New JDC chair Dr Shree Datta said: “Inadequate staffing is putting a huge strain on the NHS. A football manager would not start a match with 10 men. Yet many junior doctors work in understaffed teams every day.

“The problem of understaffed rotas has worsened because the government has mishandled changes to the immigration system leading to many overseas doctors, who used to fill the staffing shortfall, leaving the UK. Poor preparations for the working time directive are likely to have exacerbated the problem.”

A spokesperson for the DoH said the BMA’s claims were based on old data and junior doctor vacancies were only 2%.

Dr Datta said the NHS has relied on junior doctors working beyond their contracted hours for “too long” and called on the government to respond.

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Lack of staff holding maternity services back

By Mike Broad - 26th August 2009 10:44 am

Maternity services are improving but there are still significant barriers to progress, a King’s Fund report claims.

Teams reported that the barriers preventing progress include a lack of staff, poor communication between staff from different disciplines or different units, particularly during transfer, and a lack of leadership.

The report is based on the outcome of a series of regional events held with midwives, obstetricians and risk managers. It’s the first stage of the Safer Births Initiative - a service improvement programme.

Solutions identified by the teams included new ways of deploying staff, such as case loading or flexible rostering across labour ward and community teams, developing support roles to take on new responsibilities and enabling midwives and obstetricians to attend the same multidisciplinary handover.

Dr Anna Dixon, director of policy at The King’s Fund, said: “This report shows that maternity professionals are introducing new ways of working that should improve the safety of care provided to mothers and babies. We are seeing progress and an appetite locally for change - there are many examples of local innovation where solutions focus on making the best use of existing resources to deliver safe care.

“Yet frontline staff who took part in our events also identified obstacles they face in providing the safest possible care. They told us that they want to be able to exchange ideas and good practice with other trusts and that they need practical advice on how to improve safety, tailored to their local circumstances, not simply more guidance.”

The RCOG welcomed the report but also called on the government to ring fence, at trust level, the £330m it’s promised maternity services between 2008 and 2010. Clinical directors and heads of widwifery need to work with NHS managers to ensure that these funds are secured and appropriately allocated, it said.

The RCOG acknowledged that finding trained staff was a problem and that, while rota and service redesign could help, there was still a need to recruit more midwives to provide one-to-one midwifery care to women throughout their pregnancy and for more consultant presence on the labour ward.

Professor Sir Sabaratnam Arulkumaran, RCOG president, expressed support the drive for more effective use of existing resources. “You can pour money into the system however what is fundamental is not what you buy but how you go about planning your services when funds are tight,” he said. 

Read more on the RCOG’s solutions to the challenges.

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Taking the drama out of becoming a doctor

By Katherine Teale - 12th August 2009 11:27 am

My daughter has announced that she wants to be an actress. This is not because of any noticeable acting ability, but entirely due to the fact that she recently saw a picture of Cameron Diaz in a copy of Good Housekeeping magazine which my mother-in-law leaves conspicuously around the house in the vain hope that I’ll realise what a poor job I’m making of looking after her son.

Following this announcement, we moved onto the subject of secondary schools, and which subjects would be appropriate for the budding thespian to study in three years’ time (physics, chemistry and biology).

The whole things got us thinking about what career we would encourage the children in our family to follow. My husband has a ridiculously lax attitude to making a living (“anything which makes them happy”) but after prolonged domestic arguments we’ve settled on the following compromise - medicine, or law (if desperate).

But would she be accepted for medical school? A recent report by Alan Milburn claimed that medicine is becoming more socially exclusive - apparently people only get into medical school if they “know the right people” (i.e. they’re related to doctors) and go to private school.

This is both good and bad from my perspective, as obviously my daughter is related to me. However, the problem, apart from the fact that she doesn’t want to be a doctor (at least that’s something we can work on) is that she won’t go to private school. This is because my husband is a fanatical supporter of state education, probably because he teaches at a large inner city school (and if you think medical shop talk is tedious, try going out with a bunch of teachers…).

There is a glimmer of hope however. Since 2003, St George’s medical school has been offering reduced A level requirements to applicants from some state schools. Interestingly these students have subsequently done just as well as those from other schools with straight A’s. The obvious conclusion is that, beyond a certain point, A levels are a crap predictor of progress at medical school.

I could have told them that, and frankly, anyone who survives seven years at our local, 2000+ pupil comprehensive, and emerges with any A levels at all, has already demonstrated all the drive, motivation and resourcefulness necessary for a glittering medical career. 

So what is the best way to select medical students? Previously I’m pretty sure St George’s selected its students according to their rugby-playing prowess. My two ex-George’s colleagues are both fanatical rugby players, and also excellent doctors. Extrapolating only a little, rugby is at least as good a selection criterion as A levels, and the principal could easily be extended to include any team sport

This may be a little controversial, but my new, absolutely fair, entrance system would be as follows: for private school pupils, 3 A* at A level plus at least one year’s experience as head boy or girl. State school pupils: any qualification. Plus, for both groups, participation in a team sport.

So my plan is…encourage her to join the drama club, because with kids you just know you’re going to need a plan B.

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Lower tuition fees would open up profession

By Tim Crocker-Buque, chair of the BMA's medical student committee - 23rd July 2009 5:45 pm

It is a great shame that Alan Milburn decided to attack the medical profession for a mythical brand of elitism in his recent report on social inclusion, rather than showing some courage and tackling the corrosive legacy of tuition fees that his government has bequeathed to students and their parents.

Aspiring doctors face a costly route to qualification. An expensive five to six year course charging £3,140 per year in tuition fees includes a host of hidden financial costs, such as an intensive 48-week term that doesn’t allow much time for paid work and expensive materials and travel costs.

Students are now facing an estimated graduation debt of £37,000, and that is only a projected average, with many students graduating with much more.

The BMA estimates that this pressure is resulting in parents having to provide £3,000 a year in financial support to their children - a clear deterrent to those with the ability, but not the bank balance, to complete a medical degree.

If the review on tuition fees expected later this year recommends lifting the current cap medicine will only be open to those affluent individuals who can afford to pay. Figures suggested have ranged from £5,000 to anything up to £10,000. This would have a devastating effect on the future medical workforce.

It is therefore disappointing - to say the very least - that Alan Milburn’s report has left the subject virtually untouched. His one suggestion to waive fees for students living at home is an empty policy as large numbers of students do not live within travelling distance of the UK’s 32 medical schools.

The medical profession is working hard to increase social inclusion and we endorse plans for better career services and mentoring schemes. But if we are really to tackle this problem, politicians like Milburn must put an end to the rhetoric and lift the crippling financial cost of education that threatens to stifle the ambitions of thousands of talented students.

Suggesting that the projected astronomical debt figures are not a deterrent to those students from lower socio economic groups is very short sighted and with only 11% of medical students coming from the lowest three groups, this is unlikely to improve.

The government needs to recognise the financial barriers to medical education, and seriously consider its policy on tuition fees. There has got to be a more appropriate solution to the higher education funding black-hole, which does not result in the financial devastation of generations of students.

Read Jerry Nelson’s view.

Read the BMA’s view.

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“Apparently even northerners can become doctors now”

By Jerry Nelson - 9:34 am

So Alan Milburn has popped up again to remind us all what a complete, utter, first-rate, 24-carat arse he is. After a brief stint as the Worst Health Secretary Since The Dawn of Time, he resigned to spend more time shovelling money into his bank account, by, among other things, selling fizzy drinks to fat chavs.

But now he’s reappeared as the chair of something called the Panel on Fair Access to the Professions, and judging by Mr Milburn’s post-ministerial career, he’s certainly been able to pursue at least one profession very successfully, namely prostitution. His quango is a gang of the usual left-leaning ex-grammar school worthies whose job it was to ponder at our expense why social mobility is now at its worst level since the Labour Party abolished grammar schools.

So far as I can see, they haven’t treated us to their views on the causes of this supposed national blight, which means none of them has set foot inside a typical British comprehensive school or taken one of today’s really hard, not-at-all-dumbed-down A level papers.

Now excuse me, but not enough social mobility? Well, not from where I’m standing, mate - there’s far too much of it.

Take this example. The other day, my registrar - one who aspires to join the greatest profession of all, where he will bestride the earth saving lives like a colossus and who hopes one day to command the instant respect and deference that society affords to the great practitioners of the surgeon’s art - actually used the word “serviette”.

Can you arsing well believe it? He said “lounge” a couple of times, too.

And it’s not just him, they’re everywhere. I saw one leaving the doctor’s mess wearing a football shirt! One of the ENT registrars is actually called Kevin. Glottal stops are filling the air on ward rounds all over the country. Get this: medical schools are even admitting students who are actually Northern.

Memo to Alan: The professions are filling up with oiks, and it’s all your fault.

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Medicine is becoming more socially exclusive

By Mike Broad - 22nd July 2009 11:18 am

Only young people from the most affluent backgrounds can consider joining the medical profession, a government report into social mobility claims.

Former health minister Alan Milburn, chair of a study on widening access to high-status jobs, said professions - like medicine, law and journalism - have become more, not less, socially exclusive over time.

The wide-ranging study, Fair Access to the Professions, by an independent panel of experts, calls for more equal opportunities in education and employment.

It claims that a typical doctor born in 1970 grew up in a family with an income 63% above that of the average family; today, this now equates to growing up in a family that is richer than five in six of all families in the UK.

One of the study’s key proposals is to recruit university students from a wider range of social backgrounds, with tuition fees being waived for students living at home.

The BMA, however, rejected the idea that this would have a substantial impact - with too few students living close enough to medical schools.

Tim Crocker-Buque, chairman of the BMA’s Medical Student Committee, said: “Ministers have no hope of addressing this poor level of participation without examining the crippling and increasing costs of medical education.

“The Panel has been undermined from its inception by the government’s refusal to allow it to examine fully two of the main barriers blocking wider access to medicine - debt and tuition fees.”

The union estimates that just 4% of medical students currently come from the lowest two socio-economic groups and future generations of doctors face an average graduation debt of £37,000.

Other recommendations of Fair Access to the Professions include: higher education being more widely available in further education colleges; universities becoming more involved in schools, such as by having representatives on boards of governors; professions and universities publishing more details on the social background of their intake; and, better careers advice to raise pupils’ aspirations.

Richard Marks, head of policy of Remedy, said: “This is an unashamedly political report, explicitly motivated by the desire to bring about social change.

“Medicine requires individuals who are natural leaders with self-confidence, drive and ambition, prepared to make significant personal sacrifices to further their studies. Our profession can only thrive if we select doctors showing these personal skills. These traits are developed by their school and family upbringing.”

The study suggests that some professions - like law and politics - are becoming less dominated by people from private school, but others like medicine remain the same.

It does acknowledge, however, that diversity has improved, with one in four of all medical school applications and acceptances in 2007 being from ethnic minority backgrounds. Furthermore, women make up 57% of both applications to, and acceptances by, medical school.

The Prime Minister, who commissioned the report, said he will give the findings serious consideration.

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