Exploitation of junior doctors threatens NHS future warns J MEIRION THOMAS
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Don't alienate junior doctors: Exploitation of talented young medics threatens future of NHS, warns surgeon J MEIRION THOMAS
As with all organisations, the best guarantee of future success depends on identifying, recruiting, training and retaining the best staff.
For this reason, the current contractual dispute between the Government and junior doctors is of serious concern and could have irreversible consequences.
Although NHS employers clothe the argument differently, junior doctors are being asked to work antisocial hours without any additional payment.
J MEIRION THOMAS: Junior doctors are being asked to work antisocial hours without any extra payment
This unnecessary conflict amounts to exploitation and alienation of gifted young medics who should be nurtured as the next generation of hospital specialists, general practitioners, researchers and teachers.
They have been educated at public expense and have highly sought-after skills, a gift to welcoming countries such as Canada, New Zealand, Australia and America.
To apply for registration in these countries, doctors registered with the General Medical Council must apply for a Certificate of Current Professional Status (CCPS) and applications are soaring.
The British Medical Association has warned of a possible exodus of junior doctors.
Most doctors choose a medical career for humanitarian reasons, for professional satisfaction and not for financial gain. However, junior doctors are not well paid.
Dr Janis Burns wrote a moving open letter to Mr David Cameron, on July 18, which went viral on social media, after she had completed a three-night stint as a junior doctor in Intensive Care.
Demonstration: Up to 3,000 junior doctors and their supporters took part in a march through Newcastle yesterday. The British Medical Association has warned of a possible exodus of junior doctors
She pointed out that hospital doctors have to work for nine years after graduating from a five-year degree course before their basic salary equates to that of a coffee shop manager or a newly qualified tube train driver.
Money aside, the Royal College of Emergency Medicine reports that 600 Consultant and trainee A&E doctors have moved abroad over the past five years, mostly to Australia, because of 'toxic' levels of pressure in the NHS.
General Practitioners are leaving the profession in droves and nationally, a third of GP training slots remain unfilled.
This dispute follows in the wake of another pointless, doctor-bashing battle between the Department of Health and the BMA over the agreed need for seven-day working in hospitals, designed to reduce the claimed 11,000 unnecessary weekend deaths.
While that figure is probably exaggerated by accurate statistical analysis of faulty coding data, the BMA were wrongly portrayed as being unreasonable for asking practical questions like: which hospitals and which services must work all week?
The DoH think they can afford to be complacent about losing home-grown junior doctors because they know that there is a never-ending supply of foreign doctors who want to work in the NHS.
Some come for specialist training and sometimes return home. The majority come to work in the UK because they understand that the salaries, pensions and working conditions in UK are better than anything achievable in their own countries.
As a result, foreign-trained doctors have become an essential component of the NHS workforce and make an invaluable contribution.
Anger: Demonstrators march during the Let's Save the NHS rally and protest march by junior doctors on October 17 in London. For the last half century, the UK has not trained nearly enough doctors for its own needs
For the last half century, the UK has not trained nearly enough doctors for its own needs, a situation recently exacerbated by the European Working Time Directive.
The GMC registers about 13,000 new doctors every year. About 7,000 graduate from British medical schools and about 5,000 have qualified abroad.
Historically, foreign graduates have come from India, Pakistan, South Africa and Nigeria but recently most come from the EU and from countries worst affected by austerity.
As primary medical qualifications are reciprocally accepted throughout the EU, all European doctors are automatically entitled to register with the GMC without any checks of competence or language proficiency.
The concern is that entry criteria for some European medical schools may not be as rigorous as our own and the GMC has no control over quality measures such as curriculum and number of training hours.
The result is that doctors from Eastern Europe are flocking to UK and other wealthy European countries.
For example, the Romanian health service is facing a crisis because thousands of doctors are leaving.
The Romanian College of Physicians have reported that in 2011, there were 21,400 doctors working in Romanian hospitals. This number had reduced to 14,400 by 2013.
In 2014, the Polish ambassador to UK appealed on the Today programme, for the 2,300 Polish doctors working in UK to return home.
Greece has almost twice the number of practicing doctors per capita (6.1 per 1,000 population) compared to the EU average of 3.4 per 1,000. (The UK has 2.8 doctors per 1,000).
Shouting: Another view of the rally in London earlier this month. The current contractual dispute between the Government and junior doctors is of serious concern and could have irreversible consequences
In 2015, there were 3,514 Greek doctors practicing in UK. For reasons of austerity, the Greek health service is contracting rapidly and therefore it is likely that many more doctors will transfer.
Doctors from outside the EU have to pass the Professional Linguistics Assessments Board (Plab) examination but this bar may not be high enough to ensure that all international medical graduates are safe to practice in the UK and can communicate adequately.
Raising Plab pass marks is needed to ensure patient safety in the NHS.
There is evidence that some foreign-trained doctors are less competent than their British counterparts.
Research published in the British Medical Journal last year showed that only 20 per cent of international graduates achieved the average standard of UK graduates in some postgraduate examinations, although the scores of the highest performing international graduates did not differ significantly from those of UK graduates.
With these facts in mind, why don’t we value and cherish our junior doctors by providing the conditions, the training and the environment, which does not tempt them to emigrate?
Why don’t we maximise the benefits from our investment in their education and training?
Why don’t we train enough doctors for our own needs? Is there an important moral dimension to continuously luring doctors from abroad thereby depriving poorer countries of skills, often desperately needed and paid for locally?
In 2013, there were 1,800 hopeful British students with the required A-level grades, who could not find places in our medical schools. What a waste of talent and enthusiasm.
Where is our long-term strategy for medical education?
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