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So what does the medical profession make of that “compromise” announced by the Review Group?

As can be seen, respondents to my little poll have been predominantly negative. Quite a few other medical writers have come out against it.

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The Guardian feels that it has failed to placate junior doctors with Tom Dolphin from the BMA asking people to hold their nose & accept it, in the same way that they voted for Labour last time maybe? If so they ought to remember what they ended up with.

Dr Tom Dolphin, of the BMA’s junior doctors’ committee, said the deal struck with the government was a case of “salvaging something from a disastrous system” and ensuring that “the smallest number of individuals are harmed and the smallest numbers of families broken up”.

You have made a cynical calculation of mitigating harm while still allowing the system to continue. Indefensible really.

Dr Dolphin told BBC Radio 4’s Today programme: “This is far from perfect, but it’s better than it was. The way that it is being done, people are having to choose where in the country they apply to and they are very broad geographical areas they have to choose. So although you may apply to London that would be anywhere from Milton Keynes to Brighton.

What comes first to the BMA, the interests of those it represents or saving the skins of those who messed up?

Dr Dolphin added: “The concerns of the profession have been ignored really for political reasons and I can’t really defend any of it and I’m not going to try. Obviously things must be pretty bad for a secretary of state to have to apologise and we are hoping things will get better, but it’s still a bit of a disaster.”

Which begs the question, are you intent on salvaging scraps out of this disaster or are you interested in seeing justice done?

The Times has the BMA again urging acceptance as the practical way forward.

The British Medical Association gave its approval. Jo Hilborne, chairman of the BMA’s Junior Doctors’ Committee, said that the move was “a practical way forward”. Jonathan Fielden, Chairman of the BMA’s Consultants Committee, said that it was the most practical way to secure a fair outcome for junior doctors

What, have the review group realised that they have very little credibility & signed on the spineless buffoons at the BMA to do their PR for them? And this talk of “practical way” makes my skin crawl.

Does too much brown-nosing as a medical politician leave people morally challenged? Witness this exhibition from the JDC, Simon Eccles who was its immediate past chair & previously Andrew Hobart though he has been staying out of the limelight these days. Nizam Mamode appeared to be cut from different cloth but he did not make it in the rough & tumble world of the general membership. May be worth standing again Nizam.

We haven’t heard yet from Remedy UK but it is worth highlighting again the article in the Times from Morris Brown et al. The problem is not just MTAS, that is only a side-show. The real problem is MMC.

“This is the week for grass-roots democracy to act,” say the 23, led by Morris Brown, Professor of Clinical Pharmacology at Cambridge.

“MTAS cannot progress without participation by individual consultants in interviews.

“We hope they will say no, that individual trusts will ballot their consultants, and that medical directors and chief executives, putting patient care first, will say no.”

As the Times is alone among the broadsheets in catching up with Shelley Heard’s resignation.

MMC360 has been collecting various interesting letters & there is also blog with a satirical take on the MMC / MTAS issues where this image comes from:

But this letter from Neil Douglas attempts to defend the indefensible:

05/04/07 Letter form Neil Douglas, Chair of the Review Group
Letter to all English Consultant fellows and members

Dear colleague

As you will understand, my position as Chairman of the Review Group has hindered my ability to communicate with you about the selection process for Specialty Training. I am grateful to all of you who have written with evidence of problems and possible solutions. The views are divergent but the anger and frustration universal. In trying to reach a way forward the Review Group has concentrated on trying to be fair to all candidates and maximising their choice within the real constraints of the system. I attach the letter from the Review Group to all consultants in England outlining our proposals which have been accepted by Ministers, the Colleges and the BMA. I would like to thank all of you who have worked so hard in short-listing, interviewing and counselling understandably distressed applicants in this process thus far and ask for your continuing support for the extended round 1.

The Review Group has also followed exactly the two principles as stated in Morris Brown and colleagues’ letter in the Times yesterday. The first was that selection is based on the use of objective criteria which recognise scholarly and clinical achievement – the Academy representative got a decision from Patricia Hewitt on March 5th that all appointments and interviews would henceforth be based on CVs and probing questions and the Review Group has now agreed that selection in Round 2 will be based on CVs. Their other principle was flexibility in training programmes – and again the Review Group has agreed that increased flexibility in MMC is mandatory. The original ideals of Unfinished Business with broadly based early years narrowing towards specialty later have been abandoned in the implementation of MMC, with the clear exception of Medicine where Core Medical Training leading to 28 specialties offers precisely this. However the flexibility needs to be much greater and more transparent so that those who find themselves in the wrong specialty can readily transfer into another training pathway taking with them the relevant competencies that they have acquired.

Having rejected the option of abandoning the whole appointments process (as I have previously reported), the Review Group seriously considered giving all applicant 4 interviews in England but the numbers and time involved were so large that this was deemed totally impractical. We believe that the way forward agreed yesterday is the best answer to a very difficult situation and one which allows this generation of trainees to have the best chance of getting onto their chosen career ladder expeditiously. The Review Group is still working on the details of Round 2, on how to increase flexibility in MMC and on the support needed for all applicants, both successful and unsuccessful. We are also keen to initiate a more realistic process to plan how many trained doctors the UK will need in the future, a key factor in determining the number of training posts available. On a personal level I am far from convinced that so called “manpower planning” in the NHS is at all fit for purpose and the profession must unite to make a robust case for the employment of a greater number of trained doctors – in this context consultants – in the future. I also remain concerned that the balance of posts in medicine between ST1+2 in comparison to ST3 has not created enough training opportunities for those applying to ST3. Many of these are excellent committed specialist trainees and we need careful exploration of whether manpower needs mean there should be more training posts for them. Specialty specific issues will be addressed by the review group in the next 2 weeks.

I urge you to support these proposals and to participate in the remaining interviews. I believe this offers the only realistic hope of getting the best trainees into appropriate training posts, only then will their understandable anxieties be allayed.

With kind regards and Happy Easter

Neil Douglas

I have asked time and again for the evidence base upon which these decisions were made & the submissions to the group from the deaneries / DoH etc. to be made public. You have lost our trust Mr Douglas & we demand to see the evidence before we put the future of the profession into your hands.

Taking a step back from MMC / MTAS, there is a defence of the parallel trade in medicines in the Times.

Opponents of the new direct-to-pharmacy model, which makes UniChem the sole UK distributor of all Pfizer products, assert that one of its main aims is to stamp out parallel trade. The legal practice — fiercely opposed by drugmakers — entails wholesalers purchasing branded medicines in low-cost countries within the EU and exporting them at a profit to other countries. But the association, which is fighting legal actions over the issue with big drug companies in Spain, says that parallel trade encourages competition and drives down the prices paid for drugs both for consumers and the NHS, which spends £8 billion a year on branded pharmaceuticals.

The EU decision in the case of Levi Strauss vs. Tesco is sorely regretted.

The BBC finally catches up with the debacle of the Atos Origin diagnostics deal in the North West with the recall of over 900 patients for repeat scanning in NHS facilities.

And the British Orthopaedic Association rejects the idea of moving surgical instrument sterilisation into super centres across the country. Already instruments arrive in theatre inadequately cleaned & up-to 3 sets have to be opened to allow one operation to proceed. If this move happens, the rest of the cases on the list would have to be cancelled as there wouldn’t be enough time to get instruments re-sterilised or new packs delivered. Or is the DoH happy to supply redundant sets of equipment for every procedure? I wont over-spec this but 3 sets per procedure ought to be a good start.

In January, new figures obtained by Conservative MP Grant Shapps showed there had been a big increase in the number of operations cancelled due to a lack of sterile surgical instruments.

A total of 1,765 operations were cancelled in 2005/06 - up 40% from 1,252 in 2002/03.

While the HSJ has a couple of snippets of information buried within.

Professor Martin Roland, director of the National Primary Care Research and Development Centre at Manchester University was commissioned by the Department of Health to review the Expert Patients Programme which was launched as a social enterprise a few days ago. He is surprised to see the DoH quote an unverified internal evaluation to justify the programme when his rigourously conducted research showed that there was “no impact on the use of routine health services, such as GP consultations and outpatient visits.”

Nothing new there Doc, ignoring anything that goes against their pre-conceived ideas & pet projects is a favourite DoH trick.

And in another vignette, there is an admission from Bob Ricketts, Department of Health head of demand-side reform that “there could be problems with the nuts and bolts” of the new commissioning framework for health and well-being.

And the recent GPC guidance is being criticised in the Daily Mail & the FT

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This entry was posted on Friday, April 6th, 2007 at 8:48 am and is filed under Clinical, NHS, Politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.