U.K.: ELITE DOCTORS LEFT JOBLESS BY "CUTS"

A group of junior doctors selected for a specialist course designed to train the next generation of GPs has been left jobless after offers were withdrawn because of NHS funding cuts. The 29 doctors, who have studied medicine for at least six years, learnt this month that they would not be able to join their three-year course in August. The Innovative Training Posts, the final stage of formal education, were introduced to single out and nurture the best primary-care talent. The course involves two years concentrating on various specialities in hospital medicine and one year as a GP registrar.

The junior doctors, many of whom are burdened with student debts, have been told that they must defer starting the training until February. It remains unclear how the funding shortfall will be remedied by then, when budgets are normally more stretched in the run-up to the end of the financial year. Doctors’ leaders gave warning yesterday that such drastic actions were destroying workforce morale and creating a uncertainty and disaffection with the NHS. They added that the future of healthcare was being severely compromised by the growing financial problems of the health service.

Many of the junior doctors, who qualified for the course after sitting a series of interviews and examinations, have been unable to get interim hospital jobs as all senior house officer positions have been filled. The crisis, caused by budget cuts by the London Deanery and ordered by the Department of Health, is the latest to hit the NHS as it struggles with an annual deficit of more than 500 million pounds.

Richard Savage, course organiser of the Guy’s and St Thomas’ Hospital vocational training scheme, who was involved in the training of three of the doctors, described the action as outrageous. “The bureaucracy in the NHS is now so disjointed that there is no forward planning,” he said. “It is simply worked from one financial year to the next.” The British Medical Association (BMA) said that it was seeking the urgent intervention of Lord Warner, the Health Minister, to resurrect the training of would-be GPs, who were from around the country and to be based in London.

Hamish Meldrum, the chairman of the GPs’ committee of the BMA, said that even if they managed to restart the course next year, the precedent was very dangerous and left them few employment prospects in the meantime. “Underlying this story is the problem that doctors’ training is under growing financial pressure,” Dr Meldrum said. “The country is crying out for fully trained GPs. It would be a tragedy not just for these doctors but also for patients and the wider NHS if medical training is cut as a result of NHS deficits.”

The London Deanery and the Department of Health denied that the course was being cut and said that they expected the students to begin their training in the new year. “We are reassured that the deanery is working with the BMA and doctors affected to offer them careers advice and support so that this has as little impact on their professional and personal circumstances as possible,” a department spokeswoman said

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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