Like a firm of cowboy builders, the government has been casually knocking down the structures of the NHS without any serious thought to the problems it causes elsewhere. Take medical education and training for example. It is like Lansley and Co scratched their heads following the plan to demolish Strategic Health Authorities, wondered how they were going to stop the system of delivering medical education and training from collapsing, before coming up with the fudge set out in, “Developing the Healthcare Workforce”.
The BMA, along with many other concerned organisations have submitted their views on the government reforms to the listening exercise. The Junior Doctors Committee also wrote to Steve Field, the Chairman of NHS Future Forum outlining our views on their plans to change the structures that deliver medical education and training. Our concerns focused on the fate of deaneries, highlighting the importance of maintaining the current levels of expertise. We cannot afford for deaneries to go the way of PCTs which are being run down before the legislation has even been through parliament.
The proposals to break up the functions of deaneries and deal them out to different parts of the NHS are a disaster waiting to happen. In the short term disruption to the recruitment to training programs will be inevitable. With just four months before key decisions will have to be made on recruitment for 2012 the uncertainty that surrounds the fate of deaneries could throw the whole process into chaos.
In the long term there will be serious disruption to the supply of fully trained specialists. The removal of the regional oversight of deaneries, leaving local trust-led skills networks responsible for training will result in the divergence of quality standards. Workforce planning can not be left to chance – we need dialogue between all four UK nations to ensure the all patients are seen by well trained doctors wherever they live.
The government reforms have ignored the hard work that has gone into improving the recruitment process since the massive failure of the Medical Training Application Service (MTAS). Deaneries do not need to be abolished simply because SHAs are going. They could be rehoused in educational institutions or made into special health authorities.
It is a shame Lansley and Co did not seek the advice of the medical profession. They must now face up to the fact that they are out of their depth on this ill conceived reconstruction project and listen to the experts.