Leaders in medicine working to safeguard the future of medicine

Fidelio is a loose grouping of senior doctors - leaders in medicine, rather than of medicine by dint of their individual roles as Professors and/or Presidents of Specialist Societies. It is not aligned to any of the official bodies with responsibilities for medical training and education, to government or to any political party. Its members therefore feel free to speak without constraint, but responsibly, when they consider that authority is oppressive, unjust and inhumane.

Fidelio was born as a single issue campaign in March 2007, when we started to question publicly the bodies and individuals whom we saw as responsible for, or complicit in, the creation and perpetuation of non-validated, dramatic changes in junior doctor training (MMC) and appointments (MTAS). We consider both to be the fruits of evangelical centralist planning, devolved initially to individuals with more power than ability, and then to the Deaneries with the power only to obey orders. Any potential benefits of MMC and MTAS have been cancelled by an arrogant failure to discuss the details and consequences of these changes with those most likely to be affected – doctors, patients and the general public.

When government introduces major changes affecting the lives of thousands, it is imperative that there is articulate and vocal opposition so that the merits and demerits of both positions can be debated, and those who may be disadvantaged can have their views represented by powerful voices. The Fidelio group has made a point of projecting not just our views, but more importantly the views of the majority as ascertained through a series of online polls. These, together with some of the results, are accessible at http://www.cai.cam.ac.uk/people/mjb14/ . In this electronic age, it is no longer acceptable to object – as we were frequently told – that it is too difficult to sample opinion on complex issues.

A common dictum, ignored at one’s peril, is that change needs to be evolutionary not revolutionary. When the state ignores this advice, alarm bells should ring among constituencies which are threatened. In such times, there must be clear blue water between the state and the bodies who are under attack. The extraordinary feature of MMC, and the statutory seizure of decision-making from the medical Royal Colleges by the PMETB, is that this revolution entailed a naked power battle in which one side appeared to lie down without a fight. We have saluted the inspiration and courage of RemedyUK, who have carried the fight to defend junior doctors. We have had a different and lesser role, liaising with them.

Above all, our aim is to let junior doctors know they are not alone: that there are senior colleagues who share their anguish, and will leave no stone unturned to defend their rights and the future of medical education – in the interests of the service and its patients, present and future.