Letter to Times (18th July)

Junior doctor shambles threatens the NHS Sir, Last week a ministerial statement confirmed that almost half this year’s applicants under the junior doctors’ career and appointments system have had their careers in UK medicine abruptly cut short. This stark fact was transmuted by the subsequent press release into “good news”, because 85 per cent of available jobs will be filled by August 1. Even if this obfuscation of job-fill with appointment rates were true – and we believe it is a gross overestimate – it fails to acknowledge that a 15 per cent vacancy rate is ten times that of previous years in most specialties. Alarmed at so many posts being vacant on August 1, the Department of Health gives trusts two weeks to manage what the hugely expensive national competition failed to achieve in six months. Before August, trusts are ordered to find somewhere to shuffle 10,000 doctors for three months until the current crisis is past, and these doctors can then be quietly lost from the NHS for ever. Our poll shows that one third of the 4,000 who have not found jobs as doctors are among our very best graduates, with either a first-class degree or distinction. This cull of the best happened because the best graduates naturally apply for the most competitive posts and the new system randomly limited half of the applicants to just one interview. This new career structure is a top-down straitjacket forcing doctors to choose immutably their area of training merely two years after qualification. Hundreds of doctors now face transportation for seven years to posts geographically remote from their families. Although the professionalism of doctors will save the NHS from chaos in August, the NHS cannot be saved in the long term from the consequences of culling 30 per cent of our best doctors. Some flexibility and free market in posts must be reintroduced into training and appointments. Those discarded this year should be guaranteed the right to compete again on a level playing field for the next rung up on the career ladder. MORRIS BROWN, Professor of Clinical Pharmacology, Cambridge PETER BARNES, FRS, Professor of Respiratory Medicine, Imperial College NICHOLAS BOON, President Cardiovascular Society NICHOLAS BROOKS, Past-President Cardiovascular Society JOHN CAMM, Professor of Clinical Cardiology, St George's Hospital MARK CAULFIELD, Professor of Clinical Pharmacology, Queen Mary London ANGUS DALGLEISH, Professor of Oncology, St George’s Hospital JON FRIEDLAND, Professor of Infectious Diseases and Immunity, Imperial College JOHN GIBSON, Professor of Respiratory Medicine, Newcastle ASHLEY GROSSMAN, Professor of Endocrinology, Queen Mary London TONY HEAGERTY, Professor of Medicine, Manchester HUMPHREY HODGSON, Vice-Dean, RFUCMS JUAN CARLOS KASKI, Professor of Cardiovascular Science, St George's Hospital CHRISTOPHER KENNARD, Vice Principal, Charing Cross Hospital KAY-TEE KHAW, CBE, Professor of Clinical Gerontology, Cambridge JOHN LAZARUS, Professor of Clinical Endocrinology, Cardiff STAFFORD LIGHTMAN, Professor of Medicine, Bristol JIM McKILLOP, Professor of Medicine, Glasgow PETER McCOLLUM, Professor of Vascular Surgery, University of Hull JOHN MONSON, Professor of Surgery, Hull STEPHEN O'RAHILLY FRS, Professor of Medicine and Biochemistry, Cambridge MARK PEPYS FRS, Professor of Medicine, RFUCMS RODNEY PHILLIPS, Professor of Clinical Medicine, Oxford PHILIP POOLE-WILSON, Professor of Cardiology, Imperial College JON RHODES, Professor of Medicine, Liverpool JIM RITTER, Professor of Clinical Pharmacology, Kings College London BRIAN ROWLANDS, President of the Association of Surgeons NEIL SCOLDING, Professor of Neurology, Bristol JAMES SCOTT, FRS, Professor of Medicine, Imperial College RAJ THAKKER, Professor of Academic Endocrinology, Oxford DOUGLAS TURNBULL, Professor of Neurology, Newcastle ROBERT WILCOX, Professor of Cardiology, Nottingham MARK WILES, Professor of Neurology, Cardiff LORD WINSTON, Emeritus Professor of Fertility Studies, Imperial College London