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Last Updated: Tuesday, 15 May 2007, 07:11 GMT 08:11 UK
Recruitment row 'risks patients'
By Adam Brimelow
BBC News, Health corrrespondent

Junior doctor
Doctors say the recruitment process is deeply flawed
Leading consultants have warned the continuing crisis over junior doctors' training could potentially put the quality of patients' care at risk.

They say the system for recruitment is deeply flawed.

And they are particularly worried about continuity of care when teams of newly appointed doctors take up their posts in August.

Concessions by the government over interviews for training places have failed to allay their concerns.

We want to make sure that patient care does not fall between the cracks of this problem
Professor Humphrey Hodgson

The training reforms for doctors have already run into serious trouble with many complaining about a lack of posts, poorly designed recruitment forms and technical failures with the online application system.

The doctors are angry about the way everyone has been made to apply for training places at the same time, rather than the old rolling recruitment process which allowed them to keep on trying for jobs as they came up.

They say those who miss out this time won't be able to get back on the career ladder towards becoming a consultant.

A trainee surgeon based in north west London, Dr Matt Jameson Evans, says the whole process has gone from bad to worse.

He said: "I've experienced what everyone had, which is a completely inappropriate selection procedure, wrongly weighted questions whereby a creative essay of a 150 words counts for more than a three-year PhD.

"I have experienced the crashes of the system, I've experienced the worries about my data protection, I've experienced the absolute chaos and consternation around me, and now the interview process which causes further concerns."

Court challenge

Dr Jameson Evans is a member of a group of junior doctors called Remedy UK which is challenging the new training arrangements in court this week.

They have support across the profession - amid concerns that patient care will suffer.

HAVE YOUR SAY
Doctors should be subject to market forces
Brendan Webster, Weymouth

A group of leading consultants has warned the NHS faces a huge and potentially dangerous upheaval on 1 August, as completely new teams of doctors take up their posts.

Professor Humphrey Hodgson, a liver specialist at the Royal Free hospital in north west London, said the continuity of care provided under the old recruitment system will disappear.

He said: "Think of the complexities of any one individual sitting in a hospital with a combination of physical problems, psychological problems, social problems.

"The thought that all of that, and all the knowledge that is within the team that is looking after them, could be transferred seamlessly to an incoming completely different team with no overlap - well it won't happen, and something will fall through the net."

Online survey

Eighteen leading specialists, including Professor Hodgson, have organised an online survey of doctors which drew 3,500 responses.

The big problem throughout all of this has been the intransigence of the government
Dr Jo Hillborne
British Medical Association

It was a self-selecting sample, but an interesting gauge of where opinion in the profession is moving.

Eighty-five per cent of consultants who took part backed a boycott of recruitment interviews.

Ninety per cent expressed no confidence in the health secretary and chief medical officer.

The BBC has also learned - ahead of publication in the Lancet - that nearly four out of five backed a delay in the whole recruitment process until it can be properly sorted out.

Professor Hodgson said urgent action was needed.

"We are in damage limitation in which we want to make sure that patient care does not fall between the cracks of this problem and I think that some overlap between staff is important."

BMA criticised

In a further sign of the mood of militancy, 72% of those who took part in the survey disapproved of the way the doctors union - the British Medical Association - had handled the situation.

It has not backed this week's legal challenge by Remedy UK.

But its junior doctors spokesman, Dr Jo Hillborne, said it warned ministers of problems ahead well before the crisis erupted.

She said it is now too late to start again from scratch.

"Unfortunately it takes two people to make a result happen.

"It takes the people who are raising the problems and it takes the will of the people with whom the problems are being raised.

"And the big problem throughout all of this has been the intransigence of the government and its unwillingness to listen to the views of the profession, to take on board our clearly and regularly and loudly expressed reservations and to act."

The government said it will issue a ministerial statement on the training reforms and the doctors job-application process shortly.

Andrew Lansley, the Shadow Health Secretary, urged the government to listen to consultants, and warned of "serious pressures" in August.


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