On Question Time on 3 May, 2007, the Secretary of State for Health Patricia Hewitt, invited people to send her their questions, via the programme, about the NHS.
As a result, the BBC Question Time team received over 1,000 emails, many of which were from junior doctors disillusioned with the current interview process.
Here she answers a representative selection of the questions sent:
Q: You have apologised three times in the House of Commons for the distress caused to young doctors by the MTAS failures. There is much evidence to prove that the interview system is deeply unfair and two key figures, Alan Crockard and Shelley Heard, have resigned in protest at the shambles. Please can you explain why you insist in going on trying to patch up a seriously flawed system?
Why not stop it now, find an alternative to protect patient care in August, save thousands of young doctors' careers and take a fresh look at how to implement MMC, which many doctors support? You could redeem your reputation overnight by doing this.
Amanda Willmott, Honiton
A: As soon as the scale of the problem became clear, we set up a review group led by Professor Neil Douglas, vice-president of the Academy of Medical Royal Colleges, with representatives of the Royal Colleges and the BMA, including junior doctors. The first thing they looked at was the possibility of pulling out of the current selection process completely. In the end, they decided that was simply not a credible option since it would be impossible to place the best candidates in posts and fulfil the service needs in time for August using the old system.
Instead, every candidate will be offered at least one interview, for their first choice of post, and over 15,000 extra interviews are now taking place, on top of the 40,000 or so interviewed already carried out. The review group also confirmed what you say, that the problem is the
selection system - MTAS - rather than the underlying principle of MMC. But
I have also established an independent review, led by Professor Sir John
Tooke, Dean of the Peninsula medical school, to take a fresh look at how to implement MMC.
Q: If as you say that the Royal Colleges and BMA were in agreement with MMC/MTAS, then why is there a petition with over 3,500 signatures saying to stop MMC and why were consultants not told the full story as to what they agreed to with regard to reforms?
Eleanor Tiangga, London
A: Professor Douglas and his review group colleagues said themselves that the principles of Modernising Medical Careers (MMC) continue to secure widespread support among professional leaders in the Royal Colleges and the BMA.
Q: Does the Secretary of State consider, that the restriction in the MTAS review to a single interview per candidate respects the rights and equal opportunities of training doctors? Does she not realise that the rigidity inherent in this selection process not only reduces the flexibility of training, but is also extremely family-unfriendly and will consequently downgrade the quality of the workforce on which the future of the NHS depends?
And would it not be more correct and efficient to reproduce a system of selection adopted in most European countries, whereby the allocation of posts is defined by a numerical order of candidates determined by their success at postgraduate examinations, a structured CV, and concrete criteria (diametrically the contrary of the present system). Why reinvent the wheel?
Ivan J Walton, London
A: The MTAS review group itself - including junior doctor representatives - decided that giving every applicant at least one interview, for their first choice of post, was the fairest solution to the problems created by the new system. They also decided that applicants should be able to change their first preference, and thousands have now done so.
Not all training posts will be filled in the first round of interviews, which are still taking place at the moment, and the review group is now looking at arrangements for the second round of interviews and job offers. Of course we need to learn the lessons for the future and both Professor
Douglas' review group and the Tooke inquiry will ensure we do so.
Q: Does the SoS for Health think that the rock bottom morale among healthcare professionals, including junior doctors, will impact on patient care?
Dr David Woolf, London
A: I know that the very serious problems with MTAS have caused dreadful anxiety and uncertainty to junior doctors. Of course that has an impact on people's morale. But I don't have to tell you that doctors and other NHS staff have an outstanding professional commitment and dedication to patients. I believe that is why, even after a year when the NHS has had to make difficult decisions to deal with over-spending and get back into financial balance, patients' satisfaction with the care you and your colleagues provide continues to increase.
Q: On Question Time (Thursday, 26th April), Caroline Flint, health minister, stated quite clearly: "If you make an allegation, back it up with evidence and we'll investigate". This may sound straightforward, however, it should be said that there is a problem with this procedure, in that the burden to present compelling evidence seems to be required prior to any inquiry taking place. Caroline Flint went on to say: "I think you need to have the evidence to put forward, to, I think have an inquiry because I think there is a problem of people just asking for inquiries on the basis of speculation┐".
It is clear that the Department of Health (DoH) are rather fond of hiding behind this Catch-22-style situation and they have been known to help perpetuate this by withholding key evidence required by the haemophiliac community infected with HIV and Hepatitis C after receiving contaminated blood products under the NHS. How can there ever be a government-initiated inquiry into the contaminated blood catastrophe when the evidence required to provoke such an inquiry is still being suppressed?
A considerable amount of documentation has been released under the Freedom of Information Act and contained within this material was more than enough damning evidence which the Department of Health should surely have been privy to over the years, and particularly since July 2006.
Speculation aside, infected and affected persons with haemophilia have issued a sharp accusation-based polemic against the government, the DoH and the medical profession. Yet, despite thoroughly backing-up such allegations with empirical evidence, the DoH remains silent.
Copies of Tainted Blood's "accusations documents" were sent to most senior officials at the DoH and we also know that a copy was forwarded to you from the Private Office of Her Majesty The Queen. Do you think it is fair or courteous not to respond?
I now urge the secretary of state for health to make an immediate statement, followed by expeditious action, whether in the form of a government inquiry, criminal prosecutions or other remedial measures.
Andrew March, UK
A: Terrible suffering has been caused to many haemophiliacs who were infected with hepatitis C or HIV through NHS treatment in the 1970s and early 1980s. That is why we set up the hepatitis C ex-gratia financial assistance scheme in July 2004, with the Macfarlane Trust supporting patients infected with HIV and their families.
There is a very substantial published body of evidence on the state of
medical knowledge in the 1970s and early 1980s when non-A, non-B hepatitis (later known as hepatitis C) was initially viewed as a mild disease. The treatment that the NHS gave at the time was in line with that medical knowledge, which only changed as a result of research during the1980s.
As you say, the Department of Health has already released a great deal of
information on this matter. The Department has also reviewed all the papers it holds between 1970 to 1985 that refer to non-A, non-B hepatitis. A copy of the review document will be made available on request to the