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Modernising Medical Careers

I beg to move, To leave out from ““House? to the end of the Question, and to add instead thereof:"““recognises the international reputation for excellence of medical training in the UK; acknowledges the need to modernise medical careers to ensure all doctors are properly trained to nationally recognised standards, including a fairer and more transparent process for applying for specialist training; notes that Modernising Medical Careers (MMC) will deliver training to a consistently high standard which, combined with the expansion of the number of doctors, will provide high quality safe care by appropriate skilled medical staff; notes the wide consultation that took place on MMC and the strong support for the need to improve doctors’ training amongst doctors’ representatives including the medical royal colleges and the British Medical Association; welcomes the external review that is already being conducted into how MMC has worked to date and the changes made as a result; and supports the longer term review recently announced to ensure MMC works well in the future.?" Let me begin by stressing, as I did last week, that my ministerial colleagues and I are in no doubt about the distress, anxiety and uncertainty that has been caused to junior doctors by the problems with this year’s applications system. Those problems should not have arisen, but they have, and we are all—Ministers, officials in the Department, the medical royal colleges, the British Medical Association, the post-graduate deaneries—completely focused on sorting them out so that, as I said to the House last week, we have a system for this year that is fair to junior doctors and enables the NHS to make the right appointments to all the posts involved. In addition to the urgent questions that the hon. Member for South Cambridgeshire (Mr. Lansley) mentioned, there have already been three written ministerial statements as well as last week’s oral statement. I will, of course, continue to update the House on the work of the review group under the leadership of Professor Neil Douglas, which will remain in existence while we continue to sort out the problems that have arisen with this year’s applications system. Before I return to the question of the applications system and look forward to Sir John Tooke’s review, I want to say a little more about the new medical training system and what it replaces. As on previous occasions, the hon. Gentleman has simply understated the very real problems of the old system that modernising medical careers replaces. That system, as the whole House would acknowledge, has always produced outstanding doctors for the NHS, many of them world leaders. However, that system was also wasteful, inconsistent, often unfair and, indeed, as the Royal College of Surgeons said several years ago, ““most unsatisfactory?. Some junior doctors had to apply for a new training post every six months. They were sending in different applications in different formats to different hospitals and different post-graduate deaneries at different times of the year. There was no proper national curriculum and no standardised assessment process. It has always been the case that, because of the intense competition for medical training posts, junior doctors who could not secure the senior house officer job that they wanted found themselves filling in time in the wrong post—from the point of view of the skills that they wanted to develop—in non-training posts or as a locum. Sometimes, as Conservative Members pointed out, they had to do so for years on end. Remedy UK, the newly formed group that has been so critical—and understandably so—of this year’s problems says in its briefing paper on MMC that many of those in the old senior house officer job were in short-term or non-training posts or endured poorly planned training with no clearly defined end-points. There were certainly deficiencies in the selection and appointment procedures, along with inadequate supervision, assessment and career advice. It was precisely because of those problems that, following the leadership of the chief medical officer, the Department of Health sat down with the medical royal colleges, with the British Medical Association, with the post-graduate deaneries and others—including, of course, representatives of the junior doctors—to devise modernising medical careers, which almost everybody agrees is the right way forward. Indeed, Professor Douglas’s review group has confirmed that.