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Modernising Medical Careers

The county town of Stafford employs a high proportion of public sector workers because it is an administrative centre. There are workers in local government, the hospitals, the university and so on. That means that, when a problem arises in the public sector—be it last year’s efforts, which were especially bitter in Stafford, to try to deal with deficits in health trusts, or junior doctors this year struggling to find a training post and feeling that they have been badly treated—it affects not only those who work in a hospital trust or another health setting, but a large proportion of the public because of their affinity with the public sector generally. That might apply to the Member of Parliament who has such an affinity because of political values, the workers because they work in the public sector, and the public, who come into contact with public services perhaps more than in other areas because of Stafford’s higher than normal proportion of jobs in the public sector. The subject of the debate is therefore generally a serious issue for Stafford. I am happy to explain that that is one of the reasons for my participation this afternoon. However, people obviously want to bring the debate to the personal level. In preparation for the last week’s return to Parliament and the Secretary of State’s statement and today’s debate, I met the junior doctors’ leader in Stafford, local NHS managers and local providers of health education. Like many hon. Members, I have also met a junior doctor from my constituency who lobbied me about his personal circumstances, and representatives of the campaign that Remedy UK has organised for today. I am pleased to have an opportunity to take part in the debate to support the points that they made to me. It is worth starting from the point of view expressed in the original words of the motion. What has been extraordinary about the history of medical training in this country is that it suffered its share of severe underfunding for decades before 1997, which led to a shortage of training places. That led, in turn, to a shortage of qualified doctors, consultants and nurses in the NHS, which created quite a challenge for the new Government, who were committed to improving the situation very quickly. Although the Government could turn on the tap for more money to pay for more doctors, nurses and consultants, there were not enough of them to recruit because the training places had been cut for years before. That is an important point for hon. Members to take into account about the history of how we came to be in the present situation. The obvious corollary at the time was that because the money was made available and the posts were there to be filled, we recruited outside the country to fill the vacant posts. That is relevant because while people talk about the double cohort of people coming through to training posts now and the senior house officers also looking for a training post, we also have the added pressure of non-EU citizens in this country whom we recruited who still want jobs in the NHS. There was something of a failed attempt by the Government last year to squeeze them out. That in itself was hurtful to quite a large number of my constituents who came from the Indian subcontinent in order to work in this country because we needed them. All those points should be taken into account when we reflect on the situation today. It is a good thing, is it not, that more people are in training, completing it and coming forward in greater numbers? It is also a good thing that recruitment and retention generally in the NHS has been good over the past few years. I hesitate to say that it is good now, because I am not reading a Labour party brief and want to tell it as it is. Obviously, the Government’s insistence on getting rid of deep-seated deficits, which started last year—an insistence, incidentally, that I support wholeheartedly—has led to a crash in recruitment and retention. That provides a further additional pressure—on top of the three that I have already identified—when it comes to the training places available for junior doctors now. It is easy to add them up and see that four pressures have all come to bear this year on the problem of the number of places available for the junior doctors who are seeking them. The review body, comprising all the bodies that the Secretary of State described, and then Ministers took the decision that this year is the year in which modernising medical careers for junior doctors should kick in. It is certainly a difficult year. In the looking back that the hon. Member for North Norfolk (Norman Lamb) called for, and in seeking attributions of blame for the current situation, a good question to pursue would be whether there was any opportunity to hold back from making it this year. However, it is fair to say that modernising medical careers is the right thing to do and has gained widespread support. It is remarkable that no one in today’s debate has asked to turn back the clock and go back to the previous system. Every hon. Member has spoken about how MMC could have been introduced more effectively and how it should be improved in future years. In some areas of recruitment—before it was applied to junior doctors—it has been implemented without the sort of reaction that we are talking about today. General practitioners two years ago provide a good example of that. When I met the leader of the Stafford junior doctors, she drew my attention to certain issues that I strongly support. First, for example, it is right to standardise training standards for junior doctors seeking specialty posts. It is also probably right in this day and age for there to be an online system. It reminds me of my adult son and daughter who use the internet, rather than pen and paper, as second nature when it comes to compiling a CV for a job application. Those aspects are right and are here to stay. Other points that we have discussed today, however, included the scoring system, the lack of flexibility, the people who did not get acknowledgements for their online applications and felt that the applications were never read, and the doctors who felt forced to apply for jobs at the other end of the country from their families. All those personal circumstances, which I discussed with the leader of Stafford’s junior doctors, were individual tragedies.