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Modernising Medical Careers

I wish to make a statement about modernising medical careers. In my written statement to the House on 15 May 2007, I announced the plans for making offers in the first round and the principle behind the further round of the modernising medical careers specialist recruitment. I welcome yesterday’s decision by the High Court in the judicial review brought by Remedy UK while, of course, acknowledging the criticisms that the judgment contains. I also welcome the decision of Remedy UK not to appeal against the judgment. I will consider the comments of Mr. Justice Goldring on costs. I well understand the uncertainty that problems with the medical training application system have caused junior doctors and their families. We need to ensure that we learn the lessons from what has happened, which is why I asked Sir John Tooke to establish an independent review. The membership of that review has now been agreed, and I have placed a copy of Sir John’s announcement in the Library. Following the court’s decision, I am pleased to say that offers for the extended first round of specialist recruitment will start today. Interviews for the current round should be completed by the end of this month and all initial offers for hospital specialties will be made locally by the postgraduate deaneries between now and 7 June. Successful candidates might receive more than one offer. They will be able to wait until all their offers are received, allowing them to consider their options before making a decision on which to accept. Initial offers must be accepted or declined before midnight on 10 June. Following that deadline, training places that have been declined will be re-offered to the next highest-ranked appointable candidates. Those additional offers will be made from Monday 11 June until Wednesday 20 June. At its meeting on 9 May, the review group agreed a set of principles upon which the continued recruitment of specialist medical trainees this year would be based. These principles are fully supported by the deaneries, NHS employers—and, of course, the Department of Health—and are set out in a letter of 22 May that was sent to all applicants, a copy of which I have also placed in the Library. That further recruitment round will be locally planned and managed. Although there will not be a national allocation and matching system for appointments, MTAS will continue to be used by deaneries for administration and monitoring. As in the extended round 1, applicants will be provided with information on the competition ratios for each post to assist them in deciding where to apply. The number of posts available in the further recruitment round will, of course, depend upon the outcome of round 1, but will be substantial. In particular, the Douglas review group has stressed that there are fewer ST3 posts available at the moment than should be expected for the number of doctors well advanced in their specialist training. Following the review group’s recommendations and with its full agreement, we will be creating 200 additional run-through training programmes for those doctors who have already invested several years in training for their chosen specialty. For example, it is proposed that 20 new posts will be added to the 100 already available this year in cardiology, 19 new posts will be added to the 30 already available in neurology, and so on. We are in discussion with the review group and the appropriate royal colleges to finalise the details, which will take into account the needs of the NHS, as well as junior doctors. I have already told the House that we will support junior doctors during this further appointment process, including especially those whose current contracts come to an end within it. We are working with strategic health authorities to ensure that all applicants currently in NHS employment will continue to have employment while they progress through the next round. In addition to the extra run-through programmes that I have announced, we have also accepted the recommendation of the review group to create further additional training opportunities for those junior doctors who are appointable to specialist training, but for whom training opportunities may not otherwise be available this year. For those who have successfully completed the MMC foundation training programme and who demonstrate their ability to progress, there will be new training programmes through one-year fixed term appointments. We are asking PMETB to expedite the approval of both the extra fixed-term and run-through programmes. There will also be a range of sponsored training programmes available to enable doctors either to get an additional year’s experience in their chosen specialty or to choose to gain experience in a different specialty, thus giving them all a better chance to apply and secure a training programme next year. The strategic health authorities will manage the process and work with trusts, deaneries and royal colleges to determine the types of opportunities that they will make available. All those posts will be based on local service requirements and future work force planning needs. Funding to support those training opportunities will come from the Department and SHAs. At the end of the further recruitment process, there will remain a number of applicants who have been unable to demonstrate this year that they are suitable for the specialist training programmes. Many will remain in their current service posts while others will be able to apply for the non-training service posts vacated by those moving into training posts. SHAs and trusts will work together to match doctors to posts across each region. I believe we now have the right way forward both to give junior doctors the support and opportunities they need, and to ensure that the NHS has the right doctors in place to continue providing excellent care to patients. The result is that there will be more junior doctors in specialty and GP training than ever before. I am extremely grateful to Professor Douglas, the medical royal colleges, the BMA and other members of the review group for their help and support in resolving this difficult situation.