Is there a threshold of warnings to pass before government or management takes serious note of doctors long-running concerns over their education and training? This concern refers to future generations of doctors throughout their medical career with specific reference to Junior Doctors (“trainee consultants”) in their specialist training progammes. The Scottish Health Secretary has a much better track record of listening to our Scottish NHS concerns than those of her southern counterpart. So, in the light of the upcoming election in May this may be a good time for the medical professionals to make their case clear and expect definitive action.
Patients are actively encouraged to complain about treatment and care and almost immediately an entire apparatus automatically swings into action to investigate the frivolous from the legitimate – and rightly so. Why, therefore, as reported – yet again – in The Herald 30:03:11 are the Royal College of Physicians of Edinburgh (RCPE) making their concerns public – yet again? Are the evidence-based concerns of the most senior physicians not to be held in comparable regard, and action taken similar to that of patients who complain? Reaction to patients complaints without relevant pro-action on the concerns of their doctors serves to prolong medical risk with financial costs to the detriment of NHS spending on improving patient care… a tragic and often fatal false economy perhaps?
Embedded within Scots Law is the ‘duty of care’; within general medical codes are criteria for excellence in professional practice and ethical behaviour; within specific medical specialist colleges – regulations and standards and no doubt within doctors contracts of employment – duties and accountability. Along with countless individual hospital protocols and EU directives it is hardly surprising that the doctors are deeply concerned that their training and employment is being undermined by a variety of constant ‘modernisation’ and change which may perversely prevent them from adhering to their legal and professional codes of medical education and practice.
Have we as patients or potential patients (this includes doctors and nurses!) become so accustomed to being unsurprised by lower standards than we would expect, with ever more simplified access to making a complaint and obtain compensation, chosen to ignore the more subtle growing risks of inadequately prepared Junior Doctors as indicated by the President and Chairwoman of the RCPE. We are losing a high number of new medical graduates who either leave the profession altogether or the country to seek the clinical experience, so difficult to obtain here as Junior Doctors, prior to specialist (consultant) training. A member of my family is one of those hundreds of young doctors gaining valuable experience abroad after his two Foundation Year training programmes and who may or may not return to this country to embark on his specialist training. He and his other medical colleagues were encouraged by senior doctors in this country to gain experience elsewhere to augment their potential and be in a much better position to make a quality judgement and choice of which future specialist career pathway they want to pursue. Junior Doctors are now expected to make premature career choices and once started cannot be changed unless starting the process again. Specialist training now takes only five years compared with the previous ten plus years before becoming consultant material.
The European Working Time Directive has catapulted the already questionable changes to medical education and practice into sharp profile but perhaps only the doctors themselves are aware of the real subtlety and potential dangers for their current and future practice and ultimately - patient safety. Mistakenly, their concerns are put down to scare mongering and shroud waving – but is our health worth ignoring until it’s too late? It’s long past time that we listened to what the doctors are saying – but not through the vested interest filters of politics, NHS management or the MSM. In Scotland we have a good grasp through our Health Secretary – but there is plenty room for improvement. Good health is precious and our doctors want to keep it that way.