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The hon. Gentleman asked about the number of applicants for foundation programme posts whose personal details had been made available in this wholly improper manner to the postgraduate deaneries. The number of medical graduate applicants involved is just over 6,000. He referred specifically to the case of the Surrey-born doctor who was told that he was ineligible. It is not, however, the MTAS system that makes decisions about eligibility; it is the individual deaneries. I understand that that case was raised with the help desksome others certainly wereduring the re-preferencing exercise, and such cases were quite properly referred to the individual deaneries to sort
out. If the hon. Gentleman gives me further details of that case, however, I will ensure that the deanery concerned sorts it out.
We are keeping in close touch with the postgraduate deaneries on this issue, and at this stage we expect the additional 15,500 or so round 1 interviews to be completed by early June. As I have already said, information on the dates for those interviews is already being made available by the individual deans. Appointments will then be confirmedor, where necessary, changedeither directly through MTAS, when it is restored, or through the deaneries making other arrangements to contact the applicants concerned.
Ms Gisela Stuart (Birmingham, Edgbaston) (Lab): I think that those on both sides of the House agree that this was an outrageous security breach. Given that we all rely on IT, and on having access to such websites, is it not incumbent on all agencies, when they come across such security breaches, to alert the authorities rather than to exploit the situation? Am I right in understanding that ITN and Channel 4 News knew about the breach for more than two hours? If so, was it not extraordinarily irresponsible of those broadcasters to exploit that situation rather than notifying the Department of Health so that it could deal with it?
Ms Hewitt: My hon. Friend makes an important point. Of course, Channel 4 News, having been informed of the breach, was entitled to report it. It was a serious security breach, and the programme was entitled to report it; indeed, it might well claim that it had a public responsibility to do so. I agree with my hon. Friend, however, that it also had a responsibility to notify us of that breach urgentlyindeed, immediatelyso that the proper action could be taken to ensure that peoples personal confidential details were not accessed by others who had no right to access them.
Mike Penning (Hemel Hempstead) (Con): This recent debacle will have even more serious effects on family members and loved ones who are trying to get training posts. The BMA said this morning that 34,250 doctors were trying to find posts, but that only 18,500 posts were available. The BMA also said that the vast majoritytwo thirdsof those doctors will not stay in the NHS. This is a crazy situation. We need those doctors to stay in the NHSthey have been paid for by taxpayers moneybut under this Secretary of States leadership, if we can call it that, there is massive distrust in the system.
I have already said that there is a real, and unsurprising, failure of confidence in the MTAS system, the computerised application system for recruitment. I am afraid, however, that once again Conservative Members are, deliberately or inadvertently, muddling up the numbers. There are 32,000 eligible candidates for training posts. There are 23,000 training postsmore than ever before. Of the applicants, about 30,000 are already working in the NHS. Some are in training posts, but thousands are in non-training junior doctor postsstaff posts, non-career consultant grade posts, and so on. All those jobs
will continue to be needed in the NHS. It is therefore simply wrong to say that an applicant who does not get a training post, or does not get the training post that he or she wanted, will inevitably be unemployed.
David Taylor (North-West Leicestershire) (Lab/Co-op): Having spent three decades in large-scale public sector IT, I must say that I tend to agree with the chairman of the BMA, in his letter to the Secretary of State this morning, that the IT system concerned is relatively simple, and that technological failings would tend to remove the confidence of patients in the care system being developed. Will the Secretary of State indicate how she will reassure the wider general public? Will she bring in the Office of Government Commerce to consider the lamentable lapse by Methods Consulting, which seems to have been instrumental in this latest debacle?
Ms Hewitt: I have already explained what we are doing about the two lapses that took place last week, and the failures of Methodshuman failings rather than inbuilt system failingswhich allowed that to happen. On the much broader issue of the electronic patient record, we have known from the beginning that it was essential to have the highest possible level of security before putting confidential medical details about NHS patients into an electronic system. It is well worth saying, however, that the current manual system is not exactly a model of security, and that regrettable breaches of privacy and confidentiality have been reported on various occasions over many years. Because of the concerns about electronic patient records, we have gone to considerable lengths over some years to put in place a carefully worked out patient record guarantee, and to discuss that with patient representative organisations, the BMA and many others in the medical profession. We are currently piloting the electronic patient record in a small number of places in the country, to establish that there is justified public confidence in the electronic patient record.
Peter Bottomley (Worthing, West) (Con): Is the Secretary of State briefed on a daily basis on the material on the Mums4Medics and Remedy UK websites? Does she agree that the interest of the broadcast and print media has brought to public attention many of the issues from which junior doctors were suffering without the knowledge of the outside world? Will she try to clear up the eligibility issue? When I took it up with a deanery, I was told that the issue was nationally determined, whereas the Secretary of State said that it was determined by deaneries. It should not be possible for deaneries to have inconsistent views on eligibility, so will she have a clearing desk at the Department? Finally, will she give an answer on whether it is possible to apply for round 2 without having applied for round 1, given that many doctors are waiting for exam results and, on advice, withheld their applications at the beginning?
I do indeed keep up to date with the Remedy UK and other relevant websites. Various websites have raised concerns, particularly about last Wednesdays security lapse, suggesting, for instance, that peoples future credit rating might be
compromised. That is why I have taken pains not only to establish the facts and to deal with the security breach, but to put the information that we have so far been able to establish directly into the public domain.
On the issue of eligibility, there is one set of rules about eligibility in relation to immigration status, and there are specific eligibility criteria that relate to different posts, at different levels of seniority, in different specialties. In both cases, the postgraduate deaneries check whether individual candidates are eligible, in relation to their immigration status and their educational qualifications and experience, for the jobs for which they have applied. As for round 2, the review group is considering that at the moment, and I shall make a further statement in due course.
Sarah McCarthy-Fry (Portsmouth, North) (Lab/Co-op): Obviously my right hon. Friend cannot say exactly when the website will reopen, because of the rigorous checks that will be required, but can she reassure us that the delays will not jeopardise junior doctors training?
Ms Hewitt: That is an important point. Had it not been for the publicity and the heightened risk of people hacking into the site, the initial investigation by MWR InfoSecurity would have provided enough reassurance to enable us to reopen it; but because of that heightened sensitivity and the need to restore junior doctors confidence in the system, we decided to take a little longer, and to involve the national technical professions as I described. That will ensure that, without creating any unnecessary delays, we can give people the security assurance to which they are entitled and which I certainly intend to obtain.
Meg Hillier (Hackney, South and Shoreditch) (Lab/Co-op): This breach is extremely unfortunate, and a number of my constituents have written to me expressing their concernsbut what concerns them most is progress. My right hon. Friend told my hon. Friend the Member for Portsmouth, North (Sarah McCarthy-Fry) that it would take a little longer to get the site up and running. Can she be more specific? In my constituency and nationwide, junior doctors are keen to get on with it.
I know my hon. Friend will understand that I cannot say this afternoon exactly when we will be able to reopen the website, but I stress to her constituents and others that if it takes longer to establish the necessary level of security and assurance, I believe that that is worth while. The individual postgraduate deaneries have already said that if necessary they will make other administrative arrangements to contact junior doctors, confirm their interview dates and go ahead with the 15,500
additional interviews that have been made available as a direct result of the work of Professor Neil Douglas and his review group.
Peter Viggers (Gosport) (Con): Wading valiantly through this continuing disaster are more than 30,000 junior hospital doctors. When I asked the Secretary of State to give regular progress reports last week, I did not expect her to be back this week explaining that the situation had worsened. Will she ensure that when the Department thinks it has put the situation back on the rails, sheor perhaps her successorcan come to the House and reassure us that enough training posts will be available for the commitment and dedication of junior hospital doctors not to be lost?
Ms Hewitt: I do not think that either of us expected to be dealing with this subject again quite so soon, but I stress again that already more training posts are available than have been available in the NHS beforethe 23,000 to which I referred last weekand that in addition we will have new training posts. They are currently being established between the postgraduate deans and the service, and will be validated by PMETBthe Postgraduate Medical Education and Training Boardbecause that is a requirement for training posts. Moreover, we will still have the staff posts, the non-consultant grade career posts, that already exist in the service. Thousands of applicants for training posts are currently employed in those posts, and will continue to be employed in them if their applications are not successful.
Ms Hewitt: I cannot assure my hon. Friend that there has been no criminal activity. There may have been, but we do not know yet. Investigations are continuing, and if there is evidence of criminal activity it will of course be reported to the proper authorities.
Stewart Hosie (Dundee, East) (SNP):
For many years I was involved in IT systems development, including writing a security system to protect online records, which was used by the NHS. The Secretary of State described the second breach in the following terms: applicants...could randomly access another candidate's messages on the messaging facility...by varying the digits of their own message referencewithout, it appears, requiring a different password related to that different message reference. I am wholly shocked. Who agreed the security testing plan? Who signed it off? Who agreed, approved and signed off the outcome of the security testing plan for MTAS? Will she agree to place in the Library the full technical details of the security plan and its outcome, so that those in the know can have a look at those things to
determine whether the Department signed off and approved something that may not have been wholly appropriate?
Ms Hewitt: On the first point, to access the MTAS website any junior doctor applicant has, of course, to enter his unique identifier and user password, but the hon. Gentleman is right that it appearsthis is what I have been informedthat an applicant who was already legitimately on the site could access part, not all, of other candidates messages without going through a further password approval. Again, further investigations are going on into that point, but the security breach is being remedied and will be tested and assured before the website, and that messaging facility, are restored.
Procurement, the security specifications and so on were a matter for the Department, but also for the programme management board. I have asked the Office of Government Commerce to look at the details of that procurement, so that we can learn any necessary lessonsalthough I stress that Methods was already an approved Government contractor. The hon. Gentleman asked me to put into the Library the full technical details of the security systems on the site. I do not propose to do so, because although that might be helpful to him, it might also be helpful to others possibly less well disposed than he.
Rob Marris (Wolverhampton, South-West) (Lab): I welcome the Secretary of States continued openness and helpfulness on this matter. On 16 April, before the last two security breaches, I asked during the statement whether anyone had been disciplined for the problems that were then apparent, and she told me that
no disciplinary or performance management steps are being taken in the Department.[ Official Report, 16 April 2007; Vol. 459, c. 48.]
I now understand from her statement today that appropriate steps are...being taken. She also said in her statement that this was an extremely serious breach of security, as well as a breach of contract between the IT providerMethodsand the Department of Health. Can she tell me whether Methods has had its contract terminated over those two security breaches, and if not, why not?
Ms Hewitt: No, we have not terminated the contract with Methods. It is responsible for the MTAS site. Our first priority is to deal with the security breaches, and to get proper, full independent assurance that the security breaches have been remedied and that there is an adequate full level of security on the site before it is restored. Our priority is to ensure that the junior doctors can complete the first round of interviews. The job offers can then be made and we can then move on to round 2. Clearly, it would be helpful to have the MTAS system back up and running, with proper security and greater confidence in it, in order to complete the interviews.
Mr. Desmond Swayne (New Forest, West) (Con): The Secretary of State said in her statement that she would be reporting this situation to the chairmen of Channel 4 and ITN. Can she possibly imagine that they are unaware of it?
Ms Hewitt: Until my statement this afternoon, I have no idea whether the chairmen of ITN and Channel 4 News were aware of the details of what has happened, the length of time that elapsed between their beginning to access the site and actually telling us about it, or the extent of the access that was available to them. What they do with the information is entirely a matter for them, but I do intend to draw it to their attention.
Mr. David Drew (Stroud) (Lab/Co-op): Will my right hon. Friend confirm that both the BMA and the royal colleges are still in favour of reforming the system of appointment to training posts? If not, when did they change their minds? It would be helpful if there was at least some consistency from the medical profession.
Ms Hewitt: The BMA and the Academy of Medical Royal Colleges have been involved for many years in the review of medical training that has led to the decision to create modernising medical careers, as they were also involved in the successful establishment of the foundation programme two years ago. They remain closely involved, in particular through Professor Douglas review group, in helping to ensure that we overcome the serious difficulties that have arisen with the MTAS system. Those difficulties do not call into question the underlying principles of modernising medical careers or the substance of the new training programme, which remains widely supported. The problems have arisen, in the first year of transition to the new specialty training posts, with the system for application, shortlisting and interviewing. We are in the process of working through that, and I am grateful to the BMA and the academy for continuing to help us ensure that as quickly as possible we get junior doctors properly interviewed and job offers madeand that we do that in a way that is absolutely fair to junior doctors and meets the needs of the service and, above all, of patients.
Mr. Julian Brazier (Canterbury) (Con): The Secretary of State said that she hoped that interviews would be finished by early June. May I remind her of the case of my constituent about whom I have corresponded extensively with her Department? He is currently serving as a junior doctor in Afghanistan with the Territorial Army, and he has now had to fly back from there to have his interview. Given the very large increase in TA medical presence projected for next year, I urge the Secretary of State in reviewing the system to ensure that this category of junior doctor, small as it is, does not get disadvantaged again.
Dr. Julian Lewis (New Forest, East) (Con): Why do junior doctors have to declare their sexual orientation in making their applications in this competition, and will the Secretary of State give a categorical assurance that any junior doctor who declines to do so, in the light of the monumental mess that has recently arisen, will not be discriminated against in the intense competition for these posts?
Ms Hewitt: That is equal opportunities information, obtained simply for the purposes of monitoring. It is fairly standard nowadays. That information does not form part of the decision on whether a job offer should be made to someone, and of course, people are not penalised if they do not supply it.
Justine Greening (Putney) (Con): Was it ever requested that the data upload on to the MTAS website be password protected? Was Methods ever asked that? If it was not, why did the Secretary of State not take a closer interest, given that the website has been a shambles from start to finish, and given the order in which events arose and decisions were taken?
Ms Hewitt: The issue was simply that the postgraduate deaneries needed the information, and it would have to be supplied from MTAS. The decision to upload the data in the way in which it was done was made, improperly, by an individual at Methods. We could do nothing about that until we learned about it.
Tony Baldry (Banbury) (Con): Is not the reality that on the 10th anniversary of Labour coming into office, suitably qualified junior doctors do not have training posts and hospitals are at risk of losing services? If the Secretary of State thinks that that is wrong, please can she explain to my constituents why for the first time in almost half a century the Horton general hospital in my constituency is at risk of losing 24/7 childrens services and consultant-led obstetric services becausewe are told, among other reasonsthere are insufficient junior doctors? What happened to 24 hours to save the NHS?
Ms Hewitt: In the last 10 years under this Labour Government we have ensuredagainst opposition from the Conservative partythat the NHS has more than 30,000 more doctors, more than 80,000 more nurses and about 280,000 more employees in total. I well remember what was happening 10 years ago, when our constituents, and those of the hon. Gentleman, were waiting 18 months, or two years or more, for a desperately needed hip replacement operation, and when cardiac death rates were among the highest in Europe. Patients know very well just how bad things were under the Conservatives, and how much better they are nowhow much better and faster they are being cared for as a result of the policies of this Labour Government.
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