Examination of Witnesses (Questions 760-765)
MS ANNE
RAINSBERRY, DR
MOIRA LIVINGSTON
AND MS
SIAN THOMAS
24 JANUARY 2008
Q760 Dr Taylor: These sorts of posts
could be a long-term worthwhile alternative if they are organised
correctly?
Dr Livingston: They need to be.
Q761 Chairman: Earlier I quoted from
what was said to us in our session last week from a post-grad
dean. He said that in some parts of the country outside of the
Southeast these were the best cohorts of trainees they had ever
had in post-grad trainee. Could I ask you, Moira, do you have
a view about that?
Dr Livingston: Yes. We have had
regular meetings with employers across the patch throughout Round
1A, Round 1B and Round 2. After Round 1A the employers were absolutely
certain that they were very positive about the recruitment they
had made from Round 1A. Round 1B, for them, was felt to be an
add-on which was not necessary to assure them of getting the highest
calibre, but we understand nationally the need for it and support
the decision that the Programme Board made. We have also seen
improved recruitment in areas where that has been a challenge
in the past and general satisfaction with the quality of the doctors
who have been appointed.
Q762 Chairman: A marked difference
from years gone by?
Dr Livingston: I do not think
I am able to say a marked difference but I would definitely say
satisfaction with the quality of recruitment.
Ms Thomas: I have already given
some examples of the real case studies we have had. I will just
make two points. I do agree broadly with that statement but we
have also heard of very excellent doctors who have not got into
their specialty. The recruitment process did generally give us
high calibre people and generally some employers who have not
been able to recruit are recruiting, but the real question is
did we discriminate between good doctors and excellent doctors.
We did get reports from consultants that they were unable to do
that through some of the recruitment process. I think the general
answer to that is "yes", but it is a "yes, but
we may not actually have the right doctors". One example
of that I would give where there is real concern is on the clinical
academic recruitment. We were unable to recruit posts to the clinical
academic structure in some parts of the country and we are not
quite sure if we have got the really excellent clinical academic
doctors we need for the furthering of scientific research. In
a year where new money was injected into that programme, where
we really need to give emphasis on encouraging doctors not only
into clinical medicine but academic medicine and research, that
is absolutely critical to get right. Broadly, yes is the answer
but I do not think that fits for every single situation. A final
point I would want to make about recruitment issues is you have
heard a lot of evidence as a Committee about the redesign needed
of this huge change programme and time is getting on. We have
a process for 2008 which we think will run smoothly but is a one
year local fix, if you like. We have got increasing concern from
employers that we should not repeat the mistakes we have made
before, if you like. Huge change needs time, it needs testing
and it needs stakeholder engagement. I really do not know if we
are going to have all of those things in place for 2009. We talked
to John Tooke and his team about this. We may even be talking
about 2010 or 2011 before we have the actual solution for the
longer term and we must be courageous and stick to our guns if
we think that is the right thing to do and not rush headlong into
something for even 2009 which is not the right solution.
Q763 Chairman: I was just going to
give the last word on the question I asked to the Southeast.
Ms Rainsberry: We bear out what
has been said in that our fill rate in London was the lowest we
have known it, so there obviously was a redistribution that was
going on. The question of whether gold standard doctors, the stars,
were not getting into training is probably right, but the reason
for that was because they persisted in going for being a cardiothoracic
surgeon and the reality is you have lots and lots of stars going
for that. Despite giving lots of advice and lots of support, it
is very difficult to dissuade people when they have set their
heart on it. On 2009, the MMC England Programme Board has just
started to consider that and will be considering it in more detail
at the next meeting. Just to offer some reassurance, there are
a lot of stakeholders around the table saying exactly that. We
need to look at what is the change that is required and then how
long it will take to implement that change properly, not to say
we must do this by 2009. That is certainly the tenor of the discussion
at the moment.
Q764 Dr Naysmith: I wanted to pick
up what on what Sian said. Obviously we do not want discrimination,
we need to eliminate discrimination, but I have been around medical
schools most of my working life and there have always been some
people who were disappointed at not getting into their preferred
speciality. It seems to have been highly focused this year but
it is something that has always happened. The other thing is,
it has always been relatively difficult to recruit into academic
medicine, particularly with GPs getting the salaries they are
getting now, and some of the consultants. Being an academic and
spending a lot of your time doing research as well as seeing patients
is not as attractive and never was as attractive to some people,
unless you are obsessed with becoming a medical scientist. Both
of these problems have been in the system for a long time.
Ms Thomas: They have, absolutely.
Q765 Dr Naysmith: It is not true
to blame them, despite
Ms Thomas: No, but we should expect
a change through MMC to deliver improvement, that would be the
point to make.
Dr Naysmith: Yes, we can always make
things better.
Chairman: Thank you for coming along
and helping us with our inquiry.
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