Plan for army-style conscription of doctors is reconsidered
Authors: Abi Rimmer
Publication date: 10 Aug 2017
The Department of Health in England has said that it will reconsider its plan to require doctors to work in the NHS after qualification or to pay for some of their training.
The department said that it would “continue to consider return on taxpayer investment” in its response to a consultation on the expansion of undergraduate medical education.
The consultation had proposed a system similar to that in the armed forces, “whereby medical students receive funding to support them to complete their degree in return for agreeing to serve for a given period.” It said that, if doctors do not complete the required amount of time in the NHS, “then they could be required to repay a sum of money in addition to their loan repayments.”
The government’s response to the consultation said that respondents agreed on the principle of “ensuring that the significant taxpayer investment in medical education is maximised” but found no general consensus on how to achieve this. The government will ask Health Education England to consider how to take this forward.
The Department of Health also confirmed its commitment to increase medical school places by 1500 a year by 2020, delivering on a promise made by the health secretary, Jeremy Hunt, last October at the Conservative Party conference. The department added that 10 000 additional training places for nurses, midwives, and allied health professionals would also be funded by the government, with some of the places available to students as soon as next month.
An extra 500 medical student places will be allocated, to start from 2018. Details of how these places will be allocated to medical schools are not yet available, but they will be open to state funded schools only.
The remaining 1000 places will be allocated around the country and based on an open bidding process, expected to start from 2020. The Higher Education Funding Council and Health Education England have been tasked with developing the bidding process.
The extra places will be allocated to medical schools that work to help students from disadvantaged backgrounds to become doctors, as well as schools that can show a link with hospitals and general practices in rural and coastal areas. And priority will be given to general practice and psychiatry, the department said, to support the mental health workforce plan published earlier this month.
Philip Dunne, minister of state for health, said that the plans represented the biggest and most inclusive expansion of medical training places ever, “ensuring everyone has the chance to study medicine regardless of their background, and ensuring the NHS is equipped for the future with doctors serving in the areas that need them the most.”
Harrison Carter, co-chair of the BMA’s medical students committee, welcomed the announcement and its focus on under-represented social groups and regions of the country. But it was also important to make the lives of current junior doctors better so that they remain in the NHS, he said.
“The students who will benefit from these new placements will take at least 10 years to train and become senior doctors, so we mustn’t forget that this promise won’t tackle the immediate shortage of doctors in the NHS, which could become more acute after Brexit,” said Carter. “As such, we require equal focus on retaining existing doctors in high quality jobs, which will provide more immediate relief to an overstretched medical workforce.”
Danny Mortimer, chief executive of NHS Employers, said that it would take time for the full benefit of the proposed additional staff to be felt. “We look forward to working with the government to ensure an immigration system that complements domestic efforts: this will help to ensure we have the staff we need to provide first class care in the 21st century,” he said.
The consultation ran for 12 weeks, from 14 March 2017 until 2 June 2017, and had over 3600 responses.
- Department of Health. Expansion of undergraduate medical education: government response to consultation. Aug 2017. [Link] .
- Department of Health. Expansion of undergraduate medical education: a consultation on how to maximise the benefits from the increases in medical student numbers. March 2017. [Link] .
- Torjesen I. Hunt aims for fully home grown doctor workforce. BMJ 2016;355:i5399. [Link] [Link] .
- Torjesen I. Thousands more mental health posts will be created in England. BMJ 2017;358:j3676. [Link] [Link] .
Abi Rimmer The BMJ