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Gold, incentives and meh

GPs should pay off costs of medical training before moving abroad, says MP

GPs should be obliged to work in the NHS for a period of time after training, or pay off their training costs before moving abroad to work, an MP has claimed.

Writing in The Daily Telegraph today, Tom Tugendhat, the Conservative MP for Tonbridge, Edenbridge and Malling, suggests introducing a ‘return of service’ obligation for medical staff, similar to that of army personnel.

Pulse reported earlier this year that 800 GPs are applying for work abroad each year.

Mr Tugendhat, who served in Iraq and Afghanistan, says it is ‘time for us to require those trained at the British people’s expense to work a number of years in the NHS before working abroad’.

The MP claims that it costs £500,000 to train a GP, and these costs ‘aren’t remotely covered by the tuition fees they pay as undergraduates’.

He adds: ‘We spend £5bn a year on training new medical personnel. Yet an increasing amount of that money is going overseas. Every year some 5,000 doctors leave the UK. The most popular destinations are Australia, Canada and New Zealand.

‘These are wealthy countries benefiting from British taxpayers’ expenditure. It is hard to argue this is the best use of resources when our own population is ageing and in need of greater investment in medical services.’

Mr Tugendhat likens this to the Armed Forces’ ‘return of service’ commitment, which sees fighter pilots, for example, having to serve 12 years in the RAF before joining the commercial sector.

It comes after media reports that there were almost 1,700 applications to the GMC for Certificates of Current Professional Status (CCPS), which allow doctors to work abroad, within just three weeks of the announcement of the junior doctor contract imposition.  

However, Pulse can reveal that much of this surge came following a campaign by the GP Survival group for doctors to apply for the certificates to send a message to the Department of Health.

Readers' comments (43)

  • Well this will help recruitment.....

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  • I welcome this....once MPs sign up to mandatory no expense claims for 10 years and no second mortgage paid for by tax payers for 10 years.

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  • Please take into account that more than 25% of the work force did not train at the British taxpayers expense.
    And, BTW, where do you get a £500,000 figure per GP bill to the taxpayer on top of £10,000 pa paid by the trainee himself?
    Maybe we should check the literacy levels of these MPs because that poor mathematics may be reponsible for irrational opinions they voice and decisions they make.

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  • Has anyone here talked to MP's, you will never accuse them of logic and rational thought !

    Once your IQ hits double digits that usually meets exclusion criteria for being an MP ( with few notable exceptions who almost have 3 digit IQ's).

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  • 3 digit IQS !!! are you sure...........ahhh I realize you forgot to mention that includes a decimal point after the first number and at best after the second number
    Remember its a lottery now a days and you can only choose numerical values from from 1-49 --oh sorry evolution has occurred its from 1-59 from next month

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  • Provide better pay.Invest in the NHS before you come up with this ideology.

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  • Does the UK repay the training costs of all the health care staff that it takes from other poorer countries???

    How about MPs being blocked from involvement with any companies that they may have had dealings with or influence over whilst in office for 10 years???

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  • £500,000!!

    a figure made up from thin air!

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  • @11:25

    I think the point is that the costs should be borne by the person themselves ie. a foreign doctor working in the NHS would pay their own country's taxpayers back for any subsidy they received when training.

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  • Er.....we do actually work while medical students and in training posts. Typical politician - try to counteract the result of political meddling with further meddling rather than address the cause. The exodus from NHS general practice is the direct result of changes imposed by govt making continuing/entering practice untenable for many. This was not the position when training began - look to your colleagues for redress, Mr Tugendhat, not highly intelligent professionals who simply can't take any more.

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  • Electronic tagging of young doctors is the obvious solution.

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  • Vinci Ho

    You see
    This will set up the next argument which is to mass produce GP alternatives ( we all know what they are) .As I said , the government will set up its universal soldiers for NHS: obedient , robotic and cause much less money........

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  • Vinci Ho

    Bottom line is why should people work for bullies while jobs in other countries offer respect to these young colleagues?
    Treat people better , only then you get your reward and return. I suppose I cannot expect these dispicable politicians to understand .....

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  • Fortunately medical indemnity will and is starting to prevent the alternatives being a viable option.

    Those with phone triage are seeing complaints rocket, and medical solicitors are starting to focus on ANP /PA based consults

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  • Why are doctors singled out? Surely this is discriminatory as they are not proposing an English degree graduate who chooses to teach English in forign country are not forced to pay money back.

    Tom Tugendhat MP should be reported for his discriminatory remarks

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  • @1:26

    The government provides no subsidy for humanities degrees (ie. English degrees) - the cost is borne by the English graduate who pays £9,000 a year.

    Whereas the government provides a large subsidy towards the "real cost" of each year of medical school.

    International students wanting to study medicine in the UK have to pay between £30,000 - £36,000 a year for each year of medical school. UK students don't pay this amount as they receive a subsidy from the taxpayer.

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  • I suggest a transfer fee system like in football. Would Australia want you if they had to pay for you?!

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  • 1.54
    Do you actually think that £30-36,000 is the actual/real cost per year? Or it includes money to help the university further (aka subsidizing home grown students).
    Even if that is the case - 36 x 5 years is nowhere near £500k quoted. A figure plucked from thin air. Allowing for 5 years post graduate still doesn't add up as they work and train on the job.
    Even if that is the case, NHS 'imports' more than it 'exports' so there is a trade deficit. Are you willing to pay?
    Even if that is the case, that will not fill the empty posts for GP trainees as GP land is not a good place to be at the moment.

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  • "We spend £5bn a year on training new medical personnel. Yet an increasing amount of that money is going overseas. Every year some 5,000 doctors leave the UK. The most popular destinations are Australia, Canada and New Zealand."

    Hear hear.

    We could handcuff them to the country, OR, and I'm just throwing it out there, we could incentivise people to actually stay in this country by improving working conditions.

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  • @ 2pm

    Or, how about building a Berlin Wall. That worked a treat. Clueless.

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  • @2:06pm

    This is what really gets my back up. I'm sure the actual figure is enormous if you include all the money spent on universities, training subsidies to hospitals, consultants, training programme directors etc etc. You could also add in salary and the figure probably won't be far off £500k

    But when you look at what you get in return for that investment it seems like such a bargain. As everyone keeps saying - we do work whilst we train.

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  • @2:06
    The (approximate) £500,000 figure is from the BMA website but it includes around £120,000 borne by the student themselves (for tuition fees and living costs). The cost of training a consultant is more.

    I believe the suggestion is that the medic bears the cost of their own training. So overseas medics pay back their own countries the amount it cost to train them and UK medics pay back the UK taxpayer the subsidy they receive for their training. That way taxpayers in all countries don't lose out when their staff decide to flounce off for more pay abroad.

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  • Public and politicians need to consider why the terms and conditions of their healthcare workers are so inferior. One of the causes is the UK is not properly funding healthcare and managing it poorly.

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  • @2:42pm

    So we pay off our debts as we leave the country, and immigrants pay off theirs as they enter the country.
    Recruitment crisis worsens, soon there will be incentives to come to the UK because so many are leaving, incentives like having your tuition fees repaid (like teachers get) and then before you know it we're back where we started.

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  • agree

    then watch as we all go private and recoup training fees by charging £300 an hour (equivalent to barrister's fees). Politicians should start saving up as we will charge them more.

    if the fees sound to high - google some private practices and take a look.

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  • That'll help recruitment!!

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  • If only the government had made the GP job attractive, in all respects, we wouldn't be having these discussions on recruitment and retention crisis. Why can't those in power figure out this simple fact?

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  • Why can't those in power figure out this simple fact?

    - because they delude themselves.

    Had a meeting with senior NHSE bigwigs and the comment when I raised GP recruitment issues was -
    'its all cyclical - there is no real issue'.
    I then explained I was a former GP who quit permanently and there was no response.

    It is very scary meeting NHSE types, they all say the same catch phrases.

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  • Anonymous | Other healthcare professional | 23 September 2015 1:54pm

    You are sadly mistaken if £9000/year is enough to cover costs of English degree. Almost (if not all) all university degrees are subsidized to a degree. Admittedly some courses more than the other but what about others which requires expensive environment e.g. molecular physics, law, etc. Before such statement can be made, if one is being fair, analysis of all university courses and their contribution to the society should be made and then a cut off line should be drawn below which graduates are expected to repay their debts to the society.

    But this hasn't been done and the MP made a knee jerk reaction singling out the easiest target. Sadly, It's obviously winning the votes of simpletons like you.

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  • Make the job attractive with proper pay and conditions and maybe everyone wouldn't leave - but that's far too simple....

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  • Go the whole hog. Make it a military discipline.
    You get trained you sign on, are deployed to St Elsewhere's or buy yourself out.

    See how many are attracted to medicine.

    I probably would still have done it as I hate dentistry and doing the anal gland thing on dogs turns my stomach; althought law attracts bright people too.

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  • Can't rely on overseas medical graduates because of immigration laws.
    I think this will be a good bet for the conservatives to make sure that Uk medical graduates are not free to escape with out a payment to the Government.

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  • A lot of hot air - impossible to frame a law that would target just medics. Just noise from an idiotic MP

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  • Yet more conservative drivel. Cameron has no control over his party. It is weakly disciplied. Further proof that they cannot be trusted.

    -anonymous salaried!

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  • Gaurav Tewary

    UK should then stop importing nurses and Drs from overseas. The taxpayers of those countries also loose out then. Or doesn't the Hon MP care about 3rd world countries?

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  • @2.20pm

    Clueless comment was nice. My comment about Australia paying a transfer fee was a little tongue in cheek but was a compliment. I don't want us to lose our best doctors to another country for nothing.

    Don't be so paranoid. Not everyone hates you.

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  • Don't forget those who drop out of medical school- they should be forced to work as HCAs until their debt to society is paid off.

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  • if the government will repay me for the countless lives I've saved, let's say £1million / life, then yes I'll repay my training costs.

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  • @5:13pm
    Actually the last ConDem government (with David Willetts at the helm) removed all teaching grants for humanities degrees. The humanities got 100% cuts. Whereas STEM degrees including medicine retained their subsidies. Please check the facts (try the THES) yourself.

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  • And dentists?? They're doing a lot of NHS work aren't they? Dumb.

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  • Excellent response (Letters page, Telegraph) outlining the salaries and and additional benefits paid to Naval doctors. One has to compare like with like, Mr Tugendhat.

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  • The £500,000 figure was produced by the BMA. A magnificent own goal. IDIOTS.
    bma.org.uk/-/media/Files/.../pressbriefing_cost_of_training_doctors.docx

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  • I always thought we took more doctors and nurses from foreign countries that we lost. No mention of dentists. If only I had applied for that course.

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