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GPs buried under trusts' workload dump

Newly trained doctors to be tied to NHS for four years, announces Hunt

Doctors will be required to work in the NHS for at least four years upon qualification as part of a £100m plan to make the NHS 'self sufficient' for doctor recruitment by the end of the next Parliament.

Health secretary Jeremy Hunt will unveil the new requirement alongside plans to expand medical school training places by a 'up to' a quarter by 2018, from a current cap set at just over 6,000 a year.

Speaking later today at the Conservative Party's annual conference, Mr Hunt will say that 'we need to prepare the NHS for the future' by 'doing something we have never done properly before: training enough doctors'.

He will say that this comes as currently a quarter of NHS doctors come from overseas.

The news comes as the Government is working towards recruiting 5,000 new GPs by 2020, but a Pulse analysis has suggested it will miss this target by more than half.

Mr Hunt will say his plans will make the NHS in England less reliant on doctors trained overseas and locums and ensure ‘all domestic students with the skills and capability’ to be a doctor have the chance to do so.

He will say: 'They do a fantastic job and we have been clear that we want EU nationals who are already here to be able to stay post-Brexit. But is it right to import doctors from poorer countries that need them whilst turning away bright home graduates desperate to study medicine?'

He will say that this is why he is announcing an expansion of training places, but that this will come with strings.

He will say: ‘From September 2018, we will train up to 1,500 more doctors every year, increasing the number of medical school places by up to a quarter. Of course it will take a number of years before those doctors qualify, but by the end of the next Parliament we will make the NHS self sufficient in doctors.

‘In order to ensure these reforms deliver for the taxpayer, the Government will also require for the first time that all those trained as doctors on the NHS will be required to work in the NHS for a minimum of four years after graduation.

'This mirrors the approach taken for those whose higher education was funded by the Armed Forces. It currently costs the taxpayer £220,000 to produce a graduate from medical school.'

The Government expects that expanding training will cost £100m by 2020/21 but that in the long run this will be offset by savings made from the locum bill which currently stands at £1.2bn a year.

Mr Hunt is also planning for international students in the UK to pay more towards their education and training.

Mr Hunt will says: 'Our medical schools have an outstanding international reputation, and these changes will in part be funded by charging international students for the totality of their training, including clinical placements which they do not currently pay for.'

It is not clear how the commitment to become self sufficient will be squared with NHS England’s commitment to recruit more GPs from international medical schools, revealed in NHS England board papers in July.

Pulse has reported as many as 600 European GPs are currently in the ‘pipeline’ to work in England, according to recruiters working with the NHS.

BMA chair Dr Mark Porter said the announcement 'falls far short of what is needed' and 'this initiative will not stop the NHS from needing to recruit overseas staff'.

He said: 'We know there are chronic staff shortages and rota gaps across the NHS, with major recruitment problems in areas such as emergency medicine and general practice.

'The Government must tackle the root causes of this workforce crisis and the reasons why so many UK-trained doctors are considering leaving the NHS rather than forcing doctors to stay in the health service. Demotivated, burnt-out doctors who don’t want to be in their jobs, will not be good for patients.”


Readers' comments (85)

  • Dear Mr Healy, I (an ex-doctor who saw the writing on the wall a year or two ago) and many other doctors appreciate very much your comments. It is also very important to know how people in other professions, such as dentistry, are being treated to gauge what shockers are coming next.
    Thanks for your vision as it is important to see how other's perceive the medical situation.
    Keep us all in the loop please!
    I completely agree that we all need to stick together.

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  • The increase in places and the requirement to stay in the NHS should have been the case years ago. It will take till 2024 for us to see any benefit from the announcement today.

    A student at university studying film, or language or David Beckham or whatever degree they choose is paying around £10k a year for the privilege. It is not unique to medicine. When they come out of uni they are not guaranteed a job whereas medical students usually are, and a well paid job at that. (Average graduate starting salary is somewhere between £20-30k). So the costs of training doctors is paid by the tax-payer. It is not unreasonable that following their completion of training that they are required to stay in the NHS for just 4 years so that the tax-payer sees some of the benefit. In reality it is probably less than 12% of their career that they have to give to the NHS.

    For the partners so horrified by this ask yourself what you do in your practice. If a member of staff comes to you and says they want to train as an HCA do you agree to train them? Pay for their training? Reduce the amount they work currently to allow them to train. Take the burdens of costs knowing in the future you will reap the benefit. Then on the day they finish and can work as an HCA they give their notice and will be working elsewhere next month. Would you find that acceptable?

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  • Medical Students who joined the armed services get £10,000/yr and £45,000 lump sum on completion.
    Does Mr Hunt mean to do the same for those that go into the NHS?

    EX Ft Lt Pilot and GP

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  • PM @10.41
    Yes, entirely acceptable though not desirable. I would, however, ask why HCA prefers not to stay and address that rather than impose forced employment. This is the point - why is a "solution" like this even being considered?

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  • So - are we going to impose this also on engineering, science, and economics graduates - as the UK economy needs their expertise, and has contributed to the cost of their education?

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  • Having to work for the NHS for 4 years. Well most Docs probably do anyway. They will be so angry about this that they will be plotting their escape from day 1 of med school. They will take their 4 years experience and zip off to Oz etc. Comparing this idea to the armed forces is not a reasonable comparison . The armed forces are paid for one thing.
    If medical students are paid and have no tuition fees this would be reasonable. If you join the armed forces at 2nd MB you get paid .
    As others have said why pick on medics why not physics , nurses and indeed other degree subjects deemed to be of national interest.

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  • @ Rosalind Johnston Lots of employers in those sectors do impose that on their training. Some employers fund people through degrees and require the person to stay at the company for a period of time. The armed forces do it. A colleague was talking earlier that they know of a lawyer who is tied to their firm for a number of years as they funded their training. This is not new, just new to the NHS.

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  • BMA press briefing from 2013 on the cost of training doctors in the UK. the Doctors themselves will pay some of these costs by the look of it but the cost of training a GP is put at half a million.

    For those comparing it to physics or other graduates, does the UK tax payer pay anywhere near a comparable amount for those graduates?

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  • This would be fairer if medics dint have to pay tuition fees, and wern't saddled with 100k of debt after their studies.But this government is not fair.

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  • Opps forgot link @11:26

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