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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)

  • @1:52 - also, any thoughts about the fact that a large chunk of that cost is towards clinical placement, and this money often gets fed back into departments of the NHS? ie a local Derm department getting a large chunk of money for having students, which then will often get diverted back into the cost of running the department as a whole, benefiting patients?

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  • medical students are effectively funding the NHS?
    Quelle suprise as how many juniors and others already fund the NHS by working excess hours for free.
    All Jeremy has done is to legalise it.

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  • I think we're getting mired in the wrong level of debate here. If the NHS suddenly has to shackle it's staff vs the not-so-distant times when (for instance) we used to have to think how to oblige 70+yr old GPs to retire, something has become very wrong with the way we are treating our doctors. As a tax-payer and future dependent, I find that worrying.

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  • Jeremy would make a good replacement as boss of Sports Direct. Perhaps he should be dragged before the select committee and asked to explain his approach to managing his employees in a fair and reasonable manner.

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  • Well spoken Audoen Healy.
    You've hit the nail on the head!
    The future is bleak indeed!

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  • Anonymous | GP registrar04 Oct 2016 2:55pm

    "@1:52 - also, any thoughts about the fact that a large chunk of that cost is towards clinical placement, and this money often gets fed back into departments of the NHS?"


    I think this is what I meant about direct benefit to health services that discount the costs of training. You can't just look at the costs without counting the benefits.

    In the old days when I had access to these things, I noted that our nearest large teaching hospital trust's second biggest source of funding after the local PCT, was the workforce and education directorate of the SHA.

    One of the reasons why Tariff had to be phased in was to avoid destabilising large trusts.

    Shame that decisions are made about removal of MPIG, outsourcing of payments agency, removal of PMS.....all without such worries about destabilising primary care.

    Our blessing and our curse is that we are many, diverse, distributed small scale providers of mission critical, large scale services.

    Because of this and a shameful lack of data about demand, they don't know that they've broken us until the ambulances are full, the A&Es are breaching and there are no secondary care beds because of delayed transfers of care.

    GPs are the capacitors in the system and we are currently super saturated in a working day that is unsustainably "decision dense" for too many of us.

    The recognition is slowly dawning up there, but we need action not words. Unfortunately our SoS has broken the "psychological contract" for many and he is doing himself no favours with this rhetoric, however well it goes down at conference.

    Fortunately I still meet many good, determined, brave and incredibly hard working GPs, who having invested a career in serving a local community are determined not to give up. We need to support them and people like you who are the future and our cavalry.

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  • @3:56 - Thanks for your insights.

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  • Its delightful for Mr Hunt to make sweeping statements like this, but let's look at the practicalities from an individual perspective, and the risks involved.

    Medicine is a stressful career. We force 16 year olds to choose to do it. Many haven't yet formed a basic understanding of what is involved. A considerable number, while bright, discover during the course that the strains of dealing with death and severe illness you aren't cut out to deal with this stress. It makes you ill.

    Very ill. In fact, mentally ill. Depressed. Perhaps even suicidal.

    We are then forcing some young people, to commit to a service that will, through no fault of their own, harm their health. And may even contribute to their early death (via suicide). Who are unhappy, and not able to perform - to the benefit of patients.

    Occupational health services are going to be swamped with young doctors, desperate to serve their time to avoid paying a fine, whose health is harmed as a result.

    Law suits will result. Families will be sueing the government for the deaths of their young ones.

    Let us not forget that medicine is a stressful career. We have one of the highest suicide rates of any profession. Not everyone can cope, and they don't know they can cope until they try it. They should not be forced to risk their health for politically catchy soundbites.

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  • Means the government will be able to make the first 4 years as crap as they like, slash wages, insist everyone works 20 hours a day a label it ' core hours', impose a requirement to sing a song in paise of our dear leader Chairman Hunt every morning. Want to leave? Want to leave?? You owe the government £200,000. You can't leave. The government owns you.

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  • Its just a further sign that the compact between doctors and patients is eroding as the NHS shreds.
    This is a horrible time for doctors as we transition to a US style system. Unless Corbyn is correct and we are close to the historic collapse of Capitalism the market is eventually going to sweep away this loved wreck.Stop clinging to it in your head- the game is over.

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