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Independents' Day

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)

  • And it should be a minimum of 8yrs of NHS service post-qualification, for those GPs who work part- time.

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  • Same mistake as the last increase in medical students.No mention of post graduate education.Most doctors who who go into training grades train for at least another four years before they are registers GPs etc.That is when we are attractive to the rest of the world.This man shows his ignorance of is remit yet again.I suppose there going to be a lot more clearing in medicine in future though!

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  • So someone is going to have to invest at least £100k to put themselves through medical scool and Mr Hunt is going to insist that they sign a dotted line or pay another £100k potentially? I think he is going to have to redefine the word altruism to make that a little more appealing.

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  • When does the rule forcing doctors to have to work in the NHS for 4 years start?
    Is it for the students currently in the system or any future ones?
    And what does he mean by saying "all those that train on the nhs will be required to work a minimum of 4 years for the NHS???"
    When I was a med student I never considered I worked ON the NHS at all.

    I can safely say that this will ensure that my children will NEVER follow in my medical footsteps!!!!! One was tempted but this will seal the deal for her going into another career. Thanks Jezza! She is an extremely bright girl and will now realise that she would be throwing her life away by becoming a doctor.

    P.s this would put not only UK students off studying in the UK but also overseas ones who fork out loads of money for the privalige.

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  • These threats of enforced servitude are not new, and they have extended to my profession, dentistry, as well for some time now.
    Now it seems they are intending to go ahead with this.i posted the following on a dental website, GDPUK, this morning, under the heading;
    The NHS Gulag.

    It is to be announced today that the NHS will train a further 1,500 doctors per annum in order to make up the shortfall expected as a result of Brexit.
    All doctors "trained" by the NHS will be obliged to work for the NHS for a minimum of 4 years.
    You can bet that this measure will be somehow extended to include dentists.
    The implications of this are quite startling, and unprecedented outside of armed forces, either here or anywhere else in the free world.
    Such moves are rumoured to have been considered before, but found to be in breach of EU human rights laws.
    This is an early example of the "Brexit dividend" at work.
    This is nothing other than state sponsored bonded servitude, another word for slavery..
    One has to ask how this is to be enforced?
    Are young doctors (and presumably dentists) not going to be allowed to emigrate, to places where their qualifications and abilities will be better rewarded?
    What will they do about female doctors who take career breaks to have children.
    Will they be forced back into the NHS Gulag when they return to work, regardless of their age and circumstances?
    Will this imposition not encourage an increase in the already depressingly high dropout rate from the profession, by both sexes.
    Will this not mean that "middle class" parents, including doctors and dentists, will now seriously discourage their children from studying medicine and dentistry?
    Will this deter the best and brightest youngsters from taking up medicine and dentistry in the first place?
    The answers to those last 4 questions are an enphatic "yes".
    One has to ask how this will be enforced.
    Will they prevent young doctors from taking holidays abroad in case they decide to "defect"?
    Will they install "doctor detectors" at airports, along with "doctor sniffer dogs" , trained to detect that lingering trace of formaldehyde from their days in the anatomy department?
    Will they withhold evidence of their qualifications in order to prevent them from being employed abroad?
    Will they imprison members of their families, or subject them to heavy fines, if they defect?
    Will they try to have them extradited back to the UK if they defect?
    Will they send in the SAS to either abduct them or 'take them out" if another country refuses to extradite them?
    Ok, some of what I have said is tongue in cheek, but not all of it.
    You can take a bet that the Whitehall mandarins and Tory MPs behind this would not be caught dead in the resulting NHS "sweatshops" staffed by the demoralised and underresourced victims of this policy of servitude.
    They will seek their treatment in selected "centres of excellence" conveniently located close to Parliament, or in the private sector, or worst of all abroad, in more enlightened countries where medical professionals are treated with the respect they deserve for their abilities, hard work and dedication.
    Such a policy would be a flagrant abuse of human rights.
    There are ways to legally create a binding contract of future employment in repayment for training, but these only exist as an alternative to self funding.
    I can only see the above plan being morally acceptable if there is both an alternative to self fund in the first instance, and a "buy out" clause for those who wish to depart the NHS.
    Anything else is a form of enforced servitude in contravention of all concepts of freedom of the individual since the abolition of slavery 2 centuries ago.

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  • Great idea!

    Let's impose a contract which forces people to work unsociable hours in disruptive manner and then impose a rule to force new graduates to take the contract.

    I know what will happen - any student with 1/2 a brain will stay clear off medicine and we'll end up those who couldn't get into media studies taking up medicine in future

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  • To work for 4 years will cover the F1 and F2 years and two of basic SHO training as far as I understand it. This will leave them free to go wherever they like then - none would have become GPs in that time so the part time dig would not apply. Doctors are most attractive to other countries when they have some experience so I cannot see this halting any exodus.

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  • If you get straight As most will go for some other job looking at the pay and working conditions. I do worry for the future if we end up like the lousy dentists of the past with grade Cs treating us.

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  • This is a tactic employed in the so called 3rd world countries to reduce brain drain. This is pathetic.

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  • Has anybody ever seen a breakdown of the oft cited "£220,000" cost of producing a doctor? Would be interesting to see what has been included, and whether this cost has been impacted by the increasing personal contributions to tuition fees. I've seen previous estimates include salary, which seems a fairly loaded way to inflate the perceived cost to the public.

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