If ever there was undeniable evidence of the appalling failure to grasp the essential nature of training highly skilled people, the growing number of prospective doctors given placeholder jobs must surely rank as amongst the strongest.
Here we see the almost incredulous combination of increasing the number of medical school places in line with a failure to allocate sufficient Foundation Year places for medical students on graduation and subsequent training opportunities for them. This at a time when the NHS has a growing number of medical staff shortages, along with increasing numbers of doctors who are leaving the NHS. Placing a medical student on this so-called ‘placeholder list’ must be a most demoralising outcome for those gifted individuals who succeeded in gaining entry to medical school, who underwent arduous education and training there and who would have accrued a debt of around £100,000. Not welcoming them with open arms must count as one of the gravest of political mistakes for healthcare. Who could blame these bright, disillusioned people from taking their skills and training elsewhere, thus losing the NHS and the UK a great deal of investment – not to say hope?
What is desperately needed is immediate, seamless and determined cooperation and joint planning, with adequate resources, between the Department of Health and Social Care, higher educational institutions, and the UK Foundation Programme Office (UKFPO) to ensure these most important sets of numbers add up and continue to do so. Medical students must be offered the Foundation Year posts they can learn from and thrive – and no medical student must be left feeling out in the cold, with nowhere to go, quite literally a name on a list. Is this how we treat our brightest? Is this how we ensure patients get the treatment they need, when they need it? What we have seen lately, however, does not augur well: increased reliance on Physician Associates (PAs) to undertake roles which doctors should be doing, with a funding mechanism which not only favours the funding of PAs but withholds funding for medical posts in general practice. That is madness.
This is an appalling situation, which reflects the unwillingness of this and previous governments to understand that the NHS is only sustainable if it works as a learning organisation at every level. The merger of Health Education England into NHS England will have inevitably contributed to a lack of focus on training pathways. Now that NHSE is being merged with the Department of Health, training will be at risk of being forgotten completely amidst the ensuing chaos.
For the sake of future doctors, for the sake of the patients in future, and for the sake of the NHS now, let this completely avoidable waste of talent become a thing of the past. Quickly.