UK update

from Brenda Marsh Editor, European Hospital

Juggling the NHS accounts?

Following various cuts and budgeting and at last an announcement of a surplus of funding in the NHS, government figures indicate that pending  maintenance repairs of its properties would cost in the region of £4 billion – eight time higher than the NHS funding surplus. The repairs include fixing heating, roofs, drains, and measures to meet safety regulations, but do not include re-decoration of wards or furniture replacements.
Whilst the Department of Health said these repairs come under a different budget, which has no bearing on the surplus, Shadow Health Secretary and MEP Andrew Lansley CBE (Conservative Party), who obtained the figures, has said: ‘The truth is that the NHS surplus, which the government is boasting about, is a sham.’ He suggested that the budgets for public health, education and training, as well as basic maintenance and hospital upkeep were ‘laundered’ to produce the surplus figures.
 The Health Minister Ben Bradshaw (Labour Party) said that, whilst urgent maintenance work that will affect patient care is always a priority, occasionally low priority maintenance work (such as a roof repair in an un-used building) was delayed so as not to prevent disruption of patient services.

Despite healthy pay packets, doctors fear the future
British general practitioners (GPs) have, on average, seen their annual income rise to around £100,000 (a 3-year rise since a new contract introduced in 2004), and they have been assessed as the ‘happiest’ in Europe about income.
This finding came from a small poll of 399 doctors in the UK, France, Germany, Italy, and Spain – conducted by Le Generaliste , a French magazine for GPs – which showed that about 57% of UK GPs were satisfied with their pay, compared with 44% of the French GPs, 29% of the Italians, 18% of the Spanish and 12% of the doctors in Germany.
However, the future of family practices concerned 9 in 10 of the participating doctors: 90% in Spain, 87% in the UK, 84% in German, 83% in Italy and less so in France at 79%.
Under the UK pay contract, GPs were also allowed to give up responsibility for night and weekend care, but recently the government has been pressing GPs to provide better access to care, and to extend their surgery hours. This, along with a suggestion that private doctors would be called in if they do not do so, have caused worry for many. 

30,000 medical graduates chase 20,000 jobs
Following an independent report by Professor Sir John Tooke that found that thousands of British born medical graduates cannot find jobs due to soaring applications from foreign doctors, all four British countries are looking into the situation, and the government is to examine the issue of applications from beyond the European Economic Areas (EEA).
 The report examined recruitment problems following a new training system, and found that overseas applications had increased this situation – for the 20,000 posts on offer, around 16,000 of the 30,000 junior doctors applying were foreigners, and most (13,500) come from countries outside the EEA. However, about 10,000 foreign applicants had come under the UK’s highly skilled migrant programme, whilst many others paid for their medical education in this country. Although giving preference to UK graduates would present legal difficulties, this would not be the case for medical graduates born beyond the EEA.
 The British Medical Association (BMA) has pointed out that, although medical immigration does need to be controlled, this should not affect foreign junior doctors already in the country, and added that all non-UK nationals currently studying medicine in the UK should be able to complete their entire training here, and those on the highly skilled migrant programme should be allowed to compete for posts on the same basis as UK
A Department of Health spokesperson said that the proposal only affects post-graduate and specialty training, and does not affect the thousands of NHS service posts for which  doctors from beyond the EEA can apply.
The Tooke report had focused on the Modernising Medical Careers (MMC) training system, introduced by the health department in 2005, under which junior doctors could cut the current average years to reach consultant level from 14
to 11 years, by trainees heading for a
specialty earlier in their careers. However, the professor concluded that meant less broad-based experience, and it would neither encourage nor reward endeavours for excellence. Nor did it allow sufficient flexibility for doctors or the changing employee needs of the National Health Service. The report concluded that doctors should receive more years of broad-based training before embarking on the specialist route.
The report, together with other adverse events relating to job applications, have increased the desire of many doctors’ that the profession should have a greater say in health service management.


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