Training at risk in market-led NHS new junior doctors' leader says

Increased competition in the NHS in the UK could jeopardise the quality of doctors’ training, the new leader of the UK’s 49,000 junior doctors warns today (Thursday 29 September, 2005).

Dr Jo Hilborne, who has been elected chairman of the BMA’s Junior Doctors Committee, today expresses concerns that private companies running treatment centres will have no incentive to provide doctors with high quality training:

“It’s not clear whether profit-making companies running treatment centres will provide training to the same standards as the NHS. Unless a mechanism is introduced to make training as important to private companies as it is to the NHS, standards are likely to drop. Junior doctors are already under pressure from changes to their working patterns and reforms to their training, and the move to private provision makes their future even more uncertain. In an NHS based on competition, there will be winners and losers. How is a trainee surgeon supposed to learn how to do a hip replacement if their hospital has lost its contract to do them? Little thought seems to have been given to doctors’ training in a market-based NHS.”

Dr Hilborne also welcomes the government’s commitment to improving access to childcare as part of the forthcoming Childcare Bill. However, she says there is room for improvement in the NHS, where patchy access to childcare creates problems for staff working antisocial shifts, and calls for hospitals to ensure that childcare is available round the clock.

“We welcome the government’s commitment to improving childcare. However, it needs to recognise that in sectors like the NHS, staff work round the clock and there’s a need for 24-hour crèche services. Where junior doctors can find nursery care – and they often can’t – it’s usually open only in the daytime. Little attempt has been made to provide the 24-hour childcare needed for doctors who work antisocial hours. The simple facts are that soon the majority of doctors will be women, that they will continue to have children, and that 24-hour working requires 24-hour childcare.”

Dr Jo Hilborne lives in Swansea and is currently practising as a specialist registrar in obstetrics and gynaecology at University Hospital Wales in Cardiff. She replaces Simon Eccles as chairman of the BMA’s Junior Doctors Committee, becoming the first woman to lead a BMA UK committee representing one of the three largest groups of doctors - juniors, GPs, and consultants. She has three children, and has balanced work in the NHS with family commitments since 1994.