Health authorities using staff
training funds to cut deficits
2nd October 2006
Millions of pounds that should be being spent
on training junior doctors, nurses and midwives are being withheld
in a bid to meet the NHS's financial deficit, Britain's most senior
surgeon has warned.
Cash-strapped strategic health authorities are
"raiding" an average of 10% of the MPET (multi-professional
educational training) budget, which should be spent on improving
health professionals' skills, Bernard Ribeiro, president of the
Royal College of Surgeons, said.
That could have a serious impact on patient care
at a time when junior doctors' training - and in particular theatre
time - is already being slashed by a reduction in doctors' hours
caused by the European working time directive, and by a new training
system called Modernising Medical Careers, to be rolled out in
August, that will see junior doctors become consultants in seven
years rather than the current 11 years or more.
Mr Ribeiro, who practises as a consultant urologist
at Basildon Hospital, Essex, revealed that the Royal College of
Surgeons had serious concerns about cuts to the medical and dental
education levy - the part of the MPET budget to be spent on training
dentists and junior doctors once they are qualified.
"We are having reports coming through from the north-east,
around Newcastle, from the east of England, from the West Midlands,
of an average 10% being taken from funding," he said. "In
the east of England the budget for multi-professional educational
training is nearly £291m, and they are looking to save £25m
- an 8.6% reduction. In the north-east, where the budget is £199m,
the reduction is 10.6%."
The reduction, which can occur because the money
is not ringfenced, means junior surgeons will no longer be funded
to attend courses crucial to learning new skills and perfecting
their surgical techniques. Some hospital trusts have already been
withholding funding for the courses, which each cost several hundred
pounds.
Mr Ribeiro acknowledged that in countries such
as Australia doctors are expected to meet the costs of such professional
training on their own. But he warned reducing the funding now
would be a "retrograde step" that would affect the skills
of future surgeons. It would also set the precedent for cutting
future funds.
"Right now there is an expectation this
money has been allocated for training ... and we would see it
as a retrograde step to reduce that," he said.
"In trying to meet NHS deficits you will
affect the future seedcorn of surgical training by having a serious
impact on developmental funds."
He added: "The arrival of the EWTD [European
working time directive] in 2009 will limit experienced time in
hospitals still further and make it all the more important these
facilities are available."
Under the directive junior doctors in hospitals
are now allowed to work only 56 hours a week, including time on
call, instead of the 100-plus permitted in the '90s. That will
reduce to 48 hours in 2009.
Mr Ribeiro's concerns came as the Council of
Deans, which represents nursing and health faculties in higher
education, warned that it too was seeing cuts of up to 30% in
the MPET budget.
A crisis meeting held last week on the position
of all 60 universities providing healthcare education heard that
SHAs were on average providing funding for 10% fewer students,
with reductions of up to 25% for individual universities in the
east of England, London, south central and south-west SHA areas.
There were also cuts of 10%-30%, depending on
the area, in funding for nurses and midwives once they had qualified.
Dame Jill Macleod Clark, chair of the council,
warned: "These cuts in places for nursing, midwifery and
allied health profession students take no account of workforce
needs. They are driven by financial expedience. Cuts in students
now will mean fewer nurses, midwives and allied health professionals
being available to the NHS in 2009-2010."
She added that the cuts to funding future training
for qualified staff would scupper NHS reforms.
Source: Guardian Unlimited
