Foundation doctors in the UK are young doctors in their first two years of postgraduate training, following graduation from medical school. The two-year foundation programme is a bridge between medical school and speciality training or general practice training, ensuring doctors develop essential clinical and generic skills in a supervised environment.
As Pulse, the dedicated medical newspaper, has reported:
According to the results of a survey by the union, 52% of doctors said they have no ‘substantive employment or regular locum work' secured for August, when they finish their foundation training and are due to enter specialty training.
In the survey of more than 4,000 resident doctors, more than a third (34%) of those in their first foundation year also responded they did not have a job secured for next month. Overall, the survey found a third of all resident doctor respondents had no role secured for next month.
In other words, very large numbers of young doctors who have been trained to work in either hospitals or general practice, and who have accumulated maybe £100,000 of debts to put them in this position, are not at this moment being offered jobs by the NHS, and the only possible explanation for that is that Wes Streeting and Rachel Reeves have connived to ensure that the funding to employ these essential people is not available.
The argument that we are now short of doctors, which was always the excuse for the shortage of NHS appointments, is, therefore, now wholly inappropriate. There are more than enough doctors to employ in the UK now, with more following on from them as they currently go through medical school. We could meet the demand for medical services in this country, but we don't do so solely because Labour will not fund our ability to do so.
The result is that 7 million or more people are on waiting lists for treatment of some form.
Most especially, there are very large numbers of people who are unable to work because they cannot get the help that they need from the NHS as the government has decided not to make that help available by funding the NHS to provide it.
For the third time this morning, I draw attention to the economic incoherence of those who think that they are in charge of our economy, but who are in fact slaves to the defunct, dangerous, and itself incoherent policy of austerity, which is the only agenda that the UK Treasury and the prevailing political narratives in the UK permits.
We do not need austerity. We could put these doctors to work. They would create a virtuous cycle of well-being through their employment. We would all be better off as a result. The taxes they would pay would, in fact, help cover their employment costs, a fact that is often overlooked. But we are choosing to ignore all these things.
The time for excuses is over. If the NHS is failing now, the only person to blame is Wes Streeting, and the Labour government of which he is a member.
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And sadly there are reports of lots of newly qualified nurses, midwives, paramedics etc it having no jobs to go to because there’s no money to employ them. This is reminiscent of the Thatcher years and even more tragic given these young people have paid to get their training. We at least had our training paid for and a low salary to cover our living costs. This is basic stuff, ensuring our public services have enough funds to employ newly trained staff.
Correct
Thanks for sharing!
Meanwhile Roy Lilley estimates that there will be be a bill of about £6.5bn for redundancy costs from the insistence that Trusts stay within totally inadequate budgets! You couldn’t make this lunacy up – unless of course your aim was to destroy the NHS and create a Private Healthcare sector in double quick time.
Agreed
And Roy is good on this stuff.
Streeting and Starmer and Reeves presumably believe that casting young medical professionals on the scrap heap is essential to maintaining their ‘non-austerity’ policy , and to ‘getting waiting lists down’
Its incoherence but is it also ignorance or malevolence – ?
It’s how they think they will break the doctors’ stike.
It will force them to migrate for jobs and once they’ve gone, many won’t return. It makes me so sad. I believe Scotland has a policy of forcing newly qualified teachers to work for a year in Scotland, but that guarantees them their training year. It would be great if England could guarantee all teachers and healthcare workers a year’s post qualification employment too.
These people have had two years post graduate training, and then a P45.
The LINO approach in the public sector is “do more with less”.
Code for ” we are gutting the public sector”.
It will be interesting to see how many US and UK companies are making big profits ( and getting new contracts see Bain & Co) running public sector services despite the LNO mantra the “UK credit card is maxed out”.
While out walking yesterday (along what turned out to be a pretty disappointing section of the River Trent north of Newark) me and my walking companion were running through all the disappointing, depressing or downright bonkers things Starmer’s “Labour” government have done/not done over the past year. The list kept us busy for most of our outward walk (of several hours).
We’re both ex academics – a historian and a political scientist – so between us know a bit about politics. We both attended university as mature students having started life working as most working class kids do, in manual jobs, or shop work, and so on. But we were active in local Labour politics and members of the Labour Party for many years, most importantly through the dark days of the Thatcher years, and the dog days of that period under Major. And then, the almost as bad days of the Tory/Lib Dem coalition.
Anyway, after much discussion back and forth (including at one point diverting into discussing the efforts of the “New Liberals” in the 19th century to co-opt early Labour politicians into the Liberal Party) we concluded that never, ever, would we have believed that Starmer’s Labour could be as awful as it has been and seems set to continue.
All I can add is that the news in this blog confirms that in spades. It’s not only appalling policy, but also shows a lack of strategic thinking and/or slavish following of the dogma (but fallacy) of so called “fiscal rules” that beggars belief. It shows an approach to the responsibility that comes with being in government that’s brainless, cowardly and utterly contemptible.
I said in a comment earlier this week that I wouldn’t have believed what Netanyahu’s Israel is doing to Palestinians given the treatment Jews have suffered over the centuries. I can now safely say that I wouldn’t have believed a Labour government could be so un-Labour, or so bad -across all aspects of government, as Starmer’s government are if I hadn’t witnessed it with my own eyes. Utterly shocking!!!
Thanks, Ivan, and much to agree with
Cf the Eastern Daily Press lead story earlier this week about low morale at the Norfolk and Norwich Hospital, which is laying off hundreds of staff (Inc both clinical and non-clinical).
It is Labour who have failed.
Having convinced themselves that they have no sovereignty – Thatcher’s gift to Labour BTW – they now start trying to pull loose change from out the sofa. Everybody else’s sofas.
It’s all a bit pathetic isn’t it really – gaining power to then tell everyone that you…………….have none? Really?!
It sounds contrived to me – a sort of shadowy coup has taken place for sure. Labour are bought and sold. Just like the people of Gaza are being told their future, we are being shown ours (minus the missiles and bullets) – your suffering is going to be for someone else’s profit.
Clear complicity in genocide and the eventual creation of the largest concentration camp in history would appear to have strange effects upon ones’ sense of morality and political responsibility to those who voted for for you in the hope and expectations of something better.
What point have we reached as a country and polity that we can only resort to descriptions of realty as this?
What on earth was so beguiling about Thatcher’s stupid household budget nonsense that it apparently switched something in every politician’s brain ever since and made it impossible for them to see economic sense? The damage she caused never seems to end.
Janet
In an attempt to answer your question, the reason why Thatcher’s lie works is that it makes life easier for politicians – after all, making something great in this life is very hard work.
Working under an artificial imposition that a government is like a household is an easy way to make just under £100K a year as an MP, more if you have a ministerial post.
All you have to do is move the money around – taking from the bottom to give to the top – and from the most vulnerable groups as well. How often do three year olds get to tell politicians that they go to nursey or whatever, hungry?
It is depressing so many people in this country can’t figure out that the government like licenced banks creates credit from scratch but that there’s a huge difference in responsibility between them the government has to regulate and optimise the whole economy unlike a licenced bank which is simply focussed on making a profit. This is the brain fog that Thatcher managed to foist on a whole nation!
While I agree with the essence of what you say, the Pulse quote doesn’t ring true. I don’t think there are any Foundation Programme posts that don’t cover the full two year training – it isn’t credible that 34% of those in Foundation year 1 didn’t at the time of the survey have a job for August.
However other sources also suggest many Foundation year 2 doctors did not have a specialty training post to move on to. It would take a bit of teasing out of the data to work out exactly what is going on, quite a lot of new doctors seem to be planning to step outside the training programme for that year – having had two very stressful years by then – and either pick up locum work or travel overseas (such doctors are eligible to take locum positions in countries such as Australia). As a result the FY2 doctors applying for jobs are in competition with those planning to return to training after a year away, making the size of the mismatch between FY2 and specialty posts harder to measure. A crude survey won’t provide the right numerical answer but will correctly report the level of anxiety felt by the resident doctors.
It is clear that the feeling resident doctors have of being undervalued (leading to industrial action) is about the conditions of service much more than pay. Successive governments talk about NHS “inefficiencies” that have to be removed when those inefficiencies are the direct result of 15 years of austerity and need remedying by investment. Asked to save 5% if budget, all hospitals have been able to do is cut back on building maintenance, delay updating an already antiquated computer system (which consequently crashes), and cut down on the admin staff who enable clinically qualified staff to use their skills efficiently. Just two shifts into her time as an FY1 doctor our daughter is already struggling not just because of the intrinsic difficulty of the job but because of the frustrations of overcoming unnecessary obstacles.
I disagree: people have to apply for jobs on their training rotations and it has always been possible not to get one. The chance is now much higher, but the real issue they are making is re end of year 2.
‘..the only possible explanation for that is that Wes Streeting and Rachel Reeves have connived to ensure that the funding to employ these essential people is not available.’
So another immoral act to simply increase the wealth of the wealthy (?) and to further punish the poor and the majority. My, how the LP and its motley crew of pirates, charlatans, turncoats and sell outs have sold the country out. I guess also many of these Drs may seek employment elsewhere in the world if their quals are relevant elsewhere.
I said many years ago, FWIW, that eventually the establishment and the political class that does its bidding would turn on the middle class as well. Amoral greed does not stop until it is challenged. Sadly and tragically, the UK establishment is a state within a state, a rogue state that puts money, power and influence before people’s lives and it acts without moral restraint of any kind. I personally have never been gulled by the pageantry and antics of the upper echelons and ‘great and good’ of Britain. I can’t imagine many people do when seeing the political, social and particularly economic shenanigans and chaos they preside over.
The BMA’s UK resident doctors committee has called for priority for UK graduates to get into training over international medical graduates (IMGs), but not to discriminate against IMGs already here.
Of course UK medical school places have increased to supply more doctors but we are now seeing cuts in training places and ballooning competition ratios for the places for both UK and IMG doctors.
It’s a mess entirely of the government’s own making.
One of my kids was lucky enough to get into speciality training but it’s not a cakewalk – the exams in particular are brutal and expensive, and the on-call nights exhausting.
I know.
I ligfe with an MRCP who is also MRCGP and a number of other things as well
To lend large numbers of Doctors thousands of pounds to train to be Doctors and then not employ them to give them an opportunity to repay the loans is economic madness. The expensively acquired skills are not put at the disposal of the NHS and the Treasury is out of pocket. How on earth can this be considered to be saving money?
It is, as I said, incoherent.
And I think you will find a lot of newly qualified nurses, teachers etc will also find themselves without a job in September,not because we don’t need them but because budgets have been cut to the bone and pay rises granted that are not fully funded and require efficiency savings i.e. job losses. It is madness and sadly the result of a government with no clear strategy or plan.
All reports that I am seeing and hearing suggest that you are right. This is a travesty of justice for all involved.
David B adds:
I am not sure to what extent GP Practices are run as private businesses. Some are already owned by Private Equity. Knowledge of the NHS-GP Contract would provide that detail.
My observation is that GP (business) Partners are paid ‘fees’ based upon the No. of patients within a catchment. Then additional fees can be earned by training/mentoring Registrar (trainee) GP’s and medical undergraduates. Also, earnings from the provision of ‘other’ services to the NHS.
Newly qualified GP’s would need to be able to buy into an existing Practice and become a Partner in order to guarantee a position. Others would need to be offered a salaried contract of employment for the provision of GP services to the Partnership.
If my understanding is correct, the NHS will need to provide State run practices unless the objective is privatisation ie a sell out to USA-based vulture capitalism.
My GP’s surgery can’t see me for 6 weeks as I assume they don’t have enough doctors. Meanwhile we have plenty in training begging for a job, it’s like a [REDACTED] moron is running this country. I cannot express the amount of utter rage I have at this because I know the true cost from working in healthcare and from below.
My cancer wasn’t diagnosed for 3 months because there wasn’t a doctor to see me for 6 weeks, so they sent me to a physiotherapist who was grossly under qualified to diagnose conditions. I’m sure he’s good at treatment but he’s not a diagnostician. So 3 weeks into treatment I realise it isn’t working and get an appointment booked for 6 weeks time. I get sent for blood tests for a week and then finally a referral to a musculoskeletal specialist after 2 weeks.
I then have to wait 2 weeks for a biopsy and then 3 weeks for the result because we send it to the USA for testing…I can only surmise it’s because we haven’t invested in testing facilities here over the past few decades. Then there’s a wait for the operating schedule but that was due to it being a rare form. All in all it took about 6 months for a grade 3 aggressive tumour that grew to 22cm and weighed 3-4Kgs to be diagnosed and removed.
I have had follow up chemotherapy and every single patient I met there is no longer here because the cancer had usually spread before the initial complaint is discovered, weeks or months later. This is the real cost of this utter ineptitude.
I am so sorry Alex.
I have lived with a partner with cancer – now in remission for more than a decade but requiring radio and chemo – so my sympathy is very real.
I hope all goes well.
Thanks again Richard.
My dad used to say my brother knew the cost of everything but the value of nothing and it seems this is true of our government.
They know the cost of more GPs, building new hospitals, surgeries but not the value of having loved ones around for a few more yyears, or even many more years if cured.
They know the cost of building new schools, providing more teachers and assistants to handle children and the SEN students but they don’t know the value in not having a building collapse on them, or enthusiastic teachers mentoring and growing talent.
They know the cost of our water systems and of the upgrades needed but not the value of having clean affordable water in abundance.
They know the cost of building more energy generation and renewables but not the value of energy security or having businesses not disappear because they can’t afford the 3x increase in energy cost.
We could go on but it’s clear since Thatcher it’s been governments running on cost not on value.
J D Vance is “holidaying” in the UK. I’m sure it will involve some informal meetings on behalf of Palantir and other silicon valley interests, with NHS data on the table no doubt.