Government Comes Up Short On Pledge For Flexible Working In National Health Service, UK

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Main Category: Medical Students / Training
Also Included In: Public Health;  Primary Care / General Practice;  Women's Health / Gynecology
Article Date: 08 Nov 2007 - 10:00 PDT

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Despite a promise to provide more flexible working in the National Health Service (NHS), the UK government has broken its pledge, according to an article in the Postgraduate Medical Journal (BMJ).

The authors explain that almost 70% of medical students in the UK are female - by 2012 there will be more female doctors than male doctors.

Despite a pledge made by the UK government in the year 2000 in the NHS plan, the number of flexible posts has never been so low.

Authors, Drs Helen Goodyer and Finola Lynch, Medical Women's Federation, London, UK, claim that flexible working has been undermined ever since the new junior doctor's pay deal in 2000. Flexible working has just become "unaffordable to trusts", they explain. The ill feeling towards flexible trainees has widened - they are now seen as massively overpaid for the hours they do.

The pay deal was structured in such a way that flexible post trainees were getting paid more than the majority of full-time junior doctors and consultants during the first five years after becoming qualified.

An additional £7 million has been pumped in by the government to support flexible training.

However, the confusion has been exacerbated as a result of a new deal thrashed out by NHS Employers and the BMA (British Medical Association) in 2005, creating ill-feeling around pay bands for flexible training posts.

In 2005, the number of flexible training posts was estimated to have doubled by 2010. However, the body responsible for encouraging more flexible working practice lost its responsibility for hospital and general practice.

As trusts struggle to manage their debts and local funding has gone, recruitment to these posts has been frozen this year.

All reforms have done is place training posts in a state of instability. The coming implementation of the European Working Time Directive will reduce the number of hours a doctor can lawfully work each week. The authors say it is more important than ever to create flexible working.

"The principles and polices needed to create a cultural and practical shift in working practices are there. What is missing is the will (and consequently the funding) to achieve it. This approach is both short sighted and unforgivable at a time of profound change in UK medical training. Nothing less than a cultural revolution is required within the NHS," the authors write.

"Flexible working: policies are supportive but culture and finances are not" Helen M Goodyear , Finola Lynch Postgraduate Medical Journal 2007;83:669-670; doi:10.1136/pgmj.2007.059667 Click here to view Abstract online

Written by׃ Christian Nordqvist
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