NHS 'faces crisis over exodus of junior doctors'

BMA CONFERENCE: Funding 'rigged to favour Conservative areas'

A quarter of junior doctors have become so disenchanted with the health service that they are no longer working in medicine, the British Medical Association annual meeting was told yesterday.

One doctor, Helen Davison, 28, told the meeting that she had left the profession two years ago because of stress.

"I am from a medical family. I entered medical school believing that the NHS had something which appeared good to me. I started work when there were a lot of reforms in the NHS and I found myself increasingly ground down. After three years as a junior doctor I had to leave for health reasons," she told the conference in Harrogate, North Yorkshire.

A proposal that the association should establish a working party to examine the reasons for the exodus of young doctors was referred to the BMA council. The problems are now so severe that today doctors will debate setting up a helpline for over-stressed colleagues.

At a news briefing, Dr Sandy Macara, chairman of the BMA council, said the NHS was facing a manpower crisis among juniors, consultants, GPs, public health doctors and academics. "We are losing 25 to 30 per cent of our brightest youngsters." At the same time the Government was setting its face against implementing its own policy to increase consultant numbers.

Dr Davison, from Carlisle, who left medicine in 1993 and did a business management course, is now unemployed.

In the debate, Dr Brian Keighley, a GP from Stirlingshire, said that doctors already knew why their colleagues were leaving the profession. "If anybody should be investigating this it is the Government. We are asking why highly committed professional people are walking away from jobs they committed themselves to. We already know the answers; rising workload, insensitive management, inflexible training, subordination of professional values to those of the market, juniors' hours and GPs' night visits.We have been telling ministers that for years. The Government is reaping the whirlwind of its own policies." Dr Andrew Carney, chairman of the BMA junior doctors' committee, said at a briefing that at any one time one in four young doctors was not working in medicine in the first three years after qualifying. This represents between 4,000 and 5,000 recently qualified men and women. It costs pounds 30,000 to train a medical student to graduation and pounds 100,000 to train a doctor to consultant level.

"Many will return but Dr Davison is not alone. It is not just a shame, it is a disgrace and a waste of public money. It takes tens of thousands of pounds to train them, then they are treated like dirt and people are surprised when they leave," Dr Carney said. Doctor shortages now meant that large numbers of European trainees are working in Britain. The latest estimates are that there are 1,000 German doctors and 700 Dutch doctors working in training posts as senior house officers.

"Most will return when they have trained. But we can't rely on Germany to over-produce doctors to bail us out for the next 10 years," he said.

The BMA has just begun a long-term follow up of 500 medical students graduating this summer to see what they decide to do over the next 10 years.

In an emergency debate the conference also urged the Government to reverse its decision to place all junior doctors' contracts with local hospital trusts. Doctors at all levels fear this will fragment the national training programme.

Gerald Malone, health minister, said yesterday that junior doctors' conditions had improved remarkably. "The Government is fully committed to ensuring that junior doctors are properly trained in the new NHS. Nothing in the proposal to hold their contracts by NHS trusts threatens this."