Junior doctors who commit to work in Wales would have their student debt wiped out under a radical proposal to solve the country’s shortage of medical professionals.
The Welsh nationalist party, Plaid Cymru, has outlined plans to pay off average debts of £75,000 for young medics, in a bid to attract 1,000 more doctors.
The party said their policy would solve a problem which has led to Wales having one of the lowest doctor per patient ratios in Europe – 26.4 doctors per 10,000 people, ahead of only Romania and Poland.
However, the governing Labour party accused them of playing “fantasy politics” and the head of medical education in Wales said that the policy would be expensive and urged politicians to focus on improving the working experience of doctors in Wales to attract more recruits.
Wales has suffered for years from difficulties in retaining and attracting young doctors, who choose which part of the country they want to continue their training in just before completing medical school.
While some parts of the country, such as London and the south east of England are oversubscribed, Wales and some poorer parts of England struggle to recruit enough doctors.
Before completing medical school, students rank the UK’s medical training areas by order of preference. Better-performing students have an increased chance of being allocated their preferred area, leading to concerns that the best young doctors are becoming concentrated in the parts of the country perceived to have the best career opportunities and quality of life.
England is split into 13 local education and training board areas, previously known as deaneries, while Wales, Scotland and Northern Ireland are all deaneries in their own right.
Dr Andrew Collier, co-chair of the British Medical Association’s junior doctor committee, said that striking off student debt would be an “incredibly attractive proposal” new graduates but needed to be part of “a package of measures” including giving young doctors more choice about where in the country they practised.
“Wales suffers from being a very big deanery,” he said. “The doctors who choose to work there can’t really control where they end up. You could have a [training] placement in Cardiff, then one in in Llandudno. It’s not particularly attractive for a young doctor with a young family to have uproot from the Valleys, up to north Wales, then back down to Cardiff, in what could be just a six- or seven-year period. Giving juniors more control over where they live and work might address some of those problems.”
He said that Wales had problems not only attracting doctors for their first two years of training but also for specialties later on in their development. Acute medicine, accident and emergency, psychiatry and in paediatrics were areas of particular concern, he said.
Plaid Cymru also said it wanted to increase the number of places at Wales’ medical schools in Cardiff, Swansea, and Bangor, and to set quotas for the number of Welsh students.
Schemes to wipe out junior doctors’ student debt have been used to recruit in other hard-to-staff countries such as New Zealand. Dr Collier added that, with student top-up fees introduced two years ago, from 2017, trainee doctors would begin graduating with student debt as high as £110,000.
However, Professor Derek Gallen, postgraduate dean of the Wales Deanery said he was unconvinced by the plan.
“Using monies to pay off debt seems an expensive initiative in the current financial climate, when fundamentally it is the doctor's experience in post that will be a more persuasive tool to stay and work long term in Wales,” he said.
But Elin Jones, Plaid Cymru’s health spokesperson said: "For decades governments at both ends of the M4 have treated problems in our NHS with a sticking plaster," she said.
"Unfortunately the short-termism has now come home to roost which is why we are in such a difficult position in our hospitals," she said.
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