London Letters: Medics express concern over Rishi Sunak’s NHS workforce plan

Notably, this announcement comes in the backdrop of the longest-ever action planned by the junior doctors from July 13 to 18, over pay and working conditions, with hospital consultants too likely to go on strike soon. Previously, nurses and ambulance staff too had resorted to industrial action for the same reasons.

As per the plan, by 2031, the government will double the number of medical school training places, with more places in areas of the country with the greatest shortages; increase the number of GP training places by 50%; almost double the number of adult nurse training places, with 24,000 more nurse and midwife training places a year; and expand dental training places by 40% to reduce NHS’ dependence on international doctors, nurses and other medical staff. The plan also includes staff retention and reformation of the way staff works, including reducing the training time.

Talking to The Indian Express, Dr Onkar Sahota AM, Labour Party’s London Assembly Health Spokesperson, said, “I welcome that the NHS now has a long-term workplace plan even if this has come thirteen years too late. In London and across the country, we desperately need to train thousands more doctors and nurses to tackle the vacancies within the health service. However, I am concerned that plans to shorten the term of medical degrees could lead to a drop in standards. This will need to be looked at carefully so that the public still receive the highest quality care and attention. Most worryingly, this plan offers no solution to the current retention crisis which is facing the NHS. One in ten health workers are currently leaving the NHS every year with anxiety, stress and depression being the most reported reasons. Recruiting more nurses and doctors will make little difference if we lose the experienced professionals currently working hard to look after us.”

Echoing similar views, Prof Gurpreet Singh MBE, Consultant, Urologist and British Association of Urological Surgeons trustee as well as the Chair of Fitness to Practice Panels, said, “We welcome the radical proposals, including increasing training numbers and reduced training time. This, however, needs a wider consultation and a deeper dive into alternative solutions, like the role of Physician associates (PA) and artificial intelligence (AI), useful for guidelines driven diagnostics and management. Reduced training time runs the risk of a two-tiered health care system with potential patient harm. The bigger problem is retention, a large percentage of doctors in the UK, migrate to the Americas and Australasia where working conditions and staff morale is higher.”

Critiquing the plan, Nottingham-based General Practitioner Dr Carter Singh MBE, said “The headline 5 years ago was, a target of 6000 extra GPs and the reality and the bottom line is that we have a net deficit of 2000 fewer GPs. So false promises and unrealistic targets to win votes in the runup to an election without the required investment and infrastructure to back it up are less than helpful. Whilst the headline figure of £2.4bn of additional funding is welcomed and may sound like a lot but when you compare it to £4bn of unusable PPE, it suddenly pales into insignificance. I’m in favour of streamlining training to make it more appropriate and relevant, but I’m not in favour of cutting corners. It shouldn’t be a race to the bottom and a rush to meet quotas putting quantity ahead of quality.”

“I’m fully in favour of expanding medical student numbers but that’ll require not only more medical schools but also more clinicians to set aside time to supervise undergraduates but also train the junior doctors. We are going to have to radically rethink how we train doctors because if we use current models we simply wouldn’t have the staff to train the additional numbers because they are too busy and overstretched firefighting and seeing patients on the front line,” he said.

Giving vent to her exasperation, Ealing Council Cabinet member, Dr Aysha Raza said, “You cannot just magic up thousands of trained doctors and healthcare professionals. Introduction of tuition fees has led to only those with financial means going into the long medical course, reducing the natural diversity. The cost cutting measures at medical schools have already seen vital practical learning by dissecting cadavers being phased out. By also cutting out a valuable year of the curriculum, we will see more inexperienced doctors dealing with the public before they are ready. This is yet again politicking with our health rather than fixing a system that is on its knees.”

“There are three big challenges that the NHS and any health services face- the spiralling cost of keeping up with emerging technology (i.e. Genomics, gene therapy, monoclonal antibodies and personalised medicine), convincing the public that prevention or health promotion early in life is more effective than huge healthcare infrastructure after disease occurs, and sustaining a trained, engaged, dedicated workforce that can work smartly using the power of AI. The Sunak 5Y workforce plan funded by £2.4 billion does not address the three fundamental challenges,” opined Dr Indranil Chakravorty MBE, Consultant in Acute Medicine and Training Programme Director, St George’s University Hospitals.

“The plan does not address the funding and transformation required of retaining and winning hearts and minds of current health professionals who are on long term industrial action. Sunak appears to be unconnected to the current challenges and, fails to address the elephant in the room, ill-advised by his team, so the ambitions, unconnected plan is likely to be another colossal mistake. It reminds me of the plan of a Mughal emperor of shifting the capital from Delhi to Aurangabad. History will tell us what happened there,” he added.

Bolton Medical School Board Chair and Pro VC, University of Bolton Prof Iqbal Singh CBE told The Indian Express, “Last year, the number of international medical graduates joining the NHS was more than the number of UK trained medical graduates, and with the increase in number of medical school places it will mean that UK will no longer be reliant on international workforce by 2035. Therefore, doctors coming from India and overseas will have equal opportunities for further training and professional development, and will be able to return and serve their local populations. It is important that the new UK doctors are able to serve across the communities, and medical schools will have to focus on producing holistic and compassionate doctors.”

The writer is a freelance journalist based in London contributing content to digital, print, radio and TV platforms