Doctors face four-year mandatory NHS service as Jeremy Hunt expands medical training

New doctors will be obliged to work for the NHS for a minimum of four years after graduation under plans to expand medical school places by a quarter from 2018.

Health secretary Jeremy Hunt is set to unveil plans to end the NHS’s dependency on overseas doctors, making the NHS 'self-sufficient' by the end of the next parliament.

In his speech at the Conservative party conference in Birmingham on Tuesday the health secretary will announce an additional 1,500 medical places a year from 2018, supported by around £100m over the current spending review period.

Mr Hunt will pledge to reform the existing cap on the number of places medical schools can offer, currently set at 6,000 per year, but will introduce a mandatory four-year NHS service term for UK medical graduates.

The BMA hit out at the plans, warning the government it must tackle the 'root causes' of the NHS workforce crisis' and pointed out that extra training places would take a decade to deliver the extra doctors needed in the health service.

NHS workforce

The union highlighted concerns raised by junior doctors about morale and poor working conditions during the ongoing dispute over a contract the government plans to implement from this month, and urged ministers to solve these issues - which are driving doctors abroad - rather than 'forcing doctors to stay'.

Around half of students applying for medical school are turned away each year, the health secretary will say. The Conservatives want every British student with the skills and capacity to attend medical school to do so.

The reforms will aim to end the NHS’s reliance on overseas doctors - with around a quarter of the current workforce from abroad - at a time of a global shortage. The government hopes the NHS’s locum wage bill can also be reduced by the plans.

Mr Hunt is expected to tell the Conservative party conference: ‘As well as delivering higher standards today, we need to prepare the NHS for the future – which means doing something we have never done properly before: training enough doctors.

Overseas doctors

'Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to be able to stay post-Brexit. But is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?’

Mr Hunt will add: ‘From September 2018, we will train up to 1,500 more doctors every year, increasing the number of medical school places by up to a quarter. Of course it will take a number of years before those doctors qualify, but by the end of the next parliament we will make the NHS self- sufficient in doctors.’

New conditions, modelled on those imposed on Armed Forces students, will tie new doctors to serve at least fours years in the NHS in order to ensure the reforms to medical school places deliver for the taxpayer.

Universities that want to offer increased numbers of medical student places will also be required by the government to give assurances that they are offering opportunities to children from disadvantaged background.

Junior doctor contract

BMA chairman Dr Mark Porter said: ‘Jeremy Hunt has been health secretary for four years, and while it is welcome that he has finally admitted the government has failed to train enough doctors to meet rising demand, this announcement falls far short of what is needed.

‘The government’s poor workforce planning has meant that the health service is currently facing huge and predictable staff shortages. We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors. This initiative will not stop the NHS from needing to recruit overseas staff.

‘International doctors bring great skill and expertise to the NHS. Without them, our health service would not be able to cope.

‘Over the past year, junior doctors across the country have raised concerns about the reality of working in an overstretched NHS and the impact that has on their morale and patient care. We know there are chronic staff shortages and rota gaps across the NHS, with major recruitment problems in areas such as emergency medicine and general practice.

'The government must tackle the root causes of this workforce crisis and the reasons why so many UK-trained doctors are considering leaving the NHS rather than forcing doctors to stay in the health service. Demotivated, burnt-out doctors who don’t want to be in their jobs, will not be good for patients.’

Conservative ministers have been trailing the idea of a mandatory term of NHS service for medical graduates for some time. In 2014 former Conservative minister Lord Howe said the health service could place military-style restrictions to guarantee that medical graduates do not leave the UK without serving in the health service.

The House of Commons public accounts committee also raised the proposal in a report last year. Support among existing GPs for an NHS service term is not insignificant - a GPonline poll last year found that almost half of GPs would back the move.

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