Workforce planning is either feast or famine

It was not so long ago that the BMA was loudly demanding that another 10,000 new doctors were needed to fill the gaps in NHS services. Now we are hearing warnings of a glut.

The NHS Employers organisation told MPs last week that by next year there would be a 12 per cent 'over supply' of doctors, forcing large numbers of medical graduates out of the profession (presumably with their mountainous student debts still intact).

At first glance, this is perhaps not surprising given the rapid anointing of new medical schools to help drive up the number of medical students, at an average cost to the taxpayer of around £750,000 per qualified doctor.

It's the speed of the turnaround, if proved correct, that is astonishing.

Some will argue that there should be competition for jobs in the NHS and services will improve as a result. But this is clearly not the most cost-efficient way of raising standards.

And it is most certainly not the result of careful workforce planning by the powers that be.

On the contrary, it made no sense to cut the number of training places in general practice just as a tidal wave of potential new recruits was set to emerge from medical schools.

At the same time, we have a new practice-based contract for GPs that positively discriminates against the recruitment of doctors: if your partner retires or moves on, what incentive is there to recruit even a salaried replacement GP when prescribing nurses can be brought in for half the price?

Indeed, how is the awarding of full prescribing powers to nurses supposed to fit with the hordes of new doctors being trained? This at the same time as thousands of nurses face losing their posts as a result of the NHS financial crises and PCT reorganisation. They will be joined by hundreds of nursing refugees from the collapse of NHS Direct.

It was not so long ago that the BMA published a controversial discussion paper advocating that nurses should become the new gatekeepers of the NHS. Now the association is bemoaning the extension of nurse prescribing powers. How times have changed.

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