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Acute Sector

Volume 458: debated on Tuesday 13 March 2007

The new strategic health authorities provide leadership and support to ensure that trusts operate effectively and deliver improved performance. The NHS Institute for Innovation and Improvement, as its name suggests, helps trusts to introduce best practice and radical new ideas to deliver health care.

Will my hon. Friend congratulate all the staff at the Royal Bolton hospital for saving lives, increasing efficiency and cutting waste by adopting the lean style of management? What can his Department do to spread such best practice throughout the national health service?

Staff in the health service are rightly suspicious of politicians or NHS managers who appear to have swallowed a management consultancy textbook. However, I went to the Royal Bolton hospital with my hon. Friend and, like him, I was incredibly impressed by what I saw. The key principle of the lean management process is that staff lead the change. They are empowered to make changes and drive through the programme on the wards. My hon. Friend’s hospital trust has seen a 30 per cent. reduction in length of stay for trauma, a 37 per cent. reduction in post-operative mortality and a cut in the processing time for blood samples from five hours to 30 minutes. Those are the huge benefits resulting from staff leading change in the hospital.

The Minister must know that thousands of doctors across the hospital sector are deeply angry at the disgraceful mismanagement of the modernising medical careers system. Three months ago, his predecessor said:

“Doctors in training in England should…be pretty confident about securing a training post”.

Will the Minister renew that assurance now?

The hon. Gentleman will know that, on learning of the problems, we immediately set up an independent review led by Professor Neil Douglas, the vice-president of the Academy of Medical Royal Colleges. The findings emerging from the review are already being implemented. We are not seeking to minimise the problems, or saying that they are not causing uncertainty for doctors in training. We accept that, which is why we have taken this swift action and why measures are now in hand to improve the situation. I point out to the hon. Gentleman, however, that these changes were, in origin, agreed with the royal colleges.

For a start, the Minister should apologise to junior doctors for the disgraceful shambles that they have been landed in. He has issued a ministerial statement today about the review, but it does not answer this question: if there are insufficient training posts—and if the assurance that junior doctors should be “confident” about securing a training post cannot be fulfilled—will the review recommend that additional trust grade posts be converted into training posts in order to address the problem?

We will see what the review tells us. Significant changes have been made to improve selection in the second round. People want to see immediate changes so that the situation will improve. We are trying to work our way through the situation to give people more certainty. More broadly, we have to get work force planning right in the national health service to ensure that there are sufficient people in training. If the hon. Gentleman is suggesting that there are simple answers, and asking us to commit to new spending on extra posts, he is sorely mistaken.