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Time for Training (Medical Education England Report)

Volume 511: debated on Wednesday 9 June 2010

“Time for Training”, the independent review of the impact of the European working time directive on the quality of medical training is being launched today by Medical Education England. A copy has been placed in the Library and copies are available to hon. Members from the Vote office.

In response to concerns about the impact of the directive on the training of junior doctors working in the national health service, the then Secretary of State asked Medical Education England last year to commission an independent review. I want to thank Professor Sir John Temple for his report and Medical Education England for their advice in helping to bring together complementary perspectives to issues affecting the quality of patient services and training.

The objective of post-graduate medical training is to produce fully qualified specialists who are able to provide high quality and safe patient care. Experience in delivering service is an integral part of training for a junior doctor but the provision of service is not the primary purpose of post-graduate medical training. Sir John’s review challenges the service and medical profession to think afresh about the approach to training the next generation of hospital specialists in ways that will provide better patient care and well-trained professionals.

The findings in this report underline the importance of the coalition agreement commitment to limit the impact of the directive in the context of United Kingdom health services. “Time for Training” identifies ways in which safe care and high-quality training are capable of being achieved in the service. It also highlights the immediate difficulties created for trainees and for the service, especially in providing out-of-hours and weekend emergency patient care, in places where there is not yet the structure, support or flexibility of working practices needed to comply with the directive and the restrictive interpretations of the directive by the European Court of Justice.

I will support my right hon. Friend the Secretary of State for Business, Innovation and Skills in taking a robust approach to future negotiations on the revision of the directive, including maintenance of the opt-out. We will not go back to the past with tired doctors working excessive hours, but the way the directive now applies is clearly unsatisfactory and is causing great problems for health services across Europe. These difficulties are clearly reflected in the evidence from junior doctors that the implementation of the 48-hour week EWTD has impacted adversely on training and has been accompanied by unwelcome imposition of shift practices. Sir John’s report reinforces my determination to support efforts to resolve these difficulties and be ready to work constructively with the European Commission and other member states on radical, creative approaches to gain additional flexibilities.

Professor Sir John Temple’s findings demonstrate that far more can be done now by the service and the medical profession to improve medical training by changing working practices and taking greater advantage of the big increase in the number of consultants working in the national health service. I welcome his recommendations that the New Deal contract for junior doctors should be better aligned with the structures under the directive and that the consultant contract and job planning should incentivise consultants to support trainees and continuity of training. Continuity of patient care, of course, rests with the consultant who is responsible for the patient.

I have asked Medical Education England to consider with the profession, the service and medical Royal Colleges, how best to implement training practices that will support these aspirations. This will include reviewing the appropriate service component for medical specialty training with individual colleges and specialty associations, and advising NHS employers in their discussions on ways to realign and simplify New Deal working arrangements. I will continue to seek advice from Medical Education England on other matters to improve training, including development of a strategy for technology-enhanced learning and take-up of simulation training, and on the future structure of post-graduate medical education.