My right honourable friend the Secretary of State for Health (Alan Johnson) has made the following Written Ministerial Statement.
Today, the Government have laid before Parliament their response to the report from the Health Select Committee on modernising medical careers (MMC) (Cm 7338).
The department has already apologised for the difficulties encountered in 2007. It is crucial that the Government learn lessons from these problems, rebuild their relationship with the medical profession at all levels and, in consultation with it, design the best possible structure and systems for recruiting and training doctors in future.
We are grateful to those who have carefully investigated the background to what went wrong in 2007. This includes the Health Committee itself and Professor Sir John Tooke, who was commissioned by the department to carry out an independent review of MMC and who published his final report in January this year.
While we acknowledge that we have some way to go, it is important to record that much progress has been made over the past year, not least through the crucial work of the MMC England programme board, which has produced a recruitment and selection process that is more equitable and has the broad support of the medical profession.
We are grateful for the Select Committee’s recognition that the MMC England programme board has offered the medical profession a more meaningful role in decision-making and that MMC governance arrangements have been simplified and improved. We agree with the committee that the mixed economy model for specialist training structures—offering both run-through and uncoupled training posts—should continue for the time being.
A stakeholder event on this important issue was held on 3 June to meet the aim of working with the profession and building consensus on the way forward. There was broad agreement from participants that there should be no rush to introduce changes in 2009 although further work and debate is needed.
With regard to recruitment and selection, we agree that responsibility should be devolved to deaneries with some elements of central co-ordination and guidance and we further agree that there should be a staged recruitment process established in the future, expanding the additional flexibility that has already been built into the process for this year.
The House of Lords ruling on 30 April prevented the implementation of long-standing policy guidance for managing access to specialty training posts by doctors from outside the European economic area (EEA). However, there is wide consensus that government intervention is necessary and justified to maximise the training opportunities for UK-trained doctors. The changes to the Immigration Rules announced by the Home Office in February 2008 have been well received by the medical profession and will stand while we discuss with all those involved how best to resolve this issue.
We have noted and considered carefully the proposals put forward by both Sir John Tooke and the Health Committee regarding the establishment of NHS Medical Education England (NHSMEE) and the future of the MMC England programme board. There is a clear future for both types of organisation, with NHSMEE providing high-level direction setting and scrutiny and the programme board continuing its successful focus on the operational implementation of policy.
Our proposals for NHSMEE contain some changes to the remit originally envisaged by Sir John, but both the original case and counter-arguments had strengths. In respect of the programme board, responsibility for operational requirements and the implementation of policy will be devolved to the NHS and operational elements of the existing Department of Health MMC team will be devolved to the control of a strategic health authority (SHA) on behalf of the NHS in a way that carefully ensures business continuity of a function that is recognised as having made progress.