NHS red tape ban on top doctors

12 April 2012

Hundreds of brilliant surgeons and hospital specialists are being barred from taking senior jobs by dawdling, form-filling bureaucrats.

Under recently introduced rules, physicians must register with a new Government body before they are able to work as consultants in British hospitals.

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Hundreds of brilliant surgeons and hospital specialists are being barred from taking senior jobs by dawdling, form-filling bureaucrats

But the bureaucrats tasked with processing the paperwork have fallen disastrously behind schedule - leaving scores of specialists unable to work at the level for which they are qualified. Many have been obliged to take temporary, less senior posts.

Even very distinguished surgeons have fallen foul of the new rules.

The Mail on Sunday today highlights the case of Professor Chris Lavy, a top orthopaedic consultant whose attempts to register after returning from working in Africa were held up for a "nightmarish" year - during which, ironically, he was awarded the OBE in recognition of his work.

The British Medical Association said hundreds of other specialists were subject to similar "unacceptable" delays.

Prof Lavy told The Mail on Sunday: "It took 15 months to process my application, just so that I could find work in the NHS doing a job I had been doing for 20 years.

"Despite receiving professorships from the Royal College of Surgeons and Oxford University, I wasn't even allowed to work in my local hospital. It was an incredibly frustrating waste of time."

The hurdles the professor had to overcome included:

Having to fill in an application that stretched to 200 pages.

His application not even being opened until six months after he submitted it.

Further delays because he had not provided a logbook detailing his training, which took place in the Eighties, before the existence of log books.

During the long wait, he missed out on a year's earnings which, as a consultant orthopaedic surgeon working in London, would have been up to £200,000.

Since 1997, every consultant has been required to be on the Register of Specialists, introduced by the Government under pressure from the EU, to enable freedom of movement of doctors across Europe.

Those wishing to join the register now have to pay £1,250 to apply through the Postgraduate Medical Education and Training Board - a Government-appointed body set up in 2005 to oversee higher training and registration of doctors in every speciality, including general practice.

But Professor Lavy is just one of hundreds of doctors for whom the application process - which has a target completion time of just three months - has proved a much longer, and extremely costly, process.

Those worst hit by the delays include British doctors who trained overseas and women returning to work after having children.

A spokesman for the BMA said: "The delays faced by doctors applying through PMETB are unacceptable and result in patients losing out because many talented, experienced consultants cannot work as such while their applications are processed.

"PMETB does not appear to have enough resources to cope with the applications it receives. The BMA has received many complaints from doctors who have had so many problems with the tortuous application system that they have given up trying to get on the register, and are unable to work as consultants.

"There are hundreds working at lower levels than their experience would merit due to bureaucracy. They are not using their capabilities to the fullest extent and are working in lower-level jobs within hospitals.

"It can lead to disenchantment among doctors, which also adversely affects patients."

Dr Pradip Gupta, an associate specialist general surgeon working in the Calderdale and Huddersfield NHS Foundation Trust, is a British national who was born, and completed his training, in India before moving to Britain in 1981.

Since then, he has been working in the NHS, and became a locum consultant in 2002. Despite submitting his application to join the Register of Specialists to PMETB in December 2005, he has not yet received notification of the result.

Dr Gupta, 56, said: "It took a year of having my application repeatedly returned for them to accept it. Some of the documents they asked for were virtually impossible to obtain.

"In January, I learned it was finally being considered, but I have not had a reply yet, despite being told it would take three months. In the meantime, as a locum, I am earning far less than I would in a consultancy post."

Another surgeon working in a South London NHS trust, who does not wish to be named, had his application declined after an 18-month process, despite working as a locum consultant for the past nine years.

He said: "I was told, after spending £750 to apply, that I did not have the depth and breadth of experience which a young doctor just about to receive their Certificate of Completion of Training would have.

"I found this ridiculous, since I have been teaching surgery to doctors at that level for years.

"I have now paid a further £600 for a review of my application, in the hope that they will accept the experience I have gained working for decades in Britain, India and the Middle East. The system is simply not working properly."

PMETB, a partially Government-funded body which will be fully self-funded by 2009, took over responsibility for postgraduate training for doctors from the Royal colleges.

A PMETB spokesman said: "When it comes to approving doctors to work as consultants, it is vital from a patient safety perspective that we get the decision right, so we don't cut corners.

"We have a statutory responsibility to give a decision on completed applications within three months of receiving them. Many of those we receive are not completed properly, which makes the process longer.

"At the moment, some are taking longer than three months due to delays in the recommendations from the Royal colleges, but this should be rectified shortly."

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