Time to stop exploiting trust doctors

Almost a quarter of non-consultant doctors in the UK are being recruited to posts that do not conform to recognised NHS grades, leaving them unsupported and exploited, finds a study in this week's BMJ.

In a special issue of Career Focus in BMJ Careers, which accompanies the study, editor Rhona MacDonald argues that such posts are unfair, unethical, and should be replaced by a grade that does not exploit doctors or leave the NHS under resourced.

Researchers investigated the proportion of advertisements for non-standard grade (or trust grade) posts in eight random issues of BMJ Careers, which publishes 95% of hospital jobs. They also surveyed advertisers to find out why these posts exist, who fills them, and what the doctors in these jobs do.

Just under a quarter of non-consultant advertisements were for non-standard grade posts. Half of these posts are created to keep the NHS going when there is no more funding for recognised training posts, and most are expected to be filled by overseas doctors.

More than two thirds of the doctors filling these posts are required to do on-call work, and a quarter are on call for 24 hours every five days and one in five weekends, or more, breaching the European Working Time Directive.

Several individuals make it very clear how unjust they think such posts are. Paul Miller, chairman of the BMA's Central Consultants' and Specialist Committee believes that these posts are to be condemned as potentially exploitative of the doctors and misleading for patients.

Simon Eccles, chairman of the BMA's Junior Doctors' Committee argues that regardless of level achieved, all doctors below consultant level should have their experience and competence recognised.

The Department of Health admit there are significant problems with the current arrangements, but say that the consultation paper Choice and Opportunity will address this, while Postgraduate Dean, William Burr, outlines steps to reform a

Contact: Emma Dickinson
BMJ-British Medical Journal

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