Medical Students in Policy: Shaping the Future of the NHS
Written By Mahin Miah
We’ve all heard of the training bottleneck that many newly-qualified doctors are facing after having completed their two foundation training years. It has resulted in unemployment for some, despite working arduously since their teenage years for this vocation. But why is that?
This can be attributed to a lack of effective management within the NHS. There’s a mismatch between the number of specialty training posts and the exceedingly high number of applicants. Yet, the UK collectively agrees that more doctors are needed as waiting times are getting longer but the number of specialists needed to assess and treat patients is significantly lower. From 2016 to 2024 the number of medical school places has increased, yet the number of specialty training has not. This is primarily due to how money is managed within the NHS. The funding for speciality training has not kept up with inflation. Instead, money has been diverted to pay locum doctors to fill gaps within rotas. Of course, it is good that patients will therefore see a doctor however, it does not resolve the fundamental long-term issue which is the deprioritisation of education.
The UK Treasury handles money for public services, but their vision is focussed on short term fixes to avoid major public complaints.This is inefficient,lacks forward-thinking and has undoubtedly contributed to the current NHS crisis The NHS is a public institution, therefore political objectives have certainly affected funding for medical specialty training.Politicians are driven by votes. Short term fixes equate to more votes as the results are quickly noticed. Long term fixes, such as educating and training doctors? Politicians fear receiving fewer votes as the results aren’t immediate.
Being the next generation of doctors, it is crucial for us to advocate and stand by our junior doctors.
As medical students, we should educate ourselves to know how policies affecting the NHS are written and how money is distributed. Here is a short run down of this process:
The Treasury controls the money for funding → the DHSC(Department for Health and Social Care) requests funding from the Treasury, i.e for training posts→ the DHSC allocates budgets and the NHS provides training.
However, this used to be different. We used to have Health Education England (HEE) which was responsible for training doctors, funding education and managing the number of specialty training posts, but in 2023 it was merged with the NHS. This diverted attention away from the quality - and availability - of medical training as the NHS primarily deals with services like providing health services, not education. This has increased pressures on the NHS and has prevented intense scrutiny of governmental decisions, which HEE had more freedom of doing.The NHS now frequently pulls back trainees to fill in a rota gap, whereas HEE would prioritise and protect their further training.
Now what can we do as medical students? More than you think! We need to remember that the BMA protects medical students and acts as a syndicate.
- We can write ‘motions,’a short statement sent to the BMA that asks them to bring this issue to the attention of the DHSC and NHS. To increase your chance of success, try to make your statement topical, concise, and always start with ‘that this conference…’. An example could be [that this conference calls on the BMA to lobby NHS England for more specialty training posts].
- Ask your academic representatives if they can bring up this topic at the medical school council meetings.
- Raise issues with your student representative on your medical school’s BMA committee.
- Support campaigns and join protests.
- Post on social media: social awareness is key in introducing matters to the general public which has an impact on politics.
- Educate yourself on these matters: knowing the current state of affairs is fundamental to be able to contribute to improvements in the NHS training pathway. Simply having read this article is an excellent start!
Read the rest of the edition here
