CMOresign - epetition reply

12 July 2007

We received a petition asking:

"We the undersigned petition the Prime Minister to urge the Cheif Medical Officer Sir Liam Donaldson to resign at once."

Details of Petition:

"The CMO has been behind some of the most controversial and damaging reforms to the health service of late. Firstly MTAS, the Medical Training Application Service, has been a complete failure. Several prominent figures have resigned as they have realised that the reforms did not have the support of the grass roots. Secondly MMC, Modernising Medical Careers, is a scheme that does not have the support of the medical profession and is being rail roaded through despite this. MMC is arguably a massive danger to patients everywhere in the short and long term. Thirdly the CMO's draconian proposals for changes to medical regulation that are arguably unworkable and not fit for purpose. These three reasons on their own are enough to merit his resignation."

• Read the petition
• Petitions home page

Read the Government's response

Our aim is to find the right people for the right jobs for the benefit of the NHS, its patients and its staff. To this end, Modernising Medical Careers (MMC) is a major initiative aimed at improving both patient care and doctors' training through a more structured, competency-based approach, focusing on both the clinical and the more generic skills that doctors require to meet the needs of the service.

MMC will improve patient safety and service delivery through providing better trained doctors and a reduced dependence on less experienced trainees. Training will be set against the most up-to-date curricula, developed by the medical Royal Colleges, and national standards, set by the Postgraduate Medical Education and Training Board (PMETB). We also believe that MMC will benefit the NHS as a whole as training will be more sensitive and adaptable to changing service needs. With regard to trainee doctors, MMC will provide streamlined career paths and eliminate repetition and delay in training. Doctors in run-through training programmes will progress seamlessly to the completion of training.

However, in view of the concerns that have been expressed about the application forms and shortlisting process, we set up a review of the MMC recruitment and selection process. The review group was led by Professor Neil Douglas, Vice Chair of the Academy of Medical Royal Colleges and President of the Royal College of Physicians of Edinburgh, and included representatives of the Royal Colleges, junior doctors, the four UK Health Departments and employers. The review group put forward proposals for the way ahead for recruitment to specialty training which were taken forward. This included offering all eligible candidates an interview for their first choice application.

The new arrangements have the support of the British Medical Association and the Academy of Medical Royal Colleges. I accept that this has been a time of great concern and uncertainty and that many NHS Trusts, consultants and junior doctors are dedicating a great deal of time and effort to deliver the new processes on time.

With regard to the online Medical Training Application Service (MTAS), the Department of Health took urgent action to investigate the two breaches to security and we apologise to any applicants whose details have been improperly accessed. We consider the security of personal information on the site to be the highest priority.

A full security review of the system has now been completed by IT security testing specialists, MWR Infosecurity. Action has been taken to strengthen further the security arrangements and MWR now considers the MTAS site to be robust and above average for security. Both MWR and CESG (Communications Electronic Security Group), the national technical authority for information assurance, have confirmed that appropriate and sufficiently comprehensive action has been taken. The site was therefore re-opened on 4 May, restricted to postgraduate deaneries only, to support the next steps in the recruitment process.

As we have stressed before, not all training posts will be filled in the current round and there will therefore be further substantial opportunities for those who are not initially successful. The review group has agreed that this further recruitment will be locally planned and managed by the deaneries in line with national MMC principles.

Furthermore, following the review group's recommendations and with its full agreement, we will be creating 215 additional run-through training programmes for those doctors who have already invested several years in training for their chosen specialty.

We will support junior doctors during this further appointment process, particularly those whose current contracts come to an end during this period. We are working with Strategic Health Authorities (SHAs) to ensure that all applicants currently in NHS employment will continue to have employment while they progress through the next round.

We have also accepted the recommendation of the review group to create further additional training opportunities for those junior doctors who are appointable to specialist training, but for whom training opportunities may not otherwise be available this year.

For those who have successfully completed the MMC foundation training programme and who demonstrate their ability to progress, there will be new training programmes through one-year fixed-term appointments. We are asking the PMETB to expedite the approval of both the extra fixed-term and run-through programmes. There will also be a range of sponsored training programmes available to enable doctors either to get an additional year's experience in their chosen specialty or to choose to gain experience in a different specialty, thus giving them all a better chance to apply and secure a training programme next year.

SHAs will manage the process and work with Trusts, deaneries and the Royal Colleges to determine the types of opportunities that they will make available. All the posts will be based on local service requirements and future workforce planning needs. Funding to support those training opportunities will come from the Department and SHAs.

As for the longer-term future of MMC, the remit of Professor Douglas' review group has been limited to the questions and concerns raised about the operation of this year's recruitment process. We believe that the time is now right to undertake a wider review of MMC and apply the lessons we have learned to a wider context.

We therefore decided to establish an independent review, which will examine the processes underlying MMC and make recommendations to Ministers to ensure that we can implement any necessary improvements for 2008 and beyond. This review is being chaired by Sir John Tooke, Dean of the Peninsula Medical School, Chair of the Council of Heads of Medical Schools and Chair of the UK Health Education Advisory Committee. It is being conducted independently of the four Health Departments and has its own independent secretariat. It will report on an interim basis in September.

The recruitment process is of course a crucial consideration, but we need to look at the broader MMC programme. The review will clarify and strengthen the principles underlying MMC, examining the extent to which MMC has engaged the medical profession and make recommendations to ensure that it has the support of the profession in the future. It will also look at the implementation processes underlying MMC and the methods used in selection and recruitment and how MMC can deliver a flexible response and can reflect local needs across the UK as well as safeguarding national standards.

Further information can be found at: www.mmc.nhs.uk (new window)

Turning to concerns about medical regulation, following a four-month consultation on the Department of Health's proposals to reform the regulation of medical and non medical healthcare professionals, a White Paper was launched on 21 February, setting out the Government's view of the way forward.

Trust, Assurance and Safety: The Regulation of Health Professionals in the 21st Century, builds on the recommendations of the Chief Medical Officer's report, Good Doctors, Safer Patients, and the Foster review of non-medical regulation.

The White Paper sets out how the Government will reform and modernise the system of professional regulation, signalling a move towards a more robust regulatory system which both earns and sustains the confidence of all who come into contact with it. Some of the key changes include:

• making regulators more independent, including the appointment of council members and an independent adjudicator for doctors;
• measures to ensure that healthcare professionals are properly revalidated throughout their career and remain up to date with clinical best practice; and
• the creation of General Medical Council (GMC) affiliates to help deal with more cases at a local level.

At the same time, the Government has published its response to the Fifth Report of the Shipman Inquiry. Safeguarding Patients sets out a wide ranging plan of action to put new safeguards in place, also addressing the recommendations of the inquiries into the conduct of Richard Neale, Clifford Ayling, Michael Haslam and William Kerr.

These documents can be found on the Department of Health website at: www.dh.gov.uk (new window)(by searching under the titles).

A national advisory group will be set up to oversee the implementation of the White Paper and Shipman Inquiry response. Proposals such as the development of standards and testing methods for revalidation, work to develop new feedback tools, and secondary legislation to change the governance of the regulators will be taken forward quickly. Other proposals, such as the establishment of the General Pharmaceutical Council, the setting up of GMC affiliates and changing the way in which fitness to practise cases are dealt with, will require primary legislation, for which the earliest possible Parliamentary time will be sought.

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