Independent centres threaten training
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《英国医生杂志》
Increased competition in the health service could put at risk the quality of training of the United Kingdom's 49 000 junior doctors, their leader has warned.
Jo Hilborne, the new chair-woman of the BMA's Junior Doctors Committee, expressed concern last week that private companies running treatment centres have no incentive to provide doctors with high quality training.
"It's not clear whether profit making companies running treatment centres will provide training to the same standards as the NHS," she said. "Unless a mechanism is introduced to make training as important to private companies as it is to the NHS, standards are likely to drop."
Changes to working patterns and reform of training have already put junior doctors under greater pressure, said Dr Hilborne. Private provision of certain services brings with it more uncertainties for the future of junior doctors.
"In an NHS based on competition, there will be winners and losers. How is a trainee surgeon supposed to learn how to do a hip replacement if their hospital has lost its contract to do them? Little thought seems to have been given to doctors' training in a market based NHS," said Dr Hilborne.
Carol Black, president of the Royal College of Physicians, said she appreciates the situation, which needs to be closely monitored. "I wholly understand my colleagues' concern.
"The interdependency of many elements of service and training, and the need for coherence between them, implies responsible partnership between providers and commissioners. Ministers are aware of our concerns. The regulatory bodies and the colleges must be vigilant as these new arrangements unfold," Professor Black said.(Zosia Kmietowicz)
Jo Hilborne, the new chair-woman of the BMA's Junior Doctors Committee, expressed concern last week that private companies running treatment centres have no incentive to provide doctors with high quality training.
"It's not clear whether profit making companies running treatment centres will provide training to the same standards as the NHS," she said. "Unless a mechanism is introduced to make training as important to private companies as it is to the NHS, standards are likely to drop."
Changes to working patterns and reform of training have already put junior doctors under greater pressure, said Dr Hilborne. Private provision of certain services brings with it more uncertainties for the future of junior doctors.
"In an NHS based on competition, there will be winners and losers. How is a trainee surgeon supposed to learn how to do a hip replacement if their hospital has lost its contract to do them? Little thought seems to have been given to doctors' training in a market based NHS," said Dr Hilborne.
Carol Black, president of the Royal College of Physicians, said she appreciates the situation, which needs to be closely monitored. "I wholly understand my colleagues' concern.
"The interdependency of many elements of service and training, and the need for coherence between them, implies responsible partnership between providers and commissioners. Ministers are aware of our concerns. The regulatory bodies and the colleges must be vigilant as these new arrangements unfold," Professor Black said.(Zosia Kmietowicz)