Doctors who quit the NHS SHOULD pay back the cost of training

WITHOUT you lot, I wouldn’t be a doctor. It’s thanks to you, the great British taxpayer, that I received my medical education.

You paid for me to train to be a doctor, and I am eternally grateful. It was an amazing gift and has meant that I’ve had a wonderful, fulfilling and stimulating career.

And I like to think I’ve repaid the debt by working hard, full time, on the frontline of the NHS.

while many others have done the same, too often this isn’t the case, with doctors leaving the NHS before the debt can be considered to have been paid back. This is a loss we can ill afford. There’s no doubt that every medical student and every doctor who has trained in this country is a resource, an investment. Isn’t it right, therefore, that the taxpayer gets some kind of guarantee for this investment?

Increasingly, though, medical students are graduating but not practising as doctors; or doctors at all stages of their career are leaving the NHS for private work — or even quitting the profession.

There is a terrifying shortage of doctors, and in some areas fewer than half of posts are filled. Something has to be done to address this brain drain of doctors from the Health Service.

This week, Niall Dickson, the chief executive of the NHS Confederation, which represents NHS managers, suggested the answer might be to force doctors who leave to pay back part of the cost of their training. This echoes what Jeremy Hunt, the Health Secretary, has said in the past. THE

idea is that doctors should be required to work for at least five years in the NHS — or pay back a proportion of the £220,000 cost of their training.

In principle, I think it perfectly reasonable that doctors who have benefited from the generosity of the taxpayer should be value for money. The same happens in the Armed Forces, where people are required to work for a minimum period in return for their training.

But having said that, is the best way to tackle the retention crisis effectively to hold the junior medical workforce as resistant hostages who’ll want to get out the day their five years are up?

we want to retain doctors for years — decades even. After all, we want experienced doctors.

Surely, a better way of tackling this is to address why doctors are leaving in the first place?

when I was at medical school, it was almost unheard of for a student to graduate and then not work as a doctor — but this has now become commonplace. One medical school told me that 10 per cent of students decided not to practise medicine after graduation.

Something has clearly gone wrong, and I think a large part of this has been an unintended consequence of the introduction of tuition fees.

when I went to medical school there were no fees, and because my family were poor, I got a full living grant of about £5,000 a year. without this, there is no way I would have been able to do it. But the introduction of fees has turned a medical degree from a vocation into a commodity.

Regardless of the fact that the taxpayer still subsidises the actual cost, students now think that as they’ve got about £80,000 of debt, it’s up to them what they do with their training — so why shouldn’t they take lucrative offers, just as people with other degrees do?

During my junior doctor training, there was free hospital accommodation for your first year, a doctors’ mess with tea and coffee, and rooms to sleep in when you were on call. There was even a budget for training courses. This helped forge a strong sense of vocation — the job we were doing was important and valued. we felt indebted to society and the NHS because it was clear that they’d invested heavily in us.

Yet over the past few years, all of this has been gradually taken away, contributing to a malignant feeling of disenchantment among junior doctors, made all the worse by the new contract imposed last year.

More than anything, though, there is a sense in the medical profession generally of profound disappointment in the way that the NHS is being run into the ground. Many colleagues despair they’re unable to give their patients the kind of care they need.

They have to discharge patients before they’re ready, and tell others that they must wait unacceptable lengths of time for surgery. with resources stretched gossamer-thin, it’s an unimaginably dispiriting environment to work in.

Just before Christmas, a colleague who’s spent several years working in mental health, resigned. exhausted and frustrated at being unable to do the best for her patients, she has retrained as an aesthetic doctor giving Botox and fillers privately.

Yes, we could make her pay back the money it cost to train her. But for all our sakes, isn’t it better that we address the reason she feels she can’t keep working in the NHS?