Restricted emails reveal MMC tensions

Emails released under freedom of information legislation show the DH at pains to balance NHS senior managers’ views that a consultant-delivered service was unaffordable with the British Medical Association’s opposition to a cheaper “subconsultant” grade.

Pay ceiling

Officials considered leaving junior doctors to compete for jobs in the free market, but decided this would “make medical workforce planning virtually impossible”.

The preferred option was to create a “junior consultant” role with a pay ceiling of around £75,000 and little opportunity for private practice.

DH head of education, training and development Paul Loveland said in an email to the chief medical officer and senior DH workforce officials:  “BMA might be willing to contemplate this but delivering a payscale that satisfies them and meets the desired affordability is not easy.

“At least the job would be called ‘consultant’.”

He also notes that the DH was “very disappointed” at NHS Employers’ “lack of full involvement” at events held to discuss the changes.

‘Dumbing down’

Junior doctors’ campaign group Remedy UK interpreted the emails as evidence that the changes were motivated by the desire to save money, rather than to improve the quality of medical training.

A statement on its website says: “It would now appear that MMC was little more than a dumbing-down device.”

The DH refused to release the correspondence, dated 2006, on the grounds it would “impinge on the morale of health professionals thus provoking unnecessary concern and discontent … and inhibit discussions of future options as the submissions talk specifically about the affordability of the consultant workforce.”

It has been forced to publish the emails after a decision by the information commissioner.

In a note accompanying the documents, the DH stated:  “These documents are now over three years old and refer to a policy proposal that was not pursued by the Department of Health.”