Posted by: Witch Doctor | July 5, 2007

Sir Liam Donaldson – Is the green bottle spell working?



Why did James Johnson, then one of the most senior members of the BMA, choose to support Sir Liam Donaldson, the CMO in a highly visible letter at a time when most BMA members were irate about MTAS, and juniors were distraught and apparently facing unemployment?

And put his job at risk?

And lose his job over it?

And not a word from the CMO. Not a single word.


Why does Sir Liam Donaldson continually state that we are and will continue to be short of doctors while everyone else thinks we are overproducing them?

Did those who designed MTAS really think it could be pushed through without an uproar?

Did they?


Why was MTAS/MMC propelled through so quickly in spite of strong advice to delay?

It is very difficult to swallow this degree of incompetency. Was it therefore all incompetency?

The slip of the pen in the Templeton letter.

Senior medics not grasping what was going on.


And why?……….

The Witch Doctor has been grappling with lots of questions like these for some time. Things did not make sense. There was something missing.

And now…….

The Green Bottle Spell is working. It has come up with the last bit of the jigsaw for The Witch Doctor!


There are many, many facets to recent problems.

Complex facets. Contentious facets. Facets that were not talked about.

Too complex and contentious for The Witch Doctor to think aloud about. And definitely too complex and contentious to blog about.

The Green Bottle Spell says:

The CMO needs to be silent at this stage.

The CMO is a civil servant. He, is less free than the rest of the medical profession. Since, unlike his medical colleagues, he is privy to seeing the bigger picture that is driving government policies he may agree with some of these when most of the profession may disagree. If he disagrees, but cannot influence government policy then he must stick with it or resign. Sometimes resignation would be futile and not in the best interests of the patient or the medical profession.

The CMO thinks we are underproducing doctors. He does not waver in this.

The CMO does not want to see unemployment of junior doctors.

The CMO is no fool. Anything but!

The CMO entirely understands all facets of the situation. Facets unknown to most others.

The CMO may have faults but knows exactly what he is doing.

The CMO should not resign.

With his insight he probably can sort out the mess.

Maybe he even knew it was inevitably going to be a mess.

Green bottle spells are very difficult to do.

Is this green bottle spell working properly?

The Witch Doctor thinks it is.

Time will tell.

In the meantime, junior doctors. “The country needs more doctors.” Remember this. The bizarre MTAS has gone. For good. In the fullness of time you will be able to sort out MMC from any medical NHS job you will have. Just make sure you have a job. You can achieve very little from outside the system. Your intelligence, knowledge, ability and training, taken together, are scarce commodities. You will eventually be needed and be sought out. You have the advantage. Take it.

You will need to be patient. But while you are being patient keep learning.

You don’t need a training job or a number or a log book to learn!

Absolutely not!


  1. I never thought Liam was a fool. I think he knows exactly what he’s doing. He’s just evil.

    Fine and dandy saying “just make sure you have a job” but do you not understand that jobs just aren’t being advertised? Round 2 is a joke and the trusts still don’t know if or how many non-training jobs they can allocate.

    So we have the bizarre situation where the medical staffing people and the consultants are bricking it because in 4 weeks, they will not have enough juniors to staff the wards and the rota. Meanwhile, you have thousands of junior doctors like myself who are being handed our P45s at the end of the month and been kicked out of the system.

    And don’t think it’s because I’m incompetent or a bad doctor, if anything, the opposite is true. I’ve had my consultants look over my CV and applications and their comments were “if you’re not being shortlisted with this, then I have no idea what more they want from you.” Don’t think I’m alone in this situation, my story is repeated literally thousands of times up and down the nation. 32000 junior doctors into 16500 jobs doesn’t fit.

    The bitter irony was that MMC sprang from the government white paper “Unfinished Business” that stated that “morale among the SHOs was at an all-time low and the system needed to be changed.”

    So the system has been changed and how is morale now?

    If the government had wanted to, they could have prevented this at any time, but they chose not to. I have no sympathy for Liam Donaldson – i think he’s just evil.

    …end of rant

    Dr Michael Anderson

  2. Dr Michael Anderson

    It is no surprise that this apparent “good egg” approach towards the CMO does not meet with approval. After all, if he was not playing the lead role pushing through a crazy MTAS/MMC system, then who was? However, he is one of the few people consistently stating we need more doctors. This opinion does not square with unemployment as a consequence of MTAS/MMC. He is no fool and he probably has little to gain by being evil.

    The Witch Doctor is neither sympathetic nor unsympathetic with the CMO. However I smell a rat. Indeed my black cat seems to have found the rat. Others can find their own rats.

    Furthermore, MTAS/MMC is, intentionally or not, a wake up call for thousands of senior medics who have been languishing around allowing MTAS/MMC and many other changes within the NHS to happen. The languishing was bad. The wake-up call is good.

    “If the government had wanted to, they could have prevented this at any time, but they chose not to.”

    Agreed. They chose not to. However, senior doctors also could have prevented this at any time. They didn’t, probably because they were slumbering. After all, as well as consultants everywhere, if you take away the artifacts surrounding the Deaneries, the Royal Colleges, and the BMA, you are left with senior doctors. Without either their support or disinterest, the government would not have been able to push this through.

    However, the abuse of junior doctors in this way and for whatever reason(s), is unforgivable. Jobs of some kind will soon appear – I’m sure of this. Not always round peg in round hole jobs for everyone, but that was never the case anyway. Once in a hole in the NHS, square or round, it is up to the junior doctors to move the NHS in the right direction – for patients and for themselves. They have already demonstrated their ability to move mountains.

    Your rant is justified – but don’t give up.

  3. Dr Michael Anderson

    Love your blog by the way. Just found it.

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