Posted by: Witch Doctor | May 21, 2009

Was MMC embracing women doctors?



So, leaving aside the reasons why, and whether it is good or bad, it is a fact that in the foreseeable future the female sex will be the predominant one in medicine.

Medicine historically has followed a male working pattern. If women were to reach the top of their specialty they usually had to adapt to a way of life where it was necessary to distance themselves from domestic matters for long periods.

Basically, a woman doctor with family commitments needed a wife.

Apart from the retainer scheme in general practice where it was possible to work 2 sessions a week and after a few years come off the scheme to increase the sessions to say half time, no other part time system was easily accessible. The retainer scheme was quite popular in general practice because the sessions were subsidised and the retainee was already fully GP trained so was a very useful pair of hands. There were very few hospital retainees, and although a part-time supernumerary training system existed, places were few and far between. Most conventional hospital training posts were on a full time basis. Job sharing never really got off the ground. In essence, there was no satisfactory career structure in keeping with what would have been considered to be a female working pattern.

It could be argued, therefore, that the concept of MMC heralded a major change from a male to a female working pattern for the medical profession ie quicker access to CCT, the option to exit and re-enter training, and, for those who would not make it to consultant status, the ability to capture a collection of competencies in the way that could give a satisfying career.

It could also be argued, that with 70% intake of female medical students, the introduction of MMC or something like it was a necessity.

The Witch Doctor admits she could be totally wrong about this, but she feels this initially was one of the important forces behind MMC before it was turned, by somebody somewhere, into a rogue form.

There were clues that a rogue form of MMC was being created. Firstly, the word “consultant” was completely omitted from the diagram that was published explaining the new structure. The Witch Doctor was surprised how few doctors picked up on this. Perhaps it was not considered credible that a consultant workforce could almost disappear. Secondly, the selection and appointment process ie MTAS was the antithesis of female friendly. In fact, in the early days of this blog, The Witch Doctor felt that the selection process discriminated against women. See “LETS TALK ABOUT SEX” Thirdly, there were serious dumbing down activities going on in the background involving “national practitioners” and The Skills Escalator. At that time few medical staff had heard of The Skills Escalator. The Witch Doctor certainly hadn’t but when she stumbled upon it, she realised it was closely related to Agenda for Change and she reckoned that MMC was designed to fit into the various steps on the escalator. Medical graduates were to merge into the structures other “practitioners” were following. She tried to find some evidence of this. She eventually found it in Australia of all places. The original document has since been removed from the Australian website but there is reference to it in the tab above – “THE SECRET NHS.”

The Witch Doctor therefore believes that MMC became integrated into a very complex plan. A political plan.

A plan that some senior members of the medical profession must have bought into and then remained silent. Or perhaps they were very blinkered.

I would like to know what the CMO thought of all of this – how closely the final MMC related to his original concept and whether he was party to the version that was eventually rolled out. If he did not approve, I often wonder, as a civil servant, what he could have done – apart from resign. And that would have changed nothing. He would just have disappeared off the horizon.

The Witch Doctor has not been so hard on the CMO as other bloggers because:
a) he consistently said this country needs more doctors.
b) he seemed to be given a bit of a hard time in government committees before MTAS surfaced
c) he refused to be drawn into the extended role of nurses
d) he seemed to be a bit frustrated by the blinkered views of the College of Physicians.

But then, The Witch Doctor was only reading between the lines. She does not really know his views or whether they have changed with the passage of time.

It is time for Sir Liam Donaldson to replace his civil servant hat for a medical one and speak to the medial profession clearly and honestly regarding whether MMC changed from his original concept. If it did, he needs to explain how and why it changed and whether he was behind that change.

One A4 piece of paper in the form of a letter, free from political embellishments or influence, to every medical practitioner in the land would be a start.

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