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The junior doctors' group Remedy UK has lost its court case to strike down changes made to the flawed NHS medical training application service (MTAS). But the judge had harsh words for the government's handling of the affair and left the door open for appeals by individual doctors.
Remedy UK, a group formed in November 2006 in opposition to the proposed web based system for job applications, applied for judicial review of changes made to MTAS by a review group in April. The review group, which included representatives of the BMA, was set up after it became apparent that the system was failing to match qualified doctors with suitable posts.
But Mr Justice Goldring rejected Remedy UK's argument that the review group's proposals were “so conspicuously unfair as to amount to an abuse of power.”
“This judgment does not mean I agree with the decision of the review group; merely that it was one the review group was entitled to come to,” said the judge. “Neither does it mean that individual doctors would not have good grounds to appeal regarding their allocation or that they would not have good cases before an employment tribunal. Quite the contrary; it could well be the case.”
“The premature introduction of MTAS has had disastrous consequences,” Mr Justice Goldring noted, calling it a “flawed system.”
He added, “The fact that the claimant has failed in what was accepted to be an unprecedented application so far as the law is concerned does not mean that many junior doctors do not have an entirely justifiable sense of grievance.”
Remedy UK has said it does not intend to appeal the decision, with the August deadline for doctors to be in training posts looming. The immediate result of the judge's finding is that jobs offered after interviews in the first round of applications will be of normal duration, rather than provisional. Offers of posts had been held back pending the court's decision.
The BMA appeared in the case as an interested party, contesting Remedy UK's assertion that it did not adequately fight the corner of junior doctors when participating in the review group. Jo Hilborne, chairwoman of the BMA Junior Doctors Committee, told the court that the BMA had persistently criticised MTAS, argued for delay in its implementation of the scheme, and at one point had quit the review group on a point of principle.
But the BMA had ultimately concluded that its members' interests were best served by trying to find the “least bad” solution, rather than by criticising from the sidelines, said Dr Hilborne. Speaking after the case, she said that she hoped the government would not try to claim a victory.
“The harsh fact facing us now is that there are not enough jobs,” she added. “There are 12000 doctors who will not get training posts through this system, and they must be our priority. We have demanded that the government guarantee that no doctor will be unemployed as a result of this process and have called for funding for extra training posts.”
The BMA, seeking to make amends with Remedy UK, announced that it would not seek to recover its legal costs in the case. The Department of Health sought and won the right to recover its costs from Remedy UK, but a spokesman told the BMJ that the government has not yet decided whether to claim them.
In a statement issued after the decision, Remedy UK said, “The system will survive, and the NHS will carry on, but this is not a victory of which the government or the medical institutions can be proud. After an unnecessarily chaotic changeover in August many of our most excellent doctors, some involved in cutting edge medical research, will be needlessly forced out of a medical career in this country.”
Remedy UK's own future is unclear, but the group said it “will continue to support doctors as a representative pressure group in the future or, if necessary, a new doctors' trade union.”
The future of the health secretary, Patricia Hewitt, was also the subject of speculation after she survived a Commons motion of no confidence by 282 votes to 219, with MPs voting along party lines. The vote came just hours after Wednesday's court decision.
That morning, Ms Hewitt faced a hostile reception at the annual conference of the Royal College of Midwives, in Brighton, because of the government's proposed rationalisation of maternity units.
Several of Ms Hewitt's critics in parliament predicted that she will be an early casualty in any reshuffle after Gordon Brown's appointment as prime minister.