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England's chief medical officer, Liam Donaldson, has told MPs that he was right not to resign over the chaotic recruitment system for junior doctors.
Professor Donaldson, giving evidence to the parliamentary health select committee, said he would not take personal and sole responsibility for the problems faced by junior doctors this year when they applied for posts under the new Modernising Medical Careers (MMC) programme.
The committee, in the first evidence session of its inquiry into the MMC programme, asked why Professor Donaldson had not felt it appropriate to leave his job, considering the scale of the problems. Thousands of junior doctors failed to find training places through the programme, and many complained that the new system failed to take proper account of their experience and achievements.
Professor Donaldson told the committee: “The experience for the junior doctors concerned was traumatic and distressing and created a lot of anxiety, and I have publicly apologised for that.”
He added that changes introduced as a result of John Tooke's independent inquiry into the crisis should prevent the problems recurring (BMJ 2007;335:737, 13 Oct doi: 10.1136/bmj.39363.596273.59).
The committee member and Liberal Democrat MP for Romsey Sandra Gidley said, “Is an apology enough? Seeing as you were the architect of the MMC reforms and the person ultimately responsible for overseeing their implementation, shouldn't you have resigned?”
Professor Donaldson replied: “Accountability did not rest only with me; it was spread quite widely. Policy in relation to the two factors that made the biggest difference in the crisis were on international medical graduates and on the design of the application form, and those were not matters where I had overall or sole responsibility.”
Ms Gidley asked how doctors intending to apply in the future could have any confidence, to which he replied: “We've pledged ourselves to redesigning the system, taking account of the Tooke recommendations. We're looking to learn as much as we can from the things that didn't go well in the process.”
The MPs asked whether the Department of Health thought that the review established by the department and chaired by Neil Douglas had been right to recommend that the system should not be dropped completely. Professor Donaldson said he thought it had, and he denied the suggestion from MPs that he was committed to proceeding with the system regardless of the consequences.
“We were under severe criticism,” he said, “and we were dependent on the Douglas review group for coming up with a balanced view in the middle of a furore about what the right way to proceed was.”
The deputy chief medical officer, Martin Marshall, who also gave evidence, said he had been a member of the Douglas review group and that the group had seen many letters, emails, and blogs saying that the system should be stopped.
“The people wanting it stopped were making a much louder noise, but the decision had to be a rational one and not one based on the amount of noise going on in the system,” he said.