BMA Annual representative meeting, Manchester, 27 - 30 June: UK hospit
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《英国医生杂志》
Doctors?leaders are considering how to keep UK hospitals fully staffed without draining the developing world of doctors. In an open debate at this year抯 BMA annual representatives?meeting in Manchester, doctors argued over whether recruitment agencies in developing countries should be closed down to stem the flow of junior doctors into the United Kingdom, many of whom are unable to do jobs once they arrive.
Jim Johnson, chairman of the BMA, said that draining skilled health professionals from some of the world抯 poorest countries had devastating effects. He warned that every year, 11 million children in developing countries died of diseases that could be treated. The "rape" of the poorest countries must stop, he said.
Mr Johnson called on developed countries to train enough doctors to meet their needs so that they do not need to poach from poorer nations. "The way to tackle this is not to prevent doctors coming to this country or to prevent them leaving. This sort of interchange is healthy for both sides. The most important issue is that as long as the rich countries of the world underproduce doctors, doctors from other countries will come here. What we need to do is to become self sufficient," he said.
The UK was on track in getting its "house in order," he said. It could become self reliant in terms of healthcare personnel in a decade, he estimated. The number of students coming out of medical schools had increased from 4500 a few years ago to 7500 recently. Increasing this number to 8500 or 9000 each year would be adequate to make self sufficiency "highly achievable." "If we could get the United States to do the same thing it would be really valuable," said Mr Johnson.
Other representatives argued that allowing doctors from Asia to work in the UK had helped India and other countries to develop their healthcare systems because money earned in the UK was sent back to families to pay for education. Restricting access to the UK was not the answer.
Kate Adams, from the conference of local medical committees, said that there were no easy answers to the complex problem. Ethical policies did not stop doctors and nurses leaving developing countries, she argued. Consideration should be given instead to strengthening health systems and paying for doctors and nurses through restitution policies, she suggested.
The flood of international medical graduates into the UK was a real problem, said Sumantra Ray, a member of the BMA抯 Medical and Academic Staff Committee. There are about 400 applicants for each advertised house officer post, and junior doctor posts each attract 200 applications, with recent advertisements attracting more than 1000 applicants per post, he reported.
The result is that many doctors from overseas face disillusionment, disappointment, and despair, said Dr Ray. The Junior Doctors Committee is proposing to establish an international foundation programme to advertise and fill vacancies on an annual basis through a single international application process or matching scheme. The scheme would be the only route of entry to the NHS for overseas graduates.
Victor Dedjoe, assistant general secretary of the Ghanaian Medical Association, told the conference of the enormous effects that the migration of doctors from Africa has on the local population where policy makers are trying to establish an insurance based healthcare scheme. "What kind of services can we expect people to pay for when there is only one doctor for a huge population?" he asked.
"It makes no sense to collect money from G8 countries to invest it in arms and worse, and to go into the pockets of the politicians. Let抯 cancel the recruitment services and encourage governments to make health a priority," said Dr Dedjoe.
The BMA is due to publish its proposals for confronting the problem of depleting doctors?numbers in developing countries later this week.(Manchester Zosia Kmietowicz)
Jim Johnson, chairman of the BMA, said that draining skilled health professionals from some of the world抯 poorest countries had devastating effects. He warned that every year, 11 million children in developing countries died of diseases that could be treated. The "rape" of the poorest countries must stop, he said.
Mr Johnson called on developed countries to train enough doctors to meet their needs so that they do not need to poach from poorer nations. "The way to tackle this is not to prevent doctors coming to this country or to prevent them leaving. This sort of interchange is healthy for both sides. The most important issue is that as long as the rich countries of the world underproduce doctors, doctors from other countries will come here. What we need to do is to become self sufficient," he said.
The UK was on track in getting its "house in order," he said. It could become self reliant in terms of healthcare personnel in a decade, he estimated. The number of students coming out of medical schools had increased from 4500 a few years ago to 7500 recently. Increasing this number to 8500 or 9000 each year would be adequate to make self sufficiency "highly achievable." "If we could get the United States to do the same thing it would be really valuable," said Mr Johnson.
Other representatives argued that allowing doctors from Asia to work in the UK had helped India and other countries to develop their healthcare systems because money earned in the UK was sent back to families to pay for education. Restricting access to the UK was not the answer.
Kate Adams, from the conference of local medical committees, said that there were no easy answers to the complex problem. Ethical policies did not stop doctors and nurses leaving developing countries, she argued. Consideration should be given instead to strengthening health systems and paying for doctors and nurses through restitution policies, she suggested.
The flood of international medical graduates into the UK was a real problem, said Sumantra Ray, a member of the BMA抯 Medical and Academic Staff Committee. There are about 400 applicants for each advertised house officer post, and junior doctor posts each attract 200 applications, with recent advertisements attracting more than 1000 applicants per post, he reported.
The result is that many doctors from overseas face disillusionment, disappointment, and despair, said Dr Ray. The Junior Doctors Committee is proposing to establish an international foundation programme to advertise and fill vacancies on an annual basis through a single international application process or matching scheme. The scheme would be the only route of entry to the NHS for overseas graduates.
Victor Dedjoe, assistant general secretary of the Ghanaian Medical Association, told the conference of the enormous effects that the migration of doctors from Africa has on the local population where policy makers are trying to establish an insurance based healthcare scheme. "What kind of services can we expect people to pay for when there is only one doctor for a huge population?" he asked.
"It makes no sense to collect money from G8 countries to invest it in arms and worse, and to go into the pockets of the politicians. Let抯 cancel the recruitment services and encourage governments to make health a priority," said Dr Dedjoe.
The BMA is due to publish its proposals for confronting the problem of depleting doctors?numbers in developing countries later this week.(Manchester Zosia Kmietowicz)