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Experts question the need for more doctors in the UK

Research into the health care workforce has examined whether additional medical student numbers are necessary in the UK.

The paper is published in the June issue of the Journal of the Royal Society of Medicine.

“Medical school intake has increased by 50 per cent in the last six years,”

said Dr Karen Bloor of the University of York.

“It seems extremely hasty to increase the number of students further before these doctors are even fully trained and in the NHS workforce.

“There are real questions about the appropriate number of doctors in the NHS, and research could inform these questions. But in practice, decisions to increase doctor numbers often reflect political expediency rather than better management of doctor activity in the health care system,”

Dr Bloor said.

Dr Bloor, Vivien Hendry and Alan Maynard examine whether more doctors would improve patient health in the UK. It follows the Higher Education Funding Council’s call for universities to bid for additional medical student numbers from 2006 and again in 2008, and coincides with the currently ongoing workforce planning enquiry of the Health Select Committee.

The authors found that:

• Medical workforce planning remains dominated by issues that are poorly managed and measured.
• The time lag between expanding medical school intake and producing fully trained doctors creates uncertainty and risk.
• Expansion of the medical workforce does not necessarily result in an efficient or equitable distribution of doctors, geographically or in terms of specialty.
• Expansion may create substantial expenditure inflation that will be extremely difficult to reverse.

“We cannot look at the medical workforce in isolation from other health issues, including financial constraints”

said Dr Bloor.

“The evidence suggests some scope for substitution and complementarity of staff roles. The NHS is increasingly using nurse practitioners and other health professionals are substituting for doctors, like radiographers for radiologists. The implications of this for health care workforce planning should be further explored.

“There are also large variations in activity rates of the medical workforce. We need research on the causes of these variations to inform gradual adjustment of medical school intake, rather than further precipitate large-scale expansion,”

Dr Bloor said.

[ends]

Do we need more doctors? [PDF 383k]

‘Do we need more doctors?’ by K Bloor, V Hendry and A Maynard is published in the June issue (Vol. 99) of the Journal of the Royal Society of Medicine.

JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi. www.jrsm.org