We hear everyday about how we have an NHS crisis, a GP crisis, a healthcare crisis.
And we also hear constantly about gender pay gaps, male-female inequality and discrimination.
Aside from the fact that we have massive problems with immigration, aging and health tourism, one of the biggest issues facing the NHS is not female discrimination but that, as a country we are, not only not training enough doctors but we are training people who are not staying in the job, particularly women.
Let’s look at the medical school applications process.
Most medical schools in the UK are oversubscribed by about 10:1 and every year, British universities turn away 800 students with three straight A’s at A level. This is, despite the fact, that two private universities (Buckingham and Barts Malta, part of the University of London) will take pupils with AAB at A level. Now if you can train a doctor with AAB, why are we turning all these students away with AAA? It is clearly not lack a of talent in the country, nor a lack of demand.
To make matters worse, the selection process is so fierce that many universities reject students on first application, pre A levels. Many students get straight rejections from all universities without interview the first time around; so they have to do further work experience, improve their personal statements, get their A level results and apply again. This means a gap year and you are now at least 19 years old and in some cases almost 20.
You then start university and assuming you pass all the exams first time around and do not have to resit anything and waste another year, you study for five years. Now you are 24, You then go and do two years practical experience as a junior doctor in a hospital. Now you are 26. Then if you want to be a GP, you now do another three years GP training. You are now the ripe old age of 29 to 30 and just the age that many women start to think about having a family.
So what do we as a country do? We are training far more female medical students than males and this has been going on for some time, as 69% of all GPs under 40 are female. Even worse, just 10% of GP’s in training intend to work full time. Much of this is to do with the fact that so many women are being trained and women, as is perfectly normal human behaviour, would like to have children before age 35, when their fertility declines. Many could easily have children, just as they have finished training at 28 to 29, which is exactly the average age for a first time mother in UK.
It gets even worse in paediatrics, consultants who specialise in looking after children. 75% of doctors in paediatric training are female. Not only that, these women, unsurprisingly, seem to like children, including having their own. Not only do they have children, but they have them earlier than other consultants. Many are having them before they have even finished training. The results are obvious – no paediatricians or massive shortages, as the women are constantly on maternity leave or career breaks. Some do not finish at all, some do not return after having children and even If they do return, they are almost always part-time.
This is costing the country, the government, the taxpayer and ultimately all of us, a small fortune. And it is totally unsustainable. As with many politically correct policies, it will eventually lead to total financial and social armageddon.
How much exactly it costs to train doctors is open to debate but it would appear from the Department of Health’s own numbers, it takes a total investment of £388,000 to train a GP and £510,000 to train a consultant. These were 2016 numbers so it will be higher still in 2018, as health care costs are running well above the rate of inflation.
There are some obvious things that could be done to solve this if there was the political will to go against the current politically correct trend.
The first and most obvious is to restrict the number of female students at all levels where there are more female than male students. There is an assumption in politics today, that more representation of females is a good thing but clearly, publicly funded medicine is not one of those cases. If students were entirely paying for their medical training themselves, there would not be an objection to loads of women but in fact, not only are they paying for a small part of it in the early stages with their tuition fees, but they are then actually getting paid as junior doctors when their enormous training costs are still continuing. Why should we allow 75% of paediatric consultants in training to be female? The minimum requirement should be for 50/50 male female but why not say 60/40 or even 70/30 for the greater good of society? Of course the feminists will jump up and down and protest but it will also be the same women jumping up and down when they find there is no paediatrician available to fix their child’s broken leg or provide cancer care to a baby because they are all on leave or part-time.
The second way, tried in a few countries is to legally contract doctors to work for say 10 years or 20 years to recoup their enormous training costs. This is easier said than done. Nepal managed it for a few years because there are not a lot of other opportunities until experienced and the British army successfully manages to tie people in to fixed terms. Given the massive over-subscription for medical school places, it would appear possible but would need to be done right at the very beginning of training.
The other option is to increase massively the number of doctors being trained and given the crisis that has been brewing with GPs and doctors for many years, you have to ask why this has not been done. The predictions for a timebomb in the NHS as many GP’s are retiring and not being replaced has been being made for many years. I know it takes a reasonably long lead time to build medical schools but not the 10 or more years that this crisis has been in the making. The only explanation is money.
We know from the private universities how much the tuition fees actually are for medical students for the first five years of training. £150,000 at Buckingham and Eur 150,000 at Barts, Malta. So if a British student pays £9000 in tuition fees, the university looses or has to be subsidised to the tune of £21,000 per year, per student, for five years. Meanwhile how much does it cost to put on a course for a media studies student where presumably you need little more than a room, a screen and a computer. On one course, you make a fortune, on another your lose a fortune.
Much cheaper to pinch all of Nepal’s doctors which has 20 medical schools but has just three places outside the Kathmandu valley, covering 30 million people, where you can actually get a Cesarean section: because all their doctors, trained at much expense to families, the government and the country are in the UK, filing the places of women who have decided not to work. Where is the morality in that?