MicroShaft Blog: Prof Alan Crockard's letter of resignation

The MMC/MTAS debacle of Junior Doctor's Training in the UK looks to have seen its first senior Resignation, Professor Alan Crockard has apparently resigned from his position as National Director for Modernising Medical Careers. Confirmation of the resignation or reporting of it in the mainstream media appears to be thin on the ground and even the Telegraph does not actually have a report on it , just the letter. Various Blogs by Health Professionals have the story from early this morning.

UPDATE: Telegraph appears to confirm story here:

Alan Crockard is an eminent neurosurgeon, and has been the national director of the Department of Health's programme, Modernising Medical Careers (MMC) and its online application service, the Medical Training and Application Service (MTAS), since 2004.

One paragraph from the letter is very interesting:

From my point of view, this project has lacked clear leadership from the top for a very long time. Moving to the last few weeks, I have become increasingly concerned that the well intentioned attempts to keep the recruitment and selection process running have been accompanied by mixed messages to the most important people in the whole process - the young doctor applicants.

I assume that this is a dig at Patricia Hewitt. We can only hope that she has got the idea and will follow Alan Crockard's example. This is however unlikely bearing in mind Labour's normal mode of operation of promotion on failure.

It was earlier reported today that he was being reported to the GMC by Lindsay Cooke, who founded Mums4Medics - a family support group for people caught up in the jobs fiasco, who wrote to the GMC naming Prof Crockard as he was

"ultimately responsible" for the MMC and its implementation.

"I respectfully ask the GMC to examine the conduct of Prof Crockard in this matter and, if it is found wanting, to consider disciplinary action,"

Full text of resignation is as follows.

Dear Liam,( Sir Liam Donaldson chief Medical Officer at the NHS)

I wish to resign from my position as National Director for Modernising Medical Careers with immediate effect. I am increasingly aware that I have responsibility but less and less authority.

I care deeply about medical education and training. In 2003 I moved from the College of Surgeons where I was Director of Education to join the MMC team. At the College we developed a competency based curriculum. These ideas rolled over into MMC where the team put together the Foundation Programme which was launched in 2005.

It also involved coordination of the stakeholders in curriculum development, training the trainers and carrying out numerous road shows to set the scene for consultants and trainees. It is now considered successful and fit for purpose.

In addition the doctors completing the Foundation Programme this year seem as if they will match well into the new Specialty Training Programmes. As a prelude to new Specialty Training, MMC worked closely with PMETB and all the stakeholders to facilitate the new competency based curricula and set the scene for such a radical change in training.

Manifestly, specialty training is an order of magnitude more complex than Foundation, but it became obvious that the MMC team's expertise was less used in planning of specialty rollout. MTAS was developed and procured by DH outside my influence.

An email (12 October 2005) to our team made it abundantly clear that "Debbie (Mellor) has been tasked with delivering a recruitment system to recruit junior doctor posts specifically FP's and ST's .......I am not clear how far you should (or want) to be involved in this. We don't want to tread on any toes, but equally we need to be clear about what level of autonomy this Programme has".

The MMC programme has been the subject of an OGC Gateway Review in September 2006 (DH331), they concluded "that the programme has made significant progress since the OGC health check in August 2005".

The report overall was supportive of MMC, but there was one serious red risk. This was to "identify a clear break point for the MTAS project beyond which the contingency arrangements should be activated". It also commented on the unclear leadership between DCMO and two senior responsible officers.

From my point of view, this project has lacked clear leadership from the top for a very long time. Moving to the last few weeks, I have become increasingly concerned that the well intentioned attempts to keep the recruitment and selection process running have been accompanied by mixed messages to the most important people in the whole process - the young doctor applicants.

I realise that the service must continue to allow patients to be treated and I know little of the law, but it seems to me basically unfair to advertise the possibility of four interviews and then suggest that these might not be honoured.

Equally devastating would be the suggestion of some stakeholders, that the completed interviews be discarded and the process be rerun.

I accept that in many areas and in many specialties, this round of recruitment and selection has been acceptable. But the overriding message coming back from the profession is that it has lost confidence in the current recruitment system.

With my very best wishes.

Alan