Medical workforce education and training: A failed decentralisation attempt to reform organisation,financing, and planning in England |
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| Institution: | 1. Medical Director Office, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, University of São Paulo, Brazil;2. Faculty of Medicine of the University of Porto, University of Porto, Portugal;1. Institute of Social Medicine, Faculty of Medicine University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia;2. Centre – School of Public Health, Faculty of Medicine University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia;3. Department of Statistics and Mathematics, Faculty of Economics University of Belgrade, Kamenicka 6, 11000 Belgrade, Serbia;4. Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 M.L. King Blvd CB 7590, Chapel Hill, NC 27599-7590, USA;1. Department of Surgery and Cancer, Imperial College London, Address: St Mary''s Hospital, Praed St, Paddington, London W2 1NY, United Kingdom;2. Center for Primary Care and Public Health (Unisanté), University of Lausanne, Address: Rue du Bugnon 44, 1011 Lausanne, Switzerland;1. Institute of Social Medicine, Faculty of Medicine University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia;2. Centre – School of Public Health and Health Management, Faculty of Medicine University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia;3. Institute of Public Health of Serbia, Department for International Cooperation and Project Management, Dr Subotica 5, 11000 Belgrade, Serbia;4. Centre for Workforce Intelligence, 209-215 Blackfriars Road, London SE1 8NL, UK |
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| Abstract: | The 2010–2015 Conservative and Liberal Democrat coalition government proposed introducing a radical decentralisation reform of the organisation, financing, and planning of medical workforce education and training in England. However, following public deliberation and parliamentary scrutiny of the government's proposals, it had to abandon and alter its original proposals to the extent that they failed to achieve their original decentralisation objectives. This failed decentralisation attempt provides important lessons about the policy process and content of both workforce governance and health system reforms in Europe and beyond. The organisation, financing, and planning of medical workforce education is as an issue of national importance and should remain in the stewardship of the national government. Future reform efforts seeking to enhance the skills of the workforce needed to deliver high-quality care for patients in the 21st century will have a greater chance of succeeding if they are clearly articulated through engagement with stakeholders, and focus on the delivery of undergraduate and postgraduate multi-professional education and training in universities and teaching hospitals. |
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| Keywords: | Health workforce governance Medical education and training Decentralisation Healthcare reform England |
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