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Calman reforms

Drug Dependency Unit, Homerton Hospital, Homerton Row, London E9 6SR

Sir: I was interested to read Cavanagh & Haut's survey of higher psychiatric trainees to assess satisfaction with changes brought about by the Calman reforms (Psychiatric Bulletin, August 1999, 23, 493-496). The survey uncovered dissatisfaction with the new specialist registrar (SpR) grade, which took the place of the senior registrar (SR) grade in 1996. Little objective evidence was found of differences between the two grades. However, one such difference is that of pay scales. The abolition of the registrar grade has meant that trainees remain on the senior house officer pay scale until they are appointed as SpRs. In addition to this, the SpR scale starts at £23 300, compared with £26 840 on the SR scale, and only reaches the higher figure at the fourth point of the SpR scale. Therefore, rather than the reforms putting "training at the top of the agenda" (Smith, 1994), they could be more cynically viewed as a costcutting exercise. The authors found that more flexibility for time in higher training and restoring the SR title would help to improve morale. Surely restoring SR pay would further contribute to such an improvement.

References

SMITH, R. (1994) Challenging doctors: an interview with England's chief medical officer. British Medical Journal, 308, 1221-1224.[Free Full Text]

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