PMETB had already recognised that when standards of training were not up to the mark then the units should be de-recognised for training. And historically the Royal Colleges, who were responsible for approving training bodies, had taken the same approach. We even know of one famous London Teaching Hospital that was temporarily derecognised in order to tempt the consultants away from their golf course.

Alas the new GMC-PMETB conglomerate has a different view.

This is of significant importance to any doctors caught up in the recruitment process, who would have been deprived of many employment rights by these proposals.

The legislation governing the conduct of Employment Agencies was passed by Parliament in order to give protection to vulnerable workers.

A government consultation in early 2009 stated that they “… consider that [Deaneries] operate as employment agencies within the definition contained in the Act” and that they wished to introduce an exemption. Their reasons for doing so were unclear.

The Remedy challenge arises following the consultation over whether or not to exempt Deaneries from Employment Agency legislation designed to protect work-seekers from abuse by employers.

The reason given for this exemption was that the potential consequences of getting Deaneries to comply with this legislation could hinder the recruitment of doctors and increase costs to the NHS.

Remedy believes that this decision is wrong for three reasons. Firstly it means that the 'protection' afforded to other workers is denied to junior doctors. We also believe that the proposed legislation will open a loophole that can be exploited by other employment agencies in the medical field, relieving them of the tiresome burden of complying with legislation. And finally we believe that the status of Deaneries in Employment Law terms is now very unclear.

The full government response to the consultation can be read here

But whether or not there truly is an effect on patient care has always been difficult to ascertain.

Now a study from Imperial College London has added some facts to the debate. In their retrospective analysis of hospital mortality they found that in 2007 and 2008, when the system for junior doctors' job applications changed, patients who were admitted on Wednesday August 1st had 8% higher adjusted odds of death than those admitted the previous Wednesday.

The responses indicate that nearly half of hospital doctors’ rotas may fail to comply with the new European Working Time Directive (EWTD) regulations, implemented in August 2009.

The survey carried out by Remedy, shows that 47% of rotas were failing to comply with the regulations, in stark contrast to government claims. The apparent reason for the discrepancy is the number of rotas which meet the target on paper yet fail to do so in practice.

Individual responses from mainly middle-grade doctors around the country paint a picture of disillusion and demoralization among doctors, and bullying and manipulation from management.

Remedy believes the present situation is a sham. We urge individual doctors to exercise their right to ‘opt out’, and we call for greater honesty.