Physician assistants have “become substitutes” for doctors in many hospitals and GP practices, a leading academic has claimed.
Professor Martin McKee said there appears to be “powerful ideological pressure” to expand roles across the NHS.
In an opinion piece published in the Journal of the Royal Society of Medicine, he warned that “growing concerns about patient safety have been ignored” although the situation “may now be changing”.
Leading doctors, including the Royal College of GPs and the British Medical Association, have called for recruitment of physician associates (PAs) to be halted while concerns about the roles are addressed.
Professor McKee, from the School of Public Health and Policy at the London School of Hygiene and Tropical Medicine, highlighted measures designed to boost the UK’s medical workforce, including the introduction of doctoral fellows, expansion of places at medical schools and proposals to “shorten and simplify the medical degree”.
Leading doctors, including the Royal College of GPs and the British Medical Association, have called for recruitment of physician associates (PAs) to be halted while concerns about the roles are addressed (file image)
Professor Martin McKee said there appears to be “powerful ideological pressure” to expand roles across the NHS.
He added: “But changing the medical curriculum will take time, so politicians need a quick solution.”
‘The answer is to create a new group of workers, associated physicians.
Conceived as healthcare agents who can assist doctors, in many hospitals and primary care centres they have become their substitutes.
‘They offer a means by which those who live in places where it has been impossible to retain doctors can obtain basic care.
‘Although it is mandatory to have a degree to access training, in reality this can be in any area, including homeopathy or the humanities.
‘There are many examples on social media of job descriptions and other documents implying that their two-year training is equivalent to a medical degree. Growing concerns about patient safety have been ignored.
‘This situation may be changing now due to growing awareness among doctors and the public about the problems, mainly related to patient safety, but also illegal prescribing, unclear accountability and damage to specialist training.
‘However, the contractual and funding arrangements that have been put in place to promote expansion in the number of PAs, including salaries much higher than those of newly graduated physicians, reflect a powerful ideological pressure to expand their roles.’
The concerns were published in an article entitled The Sovietisation of British Medicine.
Professor McKee argued that “certain developments in contemporary Britain affecting the medical profession have worrying parallels in Soviet history.”