Millions of pounds that should be being spent on training junior doctors, nurses and midwives are being withheld in a bid to meet the NHS's financial deficit, Britain's most senior surgeon has warned.
Cash-strapped strategic health authorities are "raiding" an average of 10% of the MPET (multi-professional educational training) budget, which should be spent on improving health professionals' skills, Bernard Ribeiro, president of the Royal College of Surgeons, said.
That could have a serious impact on patient care at a time when junior doctors' training - and in particular theatre time - is already being slashed by a reduction in doctors' hours caused by the European working time directive, and by a new training system called Modernising Medical Careers, to be rolled out in August, that will see junior doctors become consultants in seven years rather than the current 11 years or more.
Mr Ribeiro, who practises as a consultant urologist at Basildon Hospital, Essex, revealed that the Royal College of Surgeons had serious concerns about cuts to the medical and dental education levy - the part of the MPET budget to be spent on training dentists and junior doctors once they are qualified.
"We are having reports coming through from the north-east, around Newcastle, from the east of England, from the West Midlands, of an average 10% being taken from funding," he said. "In the east of England the budget for multi-professional educational training is nearly £291m, and they are looking to save £25m - an 8.6% reduction. In the north-east, where the budget is £199m, the reduction is 10.6%."
The reduction, which can occur because the money is not ringfenced, means junior surgeons will no longer be funded to attend courses crucial to learning new skills and perfecting their surgical techniques. Some hospital trusts have already been withholding funding for the courses, which each cost several hundred pounds.
Mr Ribeiro acknowledged that in countries such as Australia doctors are expected to meet the costs of such professional training on their own. But he warned reducing the funding now would be a "retrograde step" that would affect the skills of future surgeons. It would also set the precedent for cutting future funds.
"Right now there is an expectation this money has been allocated for training ... and we would see it as a retrograde step to reduce that," he said.
"In trying to meet NHS deficits you will affect the future seedcorn of surgical training by having a serious impact on developmental funds."
He added: "The arrival of the EWTD [European working time directive] in 2009 will limit experienced time in hospitals still further and make it all the more important these facilities are available."
Under the directive junior doctors in hospitals are now allowed to work only 56 hours a week, including time on call, instead of the 100-plus permitted in the '90s. That will reduce to 48 hours in 2009.
Mr Ribeiro's concerns came as the Council of Deans, which represents nursing and health faculties in higher education, warned that it too was seeing cuts of up to 30% in the MPET budget.
A crisis meeting held last week on the position of all 60 universities providing healthcare education heard that SHAs were on average providing funding for 10% fewer students, with reductions of up to 25% for individual universities in the east of England, London, south central and south-west SHA areas.
There were also cuts of 10%-30%, depending on the area, in funding for nurses and midwives once they had qualified.
Dame Jill Macleod Clark, chair of the council, warned: "These cuts in places for nursing, midwifery and allied health profession students take no account of workforce needs. They are driven by financial expedience. Cuts in students now will mean fewer nurses, midwives and allied health professionals being available to the NHS in 2009-2010."
She added that the cuts to funding future training for qualified staff would scupper NHS reforms.