In response to EU referendum and Britain’s decision to leave the EU, the BMA have said:

 “In the aftermath of the UK’s vote to leave the EU, the BMA reaffirms its commitment to working with our European partners and the European Union to safeguard the future of our profession and the patients we serve. We urge politicians not to play games with the UK’s health services as the country faces a new future. We stand together as one profession with our colleagues from Europe and across the world, with whom we live, work and study and on whom the NHS depends.”

 

ARM 2016

The annual representatives meeting took place from 19th – 23 rd June at the Belfast Waterfront Hall. Below is a shorten list of motions passed by ARM. All in italics are my own comments or observations. All these motions become BMA policy and will be assigned to various Committees to action upon. I have removed motion number and origins for brevity.

I have excluded motions taken as a reference and those that do not involve England,. The stems have been abbreviated and liddles included as typed. For fully accurate motion please refer to BMA.org.uk The following are an edited view of the proceedings. Any comments back to me or your local representatives. If anyone is interested in the actual debate I have the approximate times for each day.

 Monday 20th June 2016

 MEDICINE AND GOVERNMENT

 That this meeting

– believes that medical morale has never been lower and we demand that the government reveals its plans to correct this.

– is appalled by the disconnect between recommendations of the Berwick and the Francis reports and the reality of working in the current NHS.

 

  • believes that trends in reducing hospital beds have gone too far and need to be urgently re-evaluated.

 

  • calls upon NHS bodies to take ownership of concerns raised by doctors about potential high profile system failures without exposing those doctors to career risk or other detriment.

 

  • recognises that hospitals are facing unprecedented and unsafe levels of patient admissions. We call on the BMA to remove financial penalties and punitive measures for NHS services that close or divert due to patient safety concerns related to capacity
  • condemns the small number of MPs who filibustered the House of Commons debate to deny proper discussion on the NHS Reinstatement Bill.

 

NATIONAL HEALTH SERVICE

That this meeting

deplores the continual privatisation of the NHS and:-

  1. i) instructs council to bring our concerns to the government and public;
  2. ii) demands an evidence base on the effect of tendering and outsourcing of contracts.

 

  • demands that the BMA lobby government to stop private companies using the NHS logo when they deliver NHS care.

 

  • i) believes that the current crisis in health and social care is a direct result of

inadequate funding;

  • ii) condemns further unachievable efficiency savings;
  • iii) calls on the government to commit to match or exceed the average % GDP spent on health and social care made by comparable European countries.

 

  • asks the BMA to condemn the government for regarding the balancing of financial budgets as more important than safe staffing in hospitals and the community.

 

  • urges the government to ensure all NHS facilities have fit for purpose health care access for patients with disabilities, and to provide dedicated funding to achieve this.

 

  • deplores the projected future reorganisation of the NHS into 44 Sustainability and Transformation areas (Transformation Footprints) linked to Local Authorities which:-
  1. i) will require each area to have a Five Year Plan in place by June 2016;
  2. ii) will develop new models of health care policy without reliable supporting evidence and;

iii) must achieve financial balance with the threat of large penalties for failure and calls on the BMA to condemn this massive “top-down” reorganisation.

 

  • believes the current government plans for the NHS are unsustainable, are a danger to patient safety, and that in order to combat this all health workers should stand together to fight against a worsening of terms and conditions for all those working within the NHS.

 

SPECIAL REPRESENTARTIVES MEETING

 That this meeting believes

the current government plans for the NHS are unsustainable, are a danger to patient safety, and that in order to combat this all health workers should stand together to fight against a worsening of terms and conditions for all those working within the NHS

 

BRITISH MEDICAL JOURNAL

 That this meeting believes

 

  • the new British National Formulary (BNF) is very poor in layout compared to the previous ones and wishes the changes to be reversed.(This was taken as a reference)

 

OPEN DEBATE ON SEVEN DAY SERVICES

 

An open debate took place

 

The government continues to promote moves to a largely undefined seven day service often quoting research on a “weekend effect”. This session heard from two expert speakers on the latest research on the “weekend effect”. • Professor Paul Aylin, Professor of epidemiology and Public Health and the Co- Director of the Dr Foster Unit at Imperial College, London, and • Professor Tim Doran, Professor of Health policy at the University of York  presented recent research, followed by open debate by members of the Representative Body.

 

SEVEN DAY SERVICES

That this meeting,

with respect to seven day urgent and emergency services:-

  1. i) condemns the persistent misinterpretation by politicians of data on morbidity adjusted hospital mortality, by day of week;
  2. ii) demands that the government should be evidence based in its approach.

 

  • i) is unequivocal in its support for patients having access to the same high standard of urgent and emergency care throughout the week;
  1. ii) believes that it is impossible to deliver routine non-urgent seven-day services across primary and secondary care, within the current five day financial resources and workforce;

iii) calls on the government, to publish a fully funded model for how it will deliver on its manifesto commitment for a seven day service.

 

  • calls on all NHS employers to recognise the emotional needs of staff with caring responsibilities, or who are recently bereaved, and to put in place individualised support tailored to that person’s needs

 

MEDICAL ACADEMIC STAFF

 Report from the medical academic staff committee co-chairs (Peter Dangerfield and Michael Rees).

That this meeting,

calls on the BMA to lobby HEE in order to recognise that academic research, whether it be undertaking an MD or a PhD, is a valid reason and a right to defer the start of a training program either at core training or specialty training level.

  • notes with concern the reports that a number of medical academics have found it difficult to find a suitable appraiser and to be revalidated. This meeting believes that a revalidation process wholly focussed on clinical activity will narrow and diminish what it means to be a doctor and that important parts of the role are those of teacher and researcher. This meeting, therefore, calls on the BMA to work with the Medical Royal Colleges to enhance the status of academic medicine and improve the support offered to medical academics through the establishment of a joint Faculty of Academic Medicine which would provide the responsible officer function to those who need it, lobby on behalf of academic medicine to government and co-ordinate and enhance the support available regarding academic training and careers

FINANCES OF THE ASSOCIATION

 That this meeting

calls for a full report from the Association on the introduction of the outsourcing of BMA expenses claims to include costs and savings.

It should be noted fees are frozen for a third consecutive year

 

BMA STRUCTURE AND FUNCTION

 

  • welcomes the BMA pilot on local membership engagement and demands the outcome of the pilot:-
  1. i) specifically enhances BMA visibility and meaningfulness to the members in the regions;
  2. ii) encourages genuine membership engagement with new ways of communicating at a local level;

iii) assists in providing a far greater and meaningful role for Regional Councils in planning and delivering positive outcomes in important issues such as ‘new models of care’.

 

  • asks the BMA to explore providing systems to assist members in volunteering their skills and knowledge internationally and locally.

 

Tuesday 21st June 2016

PROFESSIONAL REGULATION, APPRAISAL AND THE GMC

That this meeting

 

– demands that:-

 

  1. i) there is critical and peer-reviewed assessment of the appraisal process to ensure it is fit for purpose, equitable nationwide and does not discriminate against doctors in portfolio or non-standard careers;
  2. ii) there is robust and peer-reviewed evidence that appraisal and revalidation

processes are actually producing outcomes of improved patient safety and patient confidence in the profession;

iii) the appraisal system should be only for professional development and not for performance management;

  1. iv) in the area of appraisal documentation the same standards of confidentiality are applied to medical practitioner information as to patient information;

 

NORTHERN IRELAND

 Report from the BMA Northern Ireland council chair (John D Woods).

Motions not relevant to English Doctors but are available to scrutiny on request.

 

INTERNATIONAL AFFAIRS

Report from the BMA international committee chair (Terry John).

That this meeting

 

  • calls on governments to recognise the increased health needs of refugees and asylum seekers by including health need with social service need when allocating resources for the provision of services to refugees and asylum seekers.
  • celebrates the enormous contribution of overseas medical graduates to the NHS and:-
  • i) urges governments to recognise this at a time of severe recruitment and retention difficulties;
  1. ii) in respect of doctors, rejects the recent report from the Migration Advisory Committee;

iii) asks the BMA to negotiate the exemption from the proposed Immigration Health Surcharge of NHS staff covered by the new visa regulations.

 

The seconder speech was particularly emotional one by a Junior Doctor who was an overseas graduate. He got a standing ovation.

 

STAFF, ASSOCIATE SPECIALISTS AND SPECIALTY DOCTORS

 Received: Report from the BMA staff, associate specialists and specialty doctors

committee chair (Amit Kochhar).

 

That this meeting

 

  • wholeheartedly endorses the principles of the nationally agreed SAS Charters and calls on all employers to implement their provisions as a minimum. Furthermore, this meeting recommends that the BMA, through Local Negotiating Committees, seek to further develop and agree local implementation arrangements that improve upon and extend the minimum recommendations of the national Charters.

 

  • meeting is deeply concerned about diversion of the SAS development fund for other purposes and strongly urges the Health Education England to give clear instructions to the Local Education and Training Boards so as to:-
  1. ensure that this funding continues to be utilised for SAS development needs; and
  2. refrain from diversion of this funding for other purposes.

 

CONSULTANTS

Received: Report from the BMA consultants committee chair (Keith Brent).

 

That this meeting

 

  • requests council to produce guidance to support consultants who continue to treat NHS patients but are no longer employed by NHS trusts.

 

The Consultants Committee will be expected to action this.

 

  • meeting believes trusts and Health Boards across the country are increasingly encroaching on SPA time to convert it to direct clinical working time. This meeting wants to express its disappointment, and urges the government to respect the consultant contracts.
  • Believes trusts and Health Boards across the country are increasingly encroaching on SPA time to convert it to direct clinical working time. This meeting wants to express its disappointment, and urges the government to respect the consultant contracts.

 

MEDICAL ETHICS

Received: Report from the BMA medical ethics committee chair (John Chisholm).

That this meeting

 

  • notes that junior doctors are frequently asked to gain consent from patients for procedures that they are not able themselves to perform, or for procedures of which they have limited knowledge. This meeting therefore:
  1. i) acknowledges the GMC guidance “Consent: patients and doctors making decisions. together”, which states the doctor undertaking the procedure should discuss it with the patient, or delegate this discussion to a suitably trained person with sufficient knowledge;
  2. ii) encourages junior doctors to refuse to gain consent for a procedure if they do not have sufficient knowledge of the procedure.

 

Interestingly a motion that BMA should adopt a position of neutrality was lost

 

  • believes that following the adoption of an opt-out system for organ donation in Wales in 2015, the BMA should actively lobby the governments in England, Scotland and Northern Ireland to implement an opt-out system.

This was an emotional speech from a Junior Doctor who had lost a brother needing a transplant.

 

Wednesday 22nd June 2016

SCOTLAND

Received: Report from the BMA Scottish council chair (Peter Bennie).

Motions passed were not relevant to England but are available to view on the websitr.

 TRAINING AND EDUCATION

That this meeting

 

  • calls on all undergraduate and postgraduate Deans to ensure that doctors at every stage of training understand the Mental Capacity Act, recognise that capacity can fluctuate, recognise reversible causes of impaired capacity and understand the requirement to involve those important to a patient in a meeting about a best interests’ decision.

 

  • recognises that there may be difficulty in completing supervised learning events (SLEs). We call upon the BMA to lobby the Medical Schools Council, local trusts and Health Education England to:-
  1. allocate protected time in the rota/timetable for SLEs

 

  • i) is concerned by the reluctance of trusts to implement support for junior doctors with dyslexia following workplace assessment and condemns delays to implementing support which can often lead to support being lost when junior doctors rotate;
  • ii) calls for the BMA to lobby HEE to look into this issue as a matter of urgency and to
  • ensure that problems are addressed;
  • iii) demands that HEE implements a system where support follows the trainee rather than being tethered to a particular rotation or placement.

 

  • calls on all undergraduate Deans to ensure all medical students are trained in ways to assess pain in patients of all ages, including those with learning or communication difficulties

 

SCIENCE, HEALTH AND SOCIETY

Received: Report from the BMA board of science chair (Baroness Hollins).

That this meeting

is concerned by the recent surge in availability and use of Novel Psychoactive Substances and the resultant societal harms. Whilst applauding the government’s desire to address this through the Psychoactive Substances Act 2016 the meeting wishes to express concerns that the use of these substances, in particular synthetic cannabinoids, has now become embedded within certain deprived population groups. We therefore call upon the BMA to lobby government to ascertain what provision will be made to provide the needed support and services to these communities in order to address the continuing use of these substances.

  • requests the board of science investigates the effect of travel distance and travel costs on the outcome of health care, especially for vulnerable groups of patients.

 

  • notes that Diacetyl, a chemical which is used as a butter substitute in flavours like cotton candy and cupcake and is used in candy-flavoured e-cigarettes, is linked to the respiratory disease bronchiolitis obliterans and that when inhaled is known to cause irreversible scarring and constriction of the tiny airways in the lungs.

 

  • i) recognises the relationships between poverty, social inequality, poor physical and
  • mental health and reduced life expectancy;
  • ii) urges UK governments to prevent poverty in order to reduce social inequality and to protect all members of society, especially children, from the negative effects of poverty and social inequality on their health and quality of life.

 

  • is concerned with the lack of consistency in the Pre-school Visual Screening (PSVS) services provided by individual health boards/trusts across the United Kingdom, resulting in delayed /inadequate detection of some of the potentially reversible causes of childhood strabismus. This meeting:-ii) believes that streamlining PSVS services with orthoptist and optometrist led clinics is fundamentally crucial to the success of the service;
  • i) believes that there should be a more uniform effort across different health boards/trusts in the establishment of a consistent and sustained PSVS programme in the United Kingdom;
  1. calls for a devised guideline for the provision of PSVS service across United Kingdom

 

  • recognises the devastating impact which extreme events have on population health and health services, and the increase in the frequency and severity of such events due to climatic and societal changes, and therefore calls for UK governments to continue work to improve resilience of health care infrastructure in preparation for such events.

 

COMMUNITY  CARE

Received: Report from the BMA committee on community care chair (Gary Wannan).

 

That this meeting

 

  • believes that the government drive for earlier diagnosis of dementia without the corresponding support for those receiving such a diagnosis is pointless and only serves to increase distress for patients and families.

 

  • deplores the fact that our most vulnerable young people are being sent to inpatient units far from their local support networks, because of the continuing bed shortage, and demandsi) that councils and providers work together with a sense of urgency for care closer to home and;
  1. ii) that funding for this purpose be an immediate priority.

 

  • recognises the need for more carers to provide care in the community and welcomes a commitment to care workers receiving a living wage and supports methods to increase the number of care workers and recommends:
  1. i) employed care workers receive nationally agreed terms and conditions of service;
  2. ii) care workers are considered to be key workers and given advantageous deals on housing.

 

FORENSIC MEDICINE

Received: Report from the BMA forensic medicine committee deputy chair (Kranti

Hirematch).

That this meeting

 

  • calls for the proposed death certification process in England and Wales to be robust and adequately resourced through public funds, but through neither the imposition of a death tax on the relatives of the bereaved nor any kind of financial raid on the medical profession.

 

As my own motion was not discussed (457 was in the grey area) I was able to support this motion giving added information of the detrimental effects on Anatomical Technician incomes , with the potential for loss of important employees.

 

HEALTH INFORMATION MANAGEMENT AND IT

That this meeting

 

  • advocates the mandatory use of a universal unique identifier for each patient for NHS documentation, thus allowing available data, where not statutorily excluded, to be correctly linked and available to those caring for each patient.

 

 

 

ELCPAD special session

 

SPECIAL SESSION ON THE BMA’S END OF LIFE CARE AND PHYSICIAN ASSISTED DYING PROJECT

 

A special session with a facilitated discussion on the findings from the end of life care and physician assisted dying project and some key considerations the profession might face had there been a change in existing laws on physician assisted dying. See flyers. Representatives are asked to familiarise themselves with the reports and additional materials available in the exhibition

 

That this meeting, in response to the BMA End of Life Care and Physician

Assisted Dying (ELCPAD) project:-

 

– i) welcomes the project as a significant contribution to the ongoing debate around

end-of-life care;

  • ii) calls for governments to prioritise end of life care and to address the variability in

quality of service identified;

  • iii) encourages support for the Access to Palliative Care Bill;
  • iv) calls for the provision of appropriate training for clinicians in the skills necessary to

improve the quality of end of life care;

  • v) calls for employers to recognise the additional time required by clinicians involved

in the care of patients at the end of life;

  • vi) calls on governments to provide tools to improve awareness and discussion of endof-life issues;
  • vii) calls upon the BMA to research child bereavement including the support for

relatives of children who are dying or have died, and issues around the support of the

care of the dying child.

 

 

  • recognises that, with large numbers of deaths now taking place in hospitals, familiarity with what dying is like is less widespread than was once the case; notes that the media focus on instances of poor health care or ‘bad deaths’ has the potential to generate irrational public fears of death and dying; and believes that a crucial part of good end- of-life care should be to ensure that terminally-ill patients and those who care for them receive clear, sympathetic and intelligible guidance on what to expect when someone is dying and have a designated health care professional to turn to about their concerns.

GENERAL PRACTICE

 Received: Report from the BMA general practitioners committee chair (Chaand Nagpaul).

A number of motions from GP that are not pertaining to secondary care I exclude

 DOCTORS’ PAY AND CONTRACTS

That this meeting

believes that contracts for doctors should reflect the following principles:-

  1. i) contracts should ensure a satisfactory work-life balance, safety for patients and be

sufficiently attractive to aid medical recruitment and retention;

  1. ii) on-call requirements should take account of the risks of sleep deprivation and the

need for safe practice;

iii) contractual clauses limiting the freedom of speech of individual doctors are unacceptable;

  1. iv) all training is work and should be included in the work schedule;
  2. v) childcare provision should be available to match the work requirements of doctors;
  3. vi) doctors should have autonomy over the use of personal study leave allocations.

 

  • recognises that the current contract negotiations are at risk of being politicised resulting in the alienation of segments of the population and reducing public support. This meeting calls upon the BMA to:-
  1. discourage personal attacks on political figures or stakeholders;

 

in respect of the DDRB:-

  1. i) believes it is no longer fit for purpose;
  2. ii) calls for a just and equitable medical pay mechanism that has the confidence of all parties;
  1. believes that a period of enhanced pay growth is required to restore NHS pay levels constrained since 2008, using a benchmark of 2% growth above inflation.

 

PUBLIC HEALTH MEDICINE 

Received: Report from the BMA public health medicine committee chair (Iain Kennedy).

That this meeting:-

  1. i) condemns the public health budget cuts enacted by the government;
  2. ii) believes that public health cuts will have a devastating effect, both on the health of

the public and on primary care workload and sustainability;

iii) demands that Public Health funding must be protected.

 

  • instructs the BMA to lobby the government and Parliamentarians to re-establish Public Health England, currently an “executive agency of the Department of Health” as an independent NHS body. This is to ensure that England’s highly experienced and knowledgeable public health workforce can perform their professional duties unencumbered by the political constraints of being civil servants

 

Thursday 23rd June

 WALES

 Received: Report from the BMA Welsh council chair (Philip Banfield).

Motions passed did not apply to England

 

MEDICO-LEGAL AFFAIRS

Received: Report from the BMA medico-legal committee chair (Jan Wise).

That this meeting

 

  • believes that the current situation with respect to rapidly rising indemnity costs for GPs in England is unsustainable and calls on the Department of Health in England to put in place a fully reimbursed system for all GPs on the national performers list, with equivalent arrangements for GPs elsewhere in the UK.

 

  1. i) reiterates the BMA policy, adopted at the time of the cot death miscarriages of

justice, that there should be a public inquiry, conducted by distinguished scientists and doctors, to investigate the failure of the criminal justice system to cope adequately and sensibly with situations of scientific uncertainty;

  1. ii) reiterates the BMA policy that the rules governing expert witnesses should not operate in a way which prevents courts being presented with evidence of scientific

dissent.

 

FORENSIC MEDICINE

Received: Report from the BMA forensic medicine committee deputy chair (Kranti

Hirematch).

 

That this meeting

calls for the proposed death certification process in England and Wales to be robust and adequately resourced through public funds, but through neither the imposition of a death tax on the relatives of the bereaved nor any kind of financial raid on the medical profession.

 

See me speaking to support

http://www.bma.public-i.tv/core/portal/arm-wed

@ 2.36.20

 

HEALTH INFORMATION MANAGEMENT AND IT

That this meeting

 

  • advocates the mandatory use of a universal unique identifier for each patient for NHS documentation, thus allowing available data, where not statutorily excluded, to be correctly linked and available to those caring for each patient.

 

 

  • believes that copies of hospital outpatient letters should be sent to both GP and adult patients and this should be the default position not an opt in system to receive copies:-
  1. i) unless the patient wishes to opt out of receiving a copy letter;
  2. ii) unless it would harm the patient or another individual if a letter were sent;

and calls on council to petition all relevant authorities to effect this move in the

interest of transparency and good communication.

 

A special ELCPAD special session

 SPECIAL SESSION ON THE BMA’S END OF LIFE CARE AND PHYSICIAN ASSISTED DYING PROJECT

 

A special session with a facilitated discussion on the findings from the end of life care and physician assisted dying project and some key considerations the profession might face had there been a change in existing laws on physician assisted dying. See flyers. Representatives were asked to familiarise themselves with the reports and additional materials available in the exhibition.

END OF LIFE CARE

That this meeting,

 

  • in response to the BMA End of Life Care and Physician Assisted Dying (ELCPAD) project:-
  1. i) welcomes the project as a significant contribution to the ongoing debate around

end-of-life care;

  1. ii) calls for governments to prioritise end of life care and to address the variability in

quality of service identified;

iii) encourages support for the Access to Palliative Care Bill;

  1. iv) calls for the provision of appropriate training for clinicians in the skills necessary to

improve the quality of end of life care;

  1. v) calls for employers to recognise the additional time required by clinicians involved

in the care of patients at the end of life;

  1. vi) calls on governments to provide tools to improve awareness and discussion of endof-life issues;

vii) calls upon the BMA to research child bereavement including the support for

relatives of children who are dying or have died, and issues around the support of the

care of the dying child.

 

  • recognises that, with large numbers of deaths now taking place in hospitals, familiarit with what dying is like is less widespread than was once the case; notes that the media focus on instances of poor health care or ‘bad deaths’ has the potential to generate irrational public fears of death and dying; and believes that a crucial part of good end of-life care should be to ensure that terminally-ill patients and those who care for them receive clear, sympathetic and intelligible guidance on what to expect when someone is dying and have a designated health care professional to turn to about their concerns

Please note I have placed a number of BMA documents in the NMUH Library regarding this.

 

That this meeting

recognises that, with large numbers of deaths now taking place in hospitals, familiarity with what dying is like is less widespread than was once the case; notes that the media focus on instances of poor health care or ‘bad deaths’ has the potential to generate irrational public fears of death and dying; and believes that a crucial part of good endof-life care should be to ensure that terminally-ill patients and those who care for them receive clear, sympathetic and intelligible guidance on what to expect when someone is dying and have a designated health care professional to turn to about their concerns.

 

GENERAL PRACTICE

 

Report from the BMA general practitioners committee chair (Chaand Nagpaul).

 

That this meeting

believes that if general practice fails the NHS will fail.

 

 

  • believes in order to preserve patient safety, the BMA should undertake an immediate and necessary workload analysis that can define safe limits of working in General Practice
  • meeting demands that certification of fitness to work (‘fit notes’) need not be done by a medical professional and that:-
  • i) there should be an extension of self-certification for illness from 7 to 14 days;
  1. ii) a change in legislation is required to allow other health care professional such as midwives, allied health professionals and nurse practitioners to complete ‘fit notes’ for patients; and
  • the Department of Work and Pensions should establish their own    means of determining benefits

 

  

DOCTORS’ PAY AND CONTRACTS

 That this meeting

 

  • believes that contracts for doctors should reflect the following principles:-
  1. i) contracts should ensure a satisfactory work-life balance, safety for patients and be sufficiently attractive to aid medical recruitment and retention;
  2. ii) on-call requirements should take account of the risks of sleep deprivation and the need for safe practice;

iii) contractual clauses limiting the freedom of speech of individual doctors are unacceptable;

  1. iv) all training is work and should be included in the work schedule;
  2. v) childcare provision should be available to match the work requirements of doctors;
  3. vi) doctors should have autonomy over the use of personal study leave allocations.

 

  • recognises that the current contract negotiations are at risk of being politicised resulting in the alienation of segments of the population and reducing public support. This meeting calls upon the BMA to:-
  1. discourage personal attacks on political figures or stakeholders;

 

  • in respect of the DDRB:-
  1. i) believes it is no longer fit for purpose;
  2. ii) calls for a just and equitable medical pay mechanism that has the confidence of all parties;

iii) believes that a period of enhanced pay growth is required to restore NHS pay levels constrained since 2008, using a benchmark of 2% growth above inflation.

PROFESSIONAL FEES

That this meeting

 

  • believes that the recent revisions to the firearms licensing arrangements:-
  1. i) places an undue burden on practices, without any resource commitment, to report on every application for a gun license;
  2. ii) leaves the element of discretion too broad in reporting ‘depression’;

iii) places the GP in a vulnerable position in having to decide when to report any deterioration in the health of a patient flagged on their notes as a firearms holder;

  1. iv) should have a clear reference to a reporting fee for any such enquiries.

Unfortunately Motion 130 which I was to propose ran out of time – maybe next year !!

 

PUBLIC HEALTH MEDICINE

Receive: Report from the BMA public health medicine committee chair (Iain Kennedy).

That this meeting:-

 

–          i) condemns the public health budget cuts enacted by the government;

–           ii) believes that public health cuts will have a devastating effect, both on the health of

the public and on primary care workload and sustainability;

  • iii) demands that Public Health funding must be protected.

 

  • instructs the BMA to lobby the government and Parliamentarians to re-establish Public Health England, currently an “executive agency of the Department of Health” as an independent NHS body. This is to ensure that England’s highly experienced and knowledgeable public health workforce can perform their professional duties unencumbered by the political constraints of being civil servants.

Thursday 23rd June

WALES

Report from the BMA Welsh council chair (Philip Banfield).

Motions not detailed as not relevant to NHSE if interested see BMA site for info

 

MEDICO-LEGAL AFFAIRS

That this meeting:-

 

  • believes that the current situation with respect to rapidly rising indemnity costs for GPs in England is unsustainable and calls on the Department of Health in England to put in place a fully reimbursed system for all GPs on the national performers list, with equivalent arrangements for GPs elsewhere in the UK.
  • i) reiterates the BMA policy, adopted at the time of the cot death miscarriages of
  • justice, that there should be a public inquiry, conducted by distinguished scientists and doctors, to investigate the failure of the criminal justice system to cope adequately and sensibly with situations of scientific uncertainty;
  • ii) reiterates the BMA policy that the rules governing expert witnesses should not operate in a way which prevents courts being presented with evidence of scientific dissent.

 

MEDICAL STUDENTS

 Receive: Report from the BMA medical students committee co-chairs (Charlie Bell and Harrison Carter).

 That this meeting,

 

– with regard to the subject of student financing:-

  1. i) is appalled at the abuse of parliamentary processes by UK government to avoid

debate on the removal of maintenance grants for students, including medical tudents

from disadvantaged backgrounds;

  1. ii) calls for the retention of the NHS Bursary for medical students in its current form;

iii) calls on council to investigate ways of increasing financial support to students from

poorer backgrounds, to widen participation in medicine.

 

  • calls on medical schools to support students who have a child whilst at university and to make reasonable adjustments about clinical placements to meet their family’s needs.

 

  • calls on all medical schools to protect students who whistle-blow about poor clinical practice they witness.

 

  •  

WORKFORCE

 That this meeting

 

  • notes that the UK has fewer doctors per head of population than nearly all other European nations and believes that there must be a concerted effort, and appropriate incentives, to encourage medical recruitment and retention with the aim of increasing the number of doctors to at least the European average.

 

  • exhorts the BMA to promote a zero tolerance to bullying and harassment and:-
  1. i) is appalled that an unacceptable number of members have experienced bullying and harassment;
  2. ii) urges the BMA to promote development of support mechanisms such as resilience training and counselling for those members who are subjected to bullying and harassment;

iii) insists that those who bully or harass others are held accountable and dealt with appropriately.

 

  • deplores the negative effect of the recent cap on hospital doctors’ locum rates and calls for its abolition.

 

  • notes the challenges associated with returning to clinical practice after periods of time out, either as a result of opportunities such as research periods or longer career breaks as a result of wider life experiences. We are aware of examples of excellent practice in supporting doctors in return to work, although individual experiences can be very variable. Given this, we believe:-ii) the BMA should consult with relevant stakeholders on how return to work can be facilitated by the GMC, HEE and employers as appropriate, both for doctors who have had shorter and extended breaks from clinical work;
  • i) that “return to work” programmes should be available to all doctors after a period out of clinical practise, be formalised, appropriately accredited and tailored to the individual doctor’s requirements;
  1. that the BMA should take forwards this work by establishing guidance for doctors on return to work.

 

  • with regard to the training of physician associates, calls for:-
  1. i) an impact analysis on the training of doctors and medical students;

                        iii) the introduction of their professional regulation.

 

  • believes that the BMA should regularly survey medical students and junior doctors to

ascertain the proportion intending to continue with or leave a career in medicine in this country.

 

  • believes that government do not recognise the special difficulties of medical recruitment in rural areas and must create incentives to improve recruitment and retention in these areas.

 

 

JUNIOR DOCTORS

Receive: Report from the BMA junior doctors committee chair (Johann Malawana).

This got a standing ovation

 That this meeting

supports the junior doctors in the dispute about a proposed new junior doctor contract in England and:-

  1. i) condemns any imposition of a contract on junior doctors;
  2. ii) commends the Scottish and Welsh governments and the Northern Irish Assembly for not seeking to impose a new contract, and for maintaining good working relationships with junior doctors;

 

  • believes that all trainees appointed to a training programme should have a single lead employer for the whole of the programme, so that their continued service is recognised with the protections thereby afforded including, but not limited to:
  1. i) whistle blowing;
  2. ii) travel expenses;

iii) parental leave;

  1. iv) negating the need for repeated DBS checks;
  1. employer taking full responsibility for ensuring legal working hours across changeover between posts.

 

  • Condemns any changes in the junior doctor contract which disadvantage women, particularly those who are training part-time, who are carers or lone parents.

 

 

CHOSEN MOTIONS

That this meeting

notes that the NHS Bill 2015, a private members bill by Caroline Lucas MP, has fallen because of lack of parliamentary time. The NHS Bill 2015 was supported by the BMA. It is likely that a similar bill will be tabled again within this Parliament. This ARM calls on the BMA to support any legislation in Parliament that seeks to achieve the same aims, or substantially the same aims as the NHS Bill 2015.

 

 

  • re refugees acknowledges that, despite the many policy motions passed by this body since 1999, we are little further on in funding the training of refugee doctors to enable them to work within the NHS, including finding clinical placements, and calls once again on UK governments to direct appropriate resources to the continuing funding of programmes currently established to carry out this work.

 

  • is concerned about the impact of charging migrants for NHS services. We ask the BMA, the BMA council chair and the international committee chair to:-
  1. i) run training workshops for BMA members about the influence immigration legislation has on doctors’ clinical practice;

iii) run a public awareness campaign (including the production of materials, online infographics) on the value of migrant health workers to the NHS (on proviso that this is a business as usual and not massive campaign)

 

EMERGENCY MOTIONS

That this meeting

 

  • believes that the time commitment for newly appointed Guardians of safe working is being underestimated by Trusts and demands that:-
  1. i) the BMA advises LNCs that for most Trusts one Professional Activity (PA) session will be inadequate to fulfil this role effectively;
  2. ii) specific funding is given to Trusts to support this role.

 

  • recognises that the current refugee crisis is a public health crisis and is dismayed

that the French authorities blocked the recent aid convoy to the Calais refugee camp. This meeting calls on the BMA to release a statement condemning these actions.

 

 

  • notes the recent statements, from UEMO last week and RCGP Council at the

weekend, to demand the recognition of General Practitioners as specialists and asks that the BMA adds its vigorous support to correct this long overdue and anachronistic anomaly.

 

  From BMA Comms

The Guardian, Express and the Yorkshire Post report on the speech given by Dr Johann Malawana on the last day of the BMA’s ARM conference in Belfast. They note that strike action by junior doctors had forced “significant improvements” to the junior doctor contract as Dr Malawana said: “The government picked a fight because they thought they could win. They thought the medical profession would just roll over. We didn’t, we shouldn’t, and I’m confident to say that in the future we won’t.” 

 

A proposal to offer addicts heroin as part of their recovery treatment was passed at the BMA’s annual conference as the Mail and the Sun report that doctors believe this change would help reduce crime, prevent the spread of HIV and ensure addicts did not overdose. Commenting on this, Dr Iain Kennedy said: “The idea is that drug users can be given the appropriate opiate in a clean and safe manner. The doctors would prescribe the drug and it would be dispensed for them to use.” He added: “We are not talking about doctors injecting heroin into patients. We are acting as a physician – in the same way a physician would prescribe methadone, which is actually more addictive than heroin.”

 

 

The Times and Telegraph report that doctors at the BMA annual conference have said that the rush to diagnose patients with dementia is pointless without the appropriate care being readily available. Commenting on this, Dr Gary Wannan said:  “There’s no point in giving someone a label, but then not being able to provide support.”

 

BMA online

Doctors call for heroin to be given to help addicts

Daily Mail, Thursday 23 June 2016, (Dr Iain Kennedy)

 

Pointless to diagnose dementia with no diagnosis

Daily Telegraph, Wednesday 22 June 2016, (Dr Gary Wannan, Dr Richard Vautrey)

 

Significant improvements in junior doctors deal

Guardian, Thursday 23 June 2016, (Dr Johann Malawana)

 

Rush to diagnose dementia is pointless

The Times, Thursday 23 June 2016, (Dr Gary Wannan)

 

Treats addicts as patients not criminals

The Sun, Friday 24 June 2016, (Dr Iain Kennedy)

 

Government picked fight with junior doctors

Daily Express, Thursday 23 June 2016, (Dr Johann Malawana)

 

Driving instructors earn more than locum doctors

Daily Mail, Thursday 23 June 2016, (Dr Tom Mickleright, Dr Mark Porter)

 

INFORMATION FROM BMA COMMS

 

 

 

 

 

 

The Guardian, Express and the Yorkshire Post report on the speech given by Dr Johann Malawana on the last day of the BMA’s ARM conference in Belfast. They note that strike action by junior doctors had forced “significant improvements” to the junior doctor contract as Dr Malawana said: “The government picked a fight because they thought they could win. They thought the medical profession would just roll over. We didn’t, we shouldn’t, and I’m confident to say that in the future we won’t.” 

 

A proposal to offer addicts heroin as part of their recovery treatment was passed at the BMA’s annual conference as the Mail and the Sun report that doctors believe this change would help reduce crime, prevent the spread of HIV and ensure addicts did not overdose. Commenting on this, Dr Iain Kennedy said: “The idea is that drug users can be given the appropriate opiate in a clean and safe manner. The doctors would prescribe the drug and it would be dispensed for them to use.” He added: “We are not talking about doctors injecting heroin into patients. We are acting as a physician – in the same way a physician would prescribe methadone, which is actually more addictive than heroin.”

 

 

The Times and Telegraph report that doctors at the BMA annual conference have said that the rush to diagnose patients with dementia is pointless without the appropriate care being readily available. Commenting on this, Dr Gary Wannan said:  “There’s no point in giving someone a label, but then not being able to provide support.”

 

BMA online

Doctors call for heroin to be given to help addicts

Daily Mail, Thursday 23 June 2016, (Dr Iain Kennedy)

 

Pointless to diagnose dementia with no diagnosis

Daily Telegraph, Wednesday 22 June 2016, (Dr Gary Wannan, Dr Richard Vautrey)

 

Significant improvements in junior doctors deal

Guardian, Thursday 23 June 2016, (Dr Johann Malawana)

 

Rush to diagnose dementia is pointless

The Times, Thursday 23 June 2016, (Dr Gary Wannan)

 

Treats addicts as patients not criminals

The Sun, Friday 24 June 2016, (Dr Iain Kennedy)

 

Government picked fight with junior doctors

Daily Express, Thursday 23 June 2016, (Dr Johann Malawana)

 

Driving instructors earn more than locum doctors

Daily Mail, Thursday 23 June 2016, (Dr Tom Mickleright, Dr Mark Porter)

 

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