BMA Consultants Conference
This took place 1st March at BMA House which I attended. I spoke a few times in support of some of the motions. I would recommend you go to
and watch Keith Brent’s Speech and the Consultants Contract Talk by Rob Harwood at 3hrs 7 minutes
The following motions were carried (my edit)
That this conference believes that the government must bring the English NHS back from the brink of collapse by:
i) Providing realistic funding for both social care and health care
ii) Reversing the ill-considered £22 billion of planned cuts to Health Service funding
iii) Ensuring that funding and the provision of in-patient beds at least match that of comparable European countries as a percentage of GDP
iv) Informing the public of what services they can expect to be provided by the NHS and what services are no longer affordable Carried as a reference
v) Refraining from blaming doctors for the problems that result from underfunding of the NHS and social care
vi) Listening to the evidence and the advice of its own experts
That this conference notes that the time taken by mandatory training is rising with the expansion of an increasingly irrelevant curriculum. This is motived by Trust requirements rather than continuing professional development (CPD) needs, yet it is frequently expected that Consultants find time for this during their supporting professional activities (SPA) time. Consultants have no input into what is included in mandatory training and may feel that their time could be better spent.
We ask that:
i) The BMA issues advice that mandatory training should not detract from Consultant’s SPA time.
ii) The BMA explore the whole issue of mandatory training and finds out what the Consultant body is being expected to cover in it.
iii) The BMA explores with the Royal Colleges which aspects of mandatory training are actually felt necessary for CPD.
That this conference
i) welcomes any sensible initiative that improves standards for trainer consultants
ii) is concerned that ever-increasing regulatory stringency in this domain is impinging adversely on continuous professional development time in other domains.
Iii) will ask the General Medical Council (GMC) to monitor trends in engagement or disengagement of consultants with training
That this conference:
i) rejects the Secretary of State’s proposal that medical students should be required to work for the NHS for 4 years after registration or pay back the “cost of their training”
ii) recommends that the government should seek to understand why junior doctors might leave the NHS rather than forcing them to stay
iii) calls on the BMA to analyse exactly what is the cost of training a medical student compared with the tuition fees paid
iv) calls on the BMA to lobby government and other relevant bodies to drop this proposal.
That this conference notes that since the commissioning for public health and sexual health services was moved to local authorities in England in 2012 there have been unacceptable cuts to those services. It calls upon the government to:
i) move public health and sexual health commissioning back into the NHS
ii) restore the budget for these services to at least 2013 levels
This meeting notes with concern the recent BMJ study indicating that many clinical commissioning groups are operating referral management systems interrupting the referral of patients by general practitioners to hospital consultants.
We note that these schemes have no evidence of clinical or cost benefit and we call on the BMA to advise all doctors not to co-operate with these schemes.
Carried as a reference
SUSTAINABILITY AND TRANFORMATION PLANS
That this conference believes that the creation of Sustainability and Transformation Plans (STPs) in England is less a means of improving care for localities and more a means of shifting the blame for the acknowledged funding crisis away from central government. We call on the BMA to lobby for:
i) Adequate funding to make system changes and run a safe clinical service
ii) Accountability to be clear for providers and commissioners
iii) All STPs to have proper representation and involvement of consultants
That this conference notes that child and adolescent mental health services are under funded and that Child and Adolescent Mental Health Services (CAMHS) have been described as the Cinderella of Cinderella services. We demand that:
i) Mental health patients who need to be admitted to a psychiatric unit should be admitted within 50 miles of their home
ii) Money allocated to CAMHS should be ring fenced.
That this conference calls for the expansion of liaison psychiatric services in Northern Ireland in order to provide a standard of mental health care in the acute hospital setting, similar to that provided in England which has been demonstrated to reduce length of stay.
That this conference welcome the Prime Minister’s recent announcement for support of early intervention in mental health and we would wish for a similar pledge from the Northern Ireland Health Minister, particularly given the higher rates of mental illness when compared to the rest of the UK.
That this conference believes the increasingly coercive nature of UK mental health care, as evidenced by increased use of the mental health act year on year and increasingly locked units, should be urgently reviewed by the department of health
Carried as a reference
That this conference regrets the continuing gender imbalance in various medical specialties, with fewer than 20% of female medical graduates choosing to pursue a career in surgery and 34% of Consultant physicians being female. Despite this being recognised for many years, the mechanisms behind it have remarkably not been explored. Carried
We demand that
i) the BMA investigate the mechanisms behind this by means of a questionnaire study on ‘Imposter Syndrome’ which has recently been shown to be a significant factor in womens choices in academic careers. Lost
ii) the BMA uses this data as part of its gender equality agenda to improve freedom of choice of specialty for all doctors. Lost
That this conference notes the current difficulties in the recruitment and retention of consultant posts in acute specialties and the impact this is having on emergency care and waiting lists, and therefore calls for the following to address this:
i) improved recruitment and retention in acute specialties; Carried
ii) enhanced remuneration and safeguards if there is any attempt to redefine “emergency care” or “standard working hours”; Carried
iii) a day of action for the NHS. Taken as a reference; Lost
INTERNATIONAL MEDICAL GRADUATES
This meeting condemns the failure of both the Prime Minister & Secretary of State for Health’s failure to recognise the crucial role played by immigrant doctors in the NHS and contrasts this with Jeremy Hunt’s recent confused announcement that he will recruit an extra 500 general practitioners from Poland.
We call upon the Prime Minister to applaud the work of overseas NHS staff, to offer them appropriate meaningful assurances in the face of Brexit and to develop a sustainable long-term strategy for international recruitment to the Health Service.
GENERAL MEDICAL COUNCIL
This meeting is concerned that the GMC’s project for development of the medical register risks “mission creep” away from its primary role as a regulator. Whilst there is scope for including more information and ensuring that the information is up to date, developing the register into a means of advertising doctors’ skills to help patients choose a doctor seems
i) a function that can be much better undertaken by other organisations
ii) a development that the profession should not have to pay for.
We urge the BMA to work with the GMC to ensure proportionality and economy in developing the register.
That this conference:
i) Recognises that the hallmark of a profession is self-regulation.
ii) Deplores the increasing regulation of the profession through unelected and unaccountable members of the GMC
iii) Supports the return to the election of a majority of licensed medical practitioners to the GMC by the profession and
iv) Believes the funding of the General Medical Council should be raised through general taxation.
That this conference calls on the BMA to investigate the recent judgment in favour of younger judges who were disadvantaged by pension reform and consider similar legal action with respect to the NHS pension scheme.
That this conference requests the government to reconsider urgently the reductions in the pension annual and lifetime allowances that are a major disincentive to consultant retention within the NHS.
That this conference believes the DDRB is no longer independent and fit for purpose and calls upon the BMA to withdraw from the process.
Carried as a reference
That this conference believes that the new (2016) junior doctor contract impinges on the working lives of many consultants in England and demands that NHS Employers agree an adequate Programmed Activity (PA) allocation for the following roles:
i) Guardians of Safe Working;
ii) educational supervisors;
iii) clinical supervisors.
That this conference continues to support junior doctors, and:
i) Calls upon consultant members of the BMA to endorse exception reporting as a tool for the improvement of terms and conditions of trainee doctors.
ii) Asks its members not to suppress in any way the fair use of the exception reporting mechanism by junior colleagues.
That this conference supports maintenance of high professional standards, but:
i) Recognises that “Neutral act” suspension without time limitation is an abuse of process. Carried
ii) Proposes that that any suspension is either lifted within four weeks or immediately escalated through MHPS in accordance with nationally agreed timeframes. Carried
iii) Proposes that any local agreements to the contrary should be rescinded. Carried as a reference
That this conference is appalled that Northern Ireland is the only UK nation that does not have a dedicated consultant post for sexual and reproductive health and calls on the Northern Ireland Department of Health to make appropriate funding for the provision of dedicated consultant led services in sexual and reproductive health.
That this conference recognises that BREXIT will have a special impact in Northern Ireland due to the land border with a European Union country. We call on the UK government to ensure healthcare in Northern Ireland is prioritised in negotiations with the European Union institutions.
That this conference recognises the newly published guidelines for termination of pregnancy in Northern Ireland in 2016 and asks all Health and Social Care trusts in Northern Ireland to produce local pathways to aid the individual Obstetrician’s compliance with these guidelines.
That this conference believes that the BMA should be restructured to a federal system, with branch of practice committees having a small UK committee but also 4 separate national committees to reflect the fact that the UK is a multinational state.
Carried as a reference
That this conference acknowledges the unremitting rise in the responsibilities of Local Negotiating Committees (LNCs) and demands that BMA prioritises local support for them. Consultants working on LNCs have seen their responsibilities in respect of the junior contract increase, and aggressive job planning has been reported in many Trusts.
Conference requests that:
i) LNCs should have access to industrial relation officer (IRO) expertise throughout the week and the IRO funding should be increased to provide this if necessary.
ii) Training should be given in negotiating skills to LNC Chairs
iii) A LNC Chair hotline should be made available for urgent queries and advice
That this conference acknowledges the global threat to human health posed by antimicrobial resistance and the firm linkage to inappropriate usage both in human health and in agriculture. As such we call on the BMA:
i) to continue supporting the vision of the UK 5 Year Antimicrobial Strategy (2013-2018).
ii) to support stakeholders in making sure that there is a subsequent strategy following on from 2018
iii) to support the One Health approach to antimicrobials, recognising that usage in human health only accounts for 50% of usage worldwide and encouraging responsible use in agriculture, engineering and other industries aside from human health.
iv) to recognise their own part to play by ensuring, where possible, that subcontracted catering suppliers used for BMA meetings use antimicrobial-free produce by preference.
That this conference notes the difficulties for consultants in raising local concerns when they remain with their employer for many years and may be involved in management. These disincentives can act as a ‘gag’ preventing consultants from whistleblowing even when patient safety is compromised. Conference requests that
i) specific advice is given to LNCs on encouraging consultant whistleblowing
ii) the issue is explored on BMA communities