The BMA Professional Fees Committee took place on Wednesday 30 March 2017
Representatives from the following were present
- from the Annual Representatives Meeting ,
- Consultants Committee (me)
- Occupational Health,
- GP Committee,
- JDr Committee,
- Private Practice Committee
- Devolved nations
Apologies were received and the minutes of the previous meeting on December 14th 2016 were accepted. I have previously blogged on this on March 2nd which includes the committees terms of reference. A Chair’s report was given. It is likely the committee will take place 3 rather than 2 times a year for practical reasons,
There was an Update on firearms licencing guidance . The BMA continues to seek fair firearms licensing process Fair firearms licensing process. A guide for GPs can be found at Firearms licensing process: GP support guide including Expressions of doctors beliefs
There was a meeting with the Home Office in December. There was a discussion on “flagging notes”., the need to report within 21 days, if there is no evidence they issue a licence but not report is given if the doctor is not paid.
There was a discussion on Collaborative working and claiming fees is directed mainly at GPs see Collaberative arrangements. A survey on LMCs on their specific arrangements with collaborative fees will take place. In general there appears to be a need to “thrash it out with the LGAs”. Problems sited of commissioning by LGAs but paid by the NHS. As all branch of practice involved this is why it rest with PFC.
Personal Independence Payment
Letter to the CAB about their website was shown . Useful available sites mentioned in the letter
DWP GP forum
There was an update from chair on BMA engagement with the DWP GP forum.
Introduction of Medical Examiners and Reforms to Death Certification consultation
There was an update on the last meeting of the implementation board. On my blog www.johnfirth.wordpress.com gives additional information. At the meeting it was suggested likely posponent to October 2018. See my blog yesterday that might indicate even later. (www.johnfirth.wordpress.com)’
Questions were raised regarding the following
- Too many people in the implementation board to implement
- The over ruling strategic board what does it actually do
- There is a need for a Medical Implementation Work group
- As these will be local government appointments there is a need to learn from problems with the Public Health Doctors.
- There are established discussions between the Professional Fees Committee and the Forensic Medicines Committee
Maritime and Coastal Agency fees consultation
This is in area which is new to me but details can be found at Seafarer fitness. The BMA response to the MCA consultation report. BMA response to the MCA consultation report from October 2016 is present on the website. A more recent letter for review was seen which I presume will be soon available.The committee is awaiting a reply
A letter has been sent to DVLA regarding DR1 process for HROs. This is not yet freely available. There was a discussion of the role of a Cardiologist. It was accepted it was the role of the DVLA to tell the GP not the Cardiologist.
Section 57 Local Government (Miscellaneous Provisions) Act 1976 allows for a council to require an applicant for a Hackney carriage or private hire driver’s licence to provide a Medical Examination Certificate to the effect that the applicant is physically fit to be the driver of such vehicle. This form should be presented to the applicants own General Practitioner (GP) or a GP from the same practice. The doctor completing the medical must have been in possession of the applicants clinical records for and be fully aware of their medical history at the time of the examination. Any fee charged by the GP / Doctor is payable by the applicant. This was discussed.
What interested me was the fact that Uber drivers or equivalent do not have these requirements as they are unlicensed.
Social Security and child support fees
These were discussed HM Courts and Tribunals Service fees list
Relationships with HMRC
There was a discussion of IR35. This is an area best referred to a BMA blog. Guide to the changes to IR35 legislation and the HMRC web site HMRC IR35. From the discussion anyone paid through a company, locum agency, external body or directly by private hospitals should spend time reading this. The Occupational Health representative stated this is of importance to their field.
Annual professional fee negotiations
An uplift in professional fees for 2017 was discussed. The appropriate figure for fees uplift to propose to BMA council was discussed. I was surprised that there are over 1700 fees that can be charged. Some of these can be found at BMA Fee finder
The chair has asked BMA legal to provide a briefing on competition law with regards to fees. Legal have asked the committee to provide specific questions to answer in the briefing. This is Euopean Law driven but will persist.
Professional fees in Northern Ireland, Scotland and Wales
Representatives from Northern Ireland, Scotland and Wales reported on other professional fee activities.
There was a discussion regarding supplying information for no fee. Recognising there may be significant cost for GPs and private consultants to access paper information often stored remotely not charging a fee could amount to working for no money which is illegal under the Modern Slavery Law !
Discussion on future representation
Topics for the committee to consider for the next session were discussed. Areas likely to be discussed eg Competition Law , Brexit, Private practice and professional fees, BMJ development,