Politicians must rise above the current political instability and focus on what must be achieved in the health service if the NHS in Scotland is to flourish, BMA Scotland Peter Bennie has asserted.
In his speech to the BMA’s annual representative meeting in Bournemouth, Bennie commented that the NHS in Scotland faces a challenging climate.
“The health service is never out of the political spotlight. Over the past three years, the NHS has been front and centre in two referendums, the Scottish election, and two general elections. And we live with the on-going debate over the impact we can expect from leaving the European Union and the possibility of a second independence referendum in Scotland.”
Bennie also suggested that BMA Scotland will play a central role in ensuring that adequate healthcare services are delivered.
“Throughout this period of political instability, we at BMA Scotland have worked hard to deliver a consistent message to our politicians, urging them to focus on what must be achieved if healthcare is to flourish in Scotland.”
Bennie has identified a number of key areas where urgent action is needed.
These include the underfunding of the health service; a shortage of doctors to deliver adequate care to patients; a lack of resources to deliver a truly integrated health and social care service; and the lack of time for doctors to keep themselves up to date, to teach others, and to make joint decisions with patients.
Bennie believes that the pressure the health service has experienced has made achieving these changes more challenging.
The eminent doctor believes that healthcare professionals feel increasingly stressed and overburdened, and that patient care often suffers as a result.
“Scottish Government repeatedly says that there are more doctors than ever before – but this is simply ignoring a major risk to the health service, and it is demoralising and frustrating for doctors to hear time and time again. We need a realistic approach to workforce planning in Scotland which is based on an honest and shared understanding of the current medical workforce numbers, and an evidence based view of what future healthcare demand will mean for the number of doctors required. We need a clear and agreed approach to delivering and retaining this future workforce.”
Bennie particularly pointed to the publication of a major report from BMA Scotland, intended to point the healthcare service and doctors in the right direction.
“Our Chief Medical Officer has produced a report called Realistic Medicine in Scotland. This embodies the way we have all been taught to practise, and that we all try to practise. It is about sitting with a patient, discussing all the options, and helping them to decide what is best for them. It is about patients having clear information about their own responsibilities for their health, about the full range of help available, and about how to use it.”
Bennie also asserted that a process of collaboration is vital.
“It will only work if doctors and patients have enough time together to make joint decisions. And it will only keep working if doctors have the time to keep themselves up to date, and to train others to provide that expertise in the future. If the government and employers in Scotland are truly committed to realistic medicine, they need to demonstrate this by properly valuing the contribution and leadership role of doctors beyond the direct patient care they provide.”
The Junior Doctors Committee (JDC) of the British medical Association has called on the union to authorise further strike action as the ongoing row over contract continues.
The full council will be asked to support industrial action from early September, as healthcare professionals continue to play hardball with the government and authorities.
In response to the contractual terms offered to junior doctors, the JDC suggests that concerns that the organisation has expressed have not been satisfactorily addressed.
The contract was rejected by 58% of its members who voted in the ballot.
In a letter to members, Dr Ellen McCourt, who chairs the JDC, said the government had remained “persistently silent” on issues which, she said, had resulted in the contract being rejected.
“In light of this, the JDC Executive has voted to reject the proposed new contract in full and to call for formal re-negotiations on all of your concerns. In response to the government’s silence, JDC exec has today made a formal request for a special meeting of BMA Council to authorise a rolling programme of escalated industrial action beginning in early September.”
But Daniel Mortimer, chief executive of NHS Employers, was scathing on at the prospect of further industrial action, and its alleged impact on the health service.
Mortimer suggested that strikes “would achieve little or nothing, but place pressure on already stretched teams and services and causes worry, distress and disruption for patients, carers and their families”.
Many physicians and healthcare professionals will doubtless disagree with this stance, considering it to be something of a guilt trip.
Nonetheless, Mortimer suggested that during the past two months that dialogue had been taking place with the Junior Doctors Committee, and NHS Employers has “responded positively to concerns regarding the guardian role and whistleblowing”.
And the chief executive suggested that the conduct of the authorities was indicative of how seriously they took the contract and concerns of healthcare employees.
“Employers were hopeful that the continued positive engagement on other important topics… were a sign of how serious employers, Health Education England and the Department of Health were about honouring the agreements reached with the BMA.”
With six strikes having already occurred over the matter, including the first total walkout in the history of the NHS, there is no doubt that both sides would prefer to avoid further industrial action.
The BMA’s junior doctor leader, Dr Johann Malawana, has already resigned as a consequence of the BMA supporting the contract, which was later rejected by ballot.
Health Secretary Jeremy Hunt has insisted that the contract will be imposed on medics in England.
But it seems that this story has more mileage to run in the meantime.
Dr David Wrigley has been elected BMA deputy chairman; and it is notable that the incumbent is a staunch critic of NHS privatisation who has made strong criticisms of government policy.
The GPC member takes over the role from retired Manchester GP Dr Kailash Chand.
Wrigley has gone as far as accusing the government of starving the health service of funding, and causing the existing crisis in the NHS.
Indeed, speaking at LMCs annual conference in May, Wrigley had spoken very strongly on Government policy and the existing financial situation of the NHS.
“Our politicians are starving the NHS of funds and destroying it. Direct your anger to the politicians. The BMA should be shouting from the rooftops about this.”
The Lancashire GP indicated his delight to have been elected to the role by the BMA council, describing it as an honour.
Wrigley is also chairman of the Doctors in Unite / Medical Practitioners Union.
It is notable that this prominent individual in the British healthcare system had been re-elected to the council of this organisation having campaigned strongly against the health reforms put in place by the existing Conservative government.
Additionally, Ridley has even been critical of the failures of the British Medical Association to prevent what he perceives to be the slashing of funding for the health service.
Commenting on his appointment, Wrigley indicated that he would place a particular emphasis on uniting the profession, and discuss the relationship between the British Medical Association and the NHS.
“The NHS and the profession are under great strain with funding cuts. It is very important that the BMA protects and defends the NHS.”
Wrigley also indicated that he would strongly support junior doctors in the ongoing contract dispute with government, and was explicitly critical of the conduct of the Health Secretary Jeremy Hunt in this matter.
“It is quite clear that the contract isn’t acceptable for the majority of juniors, and Jeremy Hunt needs to hear that.”
The incoming deputy chairman also believes that the BMA council should do more to support the General Practitioners Committee.
Wrigley identified the current time as being a critical one for general practice, and suggested that the council of the British Medical Association must show more solidarity with general practitioners in this challenging climate.
The new deputy chairman has co-authored two books about the NHS, namely “NHS for Sale” and “NHS SOS”, with BMA council colleage Dr Jacky Davis and others.
Doctors’ union the British Medical Association (BMA) have announced plans for an “escalation” of strike action.
The BMA is strongly opposed to the government’s decision to impose a new contract on junior doctors.
And junior doctors have themselves voting on several occasions to support the position of the British Medical Association, with workers all over the United Kingdom concerned about both working conditions and future provisions for the NHS.
The chairman of the BMA’s junior doctor committee (JDC), Dr Johann Malawana, wrote to medics to confirm that the JDC had “voted to move towards an escalation of its planned action”.
Malawana stated that the “exact nature” of the action would be confirmed shortly.
Pay has also been a prickly issue for junior doctors, with the terms of the imposed contract ultimately resulting in a 30% reduction in salary for some individuals.
The union’s options include a full walkout by junior doctors, including those working in emergency services, or prolonged strikes extending beyond 48 hours.
In each of the junior doctor strikes so far, emergency staff have remained in post, but this is now thought to be under serious threat as the government continues to occupy an intransigent position.
A&E doctors are among those most concerned about the new contract and pressure for a full walkout has been growing among BMA members frustrated that the union has so far proved powerless to prevent the Government imposing a new contract.
According to the plans of Chancellor George Osborne, the new contract will come into effect in August, cutting pay for Saturday working in exchange for an uplift in basic pay.
“Today we heard strong voices at JDC highlighting the need to step up our action in the face of such Government obduracy,” Dr Malawana wrote to BMA members.
“We have shown solidarity, stated our case clearly and passionately to the public, and done everything possible to avert what could be the worst of all worlds for junior doctors. This is why JDC voted today to move towards an escalation of its planned action. The exact nature of this action will be confirmed shortly. We know that no doctor wants to take such action but the refusal of the Government to get back around the table forces us down this road.”
In addition to the junior doctors dispute, the government is facing numerous problems related to the NHS, most notably financial issues.
The best case scenario based on current figures is that NHS trusts across the country will be collectively £2.5 billion in deficit by the end of the fiscal year.
And numerous top doctors have spoken out to condemn the plans of the government to seek £22 billion in efficiency savings by the end of the decade, stating that this is simply impractical and logistically impossible.
The last thing that Chancellor George Osborne would choose is stringent strike action from junior doctors, but it seems that the inflexible position of the government has now made this a certainty.
The British Medical Association has indicated that junior doctors will hold three further strikes as the argument over the government’s plan to impose new contractual conditions on them rumbles on.
Each of the three strikes will last for two days, and this unprecedented action certainly represents an escalation in the bitter argument over pay, working hours and the ultimate safety of patients.
The Prime Minister David Cameron has already responded to the plans of the doctors’ union, describing the planned three-day strike as “regrettable”.
But Dr Johann Malawana, BMA junior doctor committee chair, was defiant, and indicated that the decision taken by junior doctors and the British Medical Association was the only viable course of action open to them.
“We have already seen NHS chief executives refusing to support an imposition, and patient representatives have said they are appalled by this move. Added to this, the government’s former adviser on patient safety, Don Berwick, has said it should apologise to junior doctors over the contract dispute. The government must listen to the chorus of concern coming from all quarters and reconsider this disastrous approach.”
Malawana was also keen to emphasise the pressurised conditions that junior doctors are already forced to work in, and suggested that the terms of the government at the time of writing were simply unreasonable and untenable.
“The fact is, junior doctors already work around the clock, seven days a week and they do so under their existing contract. If the government wants more seven-day services then, quite simply, it needs more doctors, nurses and support staff, and the extra investment necessary to deliver them. Rather than address these issues head on, the government wants to introduce a contract that is unfair and in which junior doctors have no confidence.”
In his intention to impose the conditions of the planned contract on NHS staff, Health Secretary Jeremy Hunt has argued that it is a necessity in order to end uncertainty for the NHS as a health service.
If the Health Secretary indeed ultimately gets his wishes, then the new contractual provisions will become active in August of this year.
The contract would result in Saturdays between 7am and 5pm become part of a junior doctor’s normal working week for the first time – an issue on which the BMA refused to negotiate during the talks.
A Department of Health spokesperson naturally contested the position of the British Medical Association in a statement.
“Further strike action is completely unnecessary and will mean tens of thousands more patients face cancelled operations — over a contract that was 90% agreed with the BMA and which senior NHS leaders including Simon Stevens have endorsed as fair and safe. The new contract will mean an average 13.5% basic pay rise, and will bring down the maximum number of hours doctors can work. We urge junior doctors to look at the detail of the contract and the clear benefits it brings.”
With 90% of the 38,000 junior doctors represented by the British Medical Association having voted in favour of striking back in the last ballot in November, it seems overwhelmingly likely that the strike will indeed go ahead unless there is an eleventh hour intervention from the government.
The 48-hour junior doctors’ strike due to start next Tuesday in England has been called off by the British Medical Association.
This decision comes in the context of negotiations and talks between the doctors’ union and the government.
However, the British Medical Association insisted that this latest manoeuvre in the ongoing dispute did not represent the reaching of a deal between the two parties.
With negotiations continuing to take place, it is still believed that a strike could go ahead on 10th February should the ongoing process fail to broker an agreement.
Despite the fact that the strike has been prevented, the planned industrial action in February is nonetheless considered to be potentially the most disruptive.
This cancelled strike would have seen junior doctors provide emergency cover, whereas the date in February will be a complete walkout.
The decision to call off next week’s strike is good news for patients. Last week more than one in 10 operations were cancelled because of the 24-hour walkout.
But although the news would seem to suggest that a compromise is near, reports have indicated that the two sides are still separated by considerable distance.
Payment for weekend working, career progression and the safeguards being proposed to stop hospitals over-working doctors still remain key sticking points.
The suggestion that the British Medical Association has called off the strike to indicate its concern for patients, while also ensuring that the ongoing talks can continue without disruption.
Commenting on the decision to suspend industrial action, BMA junior doctor committee chair Dr Johann Malawana indeed reflected this perspective.
“The BMA’s aim has always been to deliver a safe, fair junior doctor contract through negotiated agreement. Following junior doctors’ clear message to the government during last week’s action, our focus is now on building on early progress made in the current set of talks. On this basis, the BMA has today taken the decision to suspend the industrial action planned for 26 to 28 January, thereby giving trusts as much notice as possible so as to avoid disruption to patients.”
In addition, Malawana also indicated that there were still significant problems that needed to be overcome if the February walkout is to be avoided.
“It is important to be clear, however, that differences still exist between the BMA and the government on key areas, including the protection of patient safety and doctor’s working lives, and the recognition of unsocial hours. Significant, concrete progress will need to be made if future action, currently planned for 10 February, is to be averted.”
A Department of Health spokesman naturally placed a positive emphasis on this latest decision. “The strike that took place last week was unnecessary while talks are ongoing, so it’s extremely welcome news that the BMA has suspended next week’s action. In the end, the government and junior doctors want to do the same thing by improving patient care at weekends – and we look forward to further constructive discussions.”
The British government has agreed to enter into talks with ACAS over the ongoing dispute with junior doctors.
This eleventh hour effort is intended to mitigate against the threat of strikes, but the union representing junior doctors has underlined that they have not been called off at the time of writing.
Responding to the threat of strike action, Health Secretary Jeremy Hunt has indicated that he is willing to utilise the conciliation service.
Hunt had initially stated after the strike ballot results were revealed last week that he would be unwilling to enter any form of mitigation process.
At the time, Hunt had said the industrial action, due to start next week, should be cancelled to “avoid harming vulnerable patients”.
The British Medical Association (BMA) had responded strongly to this statement, indicating that the strikes would indeed take place as planned.
And although it seems that Hunt is attempting to avoid strike action, the BMA has maintained its position on the subject, at least for the time being.
The first day of action is Tuesday, starting at 8am and lasting 24 hours.
ACAS is an independent body that can help parties – normally an employer and unions – resolve employment disputes.
Because the two sides in this particular case are simply requesting conciliation, ACAS will merely be required to host the talks rather than offering any meaningful or binding recommendations.
Writing to the leader of the BMA, Dr Mark Porter, Hunt claimed that it was important for the two sides in the dispute to work together.
The Health Secretary claimed that the long running dispute could be resolved amicably were the two sides to work together in a spirit of conciliation and cooperation.
Nonetheless, Hunt also expressed his disappointment that the BMA had refused to agree to the offer that he had made previously.
He also emphasised the potential threat to safety that the strike action that is due to take place next week would represent.
However, despite the apparent intention of Hunt to enter into some form of conciliatory talks, the letter sent by the Health Secretary makes no mention of dropping his previous threat to impose the contract.
The BMA had strongly opposed this policy previously.
Commenting on the letter, the aforementioned Dr Porter stated that the talks would be critical for the future of the NHS.
“We hope to start these talks as soon as possible in order to reach a collaborative agreement for the benefit of patients and the NHS. Importantly, Jeremy Hunt must finally remove his threat of imposition in order to defer Tuesday’s industrial action.”
BMA Scotland has announced a new chair of its medical academic staff committee.
Dr Paddy Mark, a Clinical Reader and Honorary Consultant Nephrologist working at the University of Glasgow, has been appointed to this position.
Mark qualified for he profession back in 1999, and his current duties include heading the Renal Research Group at the University of Glasgow.
He is also employed as a Consultant at the Glasgow Renal and Transplant Unit at Queen Elizabeth University Hospital Glasgow.
Speaking about his elevation to this important position within the British Medical Association, Dr. Mark indicated his pride about the position, but also warned that the NHS in Scotland, and healthcare in general, faced some challenges in the foreseeable future.
“Scotland has long maintained an excellent reputation in medical education and research, but recently the committee has become concerned by the possibility of redundancies in some Scottish universities and changes to pensions, both of which could have serious implications for academic medicine in Scotland,” Mark warned.
Following on from these comments, Dr. Mark also indicated that employment issues within the health service could have a serious impact on the future of the NHS.
“The threat of redundancy may have a significantly adverse effect on academic medicine in Scotland by discouraging doctors from seeking academic careers and raise doubts about the value of research and teaching,” Mark opined.
In the meantime, the new head of the BMA body indicated that he would particularly prioritise fighting against any compulsory medical academic job losses, owing to the importance of such positions within the health service.
But he also warned that there is a risk of academics in Scotland being particularly vulnerable to certain legislative issues.
“Medical academics in Scotland will be disproportionately hit by USS (Universities Superannuation Scheme) plans to reduce pension contributions as they have to move to the USS after eight years, whereas those in England can usually choose to stay in the NHS scheme. This represents a major reduction in the remuneration package available to clinical academics in Scotland and would mean they are paid substantially less than their NHS colleagues,” Mark stated.
Concluding his comments on the subject, Mark pointed out that the potential of recruiting academic and healthcare staff within Scotland would be impacted by these issues, and resolved to play his role in having a positive impact on the issue.
“This would be a serious blow to clinicians in Scotland and a disincentive to young people considering an academic role. In the coming year, the Scottish medical academic staff committee will be pushing for alternative options to be explored to ensure doctors in training are not discouraged from seeking an academic career in Scotland,” Mark concluded.
In addition to the appointment of, Dr Paddy Mark, Dr Rebecca Riddell, a GP and clinical senior lecturer at the University of Aberdeen, was appointed deputy chair of the committee.
The British Medical Association (BMA) has announced that junior doctors are to be balloted regarding strike action.
Industrial action from the registered trade union for doctors comes in the context of new government proposals related to the contracts of trainees.
The government intends to impose these new conditions starting from August, but the BMA had indicated its opposition to the proposals.
Reforms outlined by the government have been described by the BMA as “unsafe and unfair”.
The ballot will only be distributed among trainees in England, as Scottish and Welsh trainee doctors will not face changes to their existing contracts.
Speaking on the subject, Dr Johann Malawana, the recently appointed leader of the BMA junior doctors committee, described the decision as “a reflection of the anger felt by the thousands of junior doctors who have told us that the government’s position is not acceptable”.
Malawana suggested that the government had given insufficient consideration to whether the new contract system will provide sufficient patient safety.
There are also question marks regarding whether junior doctors are being fairly remunerated for their work, and on the impact over the functioning of the health service as a whole.
“The contract they want to impose will remove vital protections on safe working patterns, devalue evening and weekend work and make specialities such as emergency medicine and general practice less attractive, even though the NHS is already struggling to recruit and retain doctors to these areas of medicine,” Malwana asserted.
It has been suggested by critics of the new proposals that trainee doctors and they could be could buy as much as 30 per cent under the government guidelines.”
In addition, under government proposals overtime rates will be scrapped for all junior doctors between 7am and 10pm except on Sundays.
With strong feeling present within the BMA, the form of industrial action that the trade union will recommend to its members is still under discussion.
Predictably the Department of Health was critical of the decision to ballot for industrial action.
A spokesman conveying the views of the department stated that it was “disappointing that the junior doctors’ committee has decided to ballot for industrial action in advance of receiving a formal offer from the government. We urge the BMA to reconsider this decision and come back to the table, because there is a great deal to discuss about how we reward the profession.”
Reporting on the issue today, The Guardian newspaper spoke to several junior doctors, all of whom painted a picture of declining pay and increasingly pressurised conditions within the NHS.
One individual suggested that once mandatory expenses were taken into consideration, she was receiving no more than £10 per hour.
Considering the extent to which qualified medical professionals are sought-after, the plans of the government could contribute to the existing ‘brain drain’.
Many qualified doctors already seek employment in pastures new, and there will be suggestions that the government’s proposals will inevitably exacerbate this existing process.
A new poll instigated by the British Medical Association indicates that the majority of people would back the introduction of a free portion of fruit and / or vegetables for older primary school pupils.
The Ipsos MORI survey of 2,000 parents across the UK found that 79 per cent of people would strongly support or tend to support the measure, while just 5 per cent would tend to oppose or are strongly opposed to it.
Although the concept of providing free fruit and vegetables may seem to be a fanciful notion there are in fact is already precedents within the United Kingdom.
Eleven local authorities in Scotland currently provide some form of free fruit and vegetables above what is routinely provided in terms of school dinners.
However, although this may appear to be a positive development, in reality it represents something of a retraction from previous positions.
As recently as 2013/14, sixteen local authorities in Scotland had schemes in place, thus there has been a significant reduction over the last two years alone.
But the fact that schemes are already operating successfully in Scotland does suggest that it would be possible for free fruit and vegetables to be offered on a wide scale basis within the United Kingdom.
The BMA-backed survey comes in the context of the recent Food for Thought report, published in July.
This report suggested that all primary age pupils should be provided with a free portion of fruit and / or vegetables on every school day.
There are also suggestions related to the regulations on the marketing of unhealthy foods to children, and a tax on sugary drinks was also advocated, suggesting that this could help subsidise a fund for free fruit and vegetables.
The notion of taxing sugary drink, though, has not been supported by all people, regardless of the negative health impact of soda and other guilty parties in general.
It is suggested that taxing these products is not actually addressing the consumption of sugary drinks, and will instead ensure that in many cases poorer members of society simply pay more for products.
However, making this clear link between the subsidisation of fruit and vegetables, effectively providing a free service to children, as a payoff for taxing sugary drinks, could make the policy seen more palatable to its detractors.
Commenting on the results from the survey, Dr Andrew Thomson, who sits on the BMA’s Board of Science strongly advocated the policy suggested by the British Medical Association.
“We need to redouble our efforts to ensure that children are eating healthily and this poll shows clear public backing for ensuring that all primary school children get access to a free portion of fruit or vegetables. Providing primary school pupils with free fruit or vegetables means that they are less likely to eat unhealthy snacks between meals and helps to build positive habits that can last throughout their lives,” Thomson asserted.
Thomson also believes that further pressure and activism is required in order to motivate the government to respond to public opinion.
“It is concerning that several local authorities have actually scrapped the provision of free fruit and vegetables in schools in recent years. Action is needed to address this variation and ensure that primary school pupils in all parts of the country benefit equally from free fruit and vegetables,” Thomson opined.
Obesity in children has been growing to such an extent in recent years that it is frequently described as an epidemic.
While one extra portion of fruit and vegetables a day would hardly reverse this situation, it is hoped by the BMA that it could make a contribution to children making healthier food choices.
One of the major announcements in yesterday’s summer Budget concerned the scrapping of educational maintenance grants – a move that will create further barriers to low-income students wishing to pursue medical careers according to the British Medical Association (BMA).
Chancellor George Osborne announced that existing maintenance grants will be phased out and replaced with a loans system of up to £8,200 per year from the 2016/17 academic year.
However, alongside the decision to remove maintenance grants, Mr Osborne did promise to increase the level of funding in the new loans.
“We firmly believe that medicine should be attracting the most able, not the most able to pay”, said BMA medical students committee (MSC) co-chair Charlie Bell. “Taking away a vital lifeline from students from disadvantaged backgrounds can only help to put some of our best applicants off careers in medicine. We call on the Government to reinstate these grants and to commit itself to widening participation across the professions.”
Adding his voice to the debate, MSC deputy chair for finance Tom Rock pointed out that UCAS figures for the year 2014/15 showed a drop in the number of applicants applying to medicine and that only 7 percent of medical students come from the three lowest socio-economic groups.
Mr Rock said: “MPs are very keen to pretend that none of this is due to cost. That is simply wrong. Current BMA members are struggling, and prospective applicants under the new £9,000 fee structure can expect to graduate with more than £60,000 of debt.
“Quite simply students are being put off by high fees. The Government has decided there is money to raise the inheritance tax threshold but not to help the poorest students study their way out of poverty.”
Following lobbying by the British Medical Association (BMA), the European Parliament has voted yes to a recommendation that public healthcare services be excluded from a free-trade agreement.
MEPs have been voting today (8 July) on a report calling for the European Commission to exclude public services — including the NHS — from the scope of TTIP (transatlantic trade and investment partnership).
“We are pleased that the full session of the European Parliament has voted to recommend that public services, such as the NHS, be excluded from TTIP”, said BMA council chair Mark Porter.
“This result follows similar favourable votes by two influential European Parliament committees, and significant lobbying by the BMA at a European and UK level. Today’s development will increase pressure on the EC to remove public services from the negotiating table, and we will continue to work with MEPs and European partners to secure its implementation.”
The full BMA/TTIP?briefing can be viewed on the BMA website.