Wednesday's updates from the Annual Meeting - BMA News
June 27 2007
Call for better DDRB evidence
BMA evidence to the DDRB (Doctors and Dentists Review Body) needs to be more robust in future, following criticism from economists.
BMA Northern Ireland consultants committee chair Stephen Austin agreed the DDRB pay award for 2006/07 was ‘disgraceful’.
But he said instead of simply condemning the DDRB, the BMA did need to take a look at the way it presented its evidence in future. A senior economist involved with the DDRB who reviewed the BMA’s evidence criticised it as unfocused, dominated by short-term thinking, sometimes addressing issues outside the DDRB’s remit and often contradictory between the branches of practice.
Doctors also agreed future evidence should be better tailored and no evidence from a branch of practice should be detrimental to another branch.
They also agreed to keep the BMA’s participation in the process under review and to fight moves to stage DDRB recommendations.
Inquiry call into troubled IT system
Doctors have voted to withdraw co-operation from putting medical records on the central computer spine because of security fears.
Doctors also called for a public inquiry into the multi-billion pound NHS national computer project.
The system, run by Connecting for Health (CfH), is over budget, has failed to meet deadlines, and has been strongly criticised by many doctors
The IT system was branded ‘doomed to fail’ by Devon GP Charlie Daniels.
‘Patients will be the biggest losers when this all goes tits up,’ he said.
Up to one million ‘key’ cards will provide access to the spine eventually and that could never be secure, he said.
Doctors said the public inquiry should decide if it has been a cost-effective use of public funds, although some feared such a move would cause further procrastination when the problems hitting the system were already wide known.
Security fears prompted doctors to call for BMA members not to co-operate with the proposed centralised storage of all medical records as ‘this seriously endangered patient confidentiality’.
They also said any patients who choose not to put their details on the spine should not be penalised.
But doctors stopped short of severing all links with the national programme for IT.
Somerset obs and gynae consultant David Wrede spoke of his despair at the new IT systems foisted on his trust. Choose and Book was proving particularly disastrous he said. ‘The majority of GPs are unhappy with the system, the consultants loathe it and the patients are bewildered,’ he said. The failing systems should be ‘thrown back in the face’ of the buyers, he said.
London GP Paddy Glackin claimed attempts to forge a national system should be scrapped in favour of local set-ups.
‘Let’s get back to running out own networks that will be responsive to our needs.’
Doctors also said patients were being bullied into giving their information to the national spine, doctors said.
Lancashire obs and gynae consultant Alan Russell said there was a trial of the electronic patient record in his area. A letter from the practice where he was a patient said that he would have be interviewed by the surgery if he refused to allow his details to be put on the record.
APMS privatisation threat
APMS (alternative provider medical services) is ‘privatisation by the front door’ and must be opposed, doctors agreed.
Doctors voted two to one in favour of calls by Berkshire GP Beth McCarron-Nash for the BMA to oppose APMS, which allows independent sector companies to bid to run general practice in areas that find it difficult to recruit GPs.
Dr McCarron-Nash said APMS could fragment patient care and lead to decreased accountability, higher healthcare costs and more GPs losing their independent practitioner status. She said she did not want her patients thinking she had ‘allowed the NHS to be sold off to the lowest bidder’.
BMA GPs committee chair Hamish Meldrum, in his speech to the ARM, expressed concerns about the dwindling number of GP partnerships.
He issued two challenges – one to new prime minister Gordon Brown and one to the profession.
He urged Mr Brown to ‘make new, meaningful partnerships with us, consulting with us, involving us, not just hearing what we say but really listening to us’.
He told the profession they should also forge new partnerships because ‘working together, we can achieve so much more’.
Attack alarms needed, say doctors
Doctors decided all healthcare workers should carry personal alarms despite pleas that this could make dangerous situations worse.
The high number of violent attacks and threats meant they were a necessity at work, said Devon GP Beth McCarron-Nash said.
But Wiltshire GP Helena McKeown warned alarms could also cause violent situations to escalate.
Two cases where she had been threatened by people armed with knives would have been worsened if she had set off an alarm, she said.
SAS doctors demand Treasury action on contract
Staff and associate specialist doctors have warned they will be seeking an alternative way forward on pay and working conditions if the Treasury does not release their proposed new contract for ballot in July.
Before the contract - negotiated by the BMA SAS committee and NHS Employers last year - can be voted on by SAS doctors, it has to be signed off by the Treasury. So now a letter to the Treasury warns that if it has not ratified the contract by July 27, there will be an emergency meeting at the BMA to consider the options for alternative ways ahead.
Pointing out that the BMA has been waiting seven months for governmental approval of the contract, SASC chair Mohib Khan said: ‘Four years after hopes were raised by the publication of the government’s consultation document ‘Choice and Opportunity’, we have still not had the chance to vote on [the contract’s] acceptability.
There is anger and outrage among SAS doctors. Our service record is exceptional but we have never been properly acknowledged or adequately rewarded.’
A petition to No 10 Downing Street, launched online by the BMA on June 13 and signed by thousand of doctors, will be delivered to new prime minister Gordon Brown next week.
BMA council acting chair Sam Everington used his speech to the BMA annual representative meeting in Torquay this week also to urge Mr Brown to release the SAS contract.
He said: ‘The modernisation of the NHS began with the wholesale revision of healthcare workers’ pay and conditions. If Gordon Brown wants a modern NHS fit for purpose in the 21st century, and the improvements to patient care that entails, then he must provide the funding to finish the job. To single out one group of healthcare workers and delay their new contract is grossly unfair.’
He said that he and the other two candidates for BMA council chair would make the SASC contract a top priority.
Key points:
- SAS doctors leaders spoke of the grades' anger and frustration over delays to the contract.
- The RB deplored the government's delay in progressing towards the implementation of the new contract and demanded the deal is backdated to April 2006.
- SASC set a deadline of July 27 for the government to ratify the new contract or it would hold an emergency meeting to seek alternative options.
- The meeting also demanded the government fully funds the contract deal and stops SAS doctors from becoming the scapegoats for the financial mismanagement of the NHS.
Non-medics ‘stealing jobs’ ARM hears
Junior doctors are having their jobs ‘stolen’ by the increasing use of non medical staff, the conference heard.
Manchester trauma and orthopaedic consultant David Sochart said it was an ‘erosion’ of the profession and a lowering of standards.
‘Depriving our junior doctors of much needed basic experience by non-medical staff because they are in theory cheaper than junior doctors,’ he said. ‘It’s about stealing jobs from junior doctors and downgrading medical staff.’
Birmingham medical student Joannis Vamvakopoulos condemned it as ‘doctors on the cheap’.
‘If its more doctors we need, let's train more doctors,’ he said.
Delegates urged the BMA to assess the impact on medical training and employment and insist on strict clinical governance arrangements.
Give international doctors a fair chance, ARM urges
The ‘shameful’ situation faced by international doctors and medical students was angrily condemned at the ARM.
The government has given a ‘clear message to our colleagues from abroad that they are not welcome here’, BMA international committee chair Edwin Borman said.
‘Let me make this absolutely clear, the BMA has not, does not and will not accept this policy,’ he continued.
Changes to immigration rules mean that non-European Economic Area doctors that do not have UK residency can only be considered for jobs where there is no suitable EEA applicant.
Birmingham medical student Tristan Ramcharan, from Trinidad and Tobago, told the conference international medical graduates rack up to £150,000 debts during their course, but could not complete their training.
Buckinghamshire GP Gill Beck said the government should honour its commitment to existing international doctors who have been caught out by the visa rule change.
Call for end to two-signature rule in abortions
Early abortions should be available without the need for two doctors’ approval, doctors at the ARM agreed.
Doctors leaders said removing the requirement of two signatures on a termination form would speed up the procedure and reduce risks.
But the ARM rejected calls to allow nurses and midwives to administer termination drugs within the first 12 weeks of a pregnancy, and also for the current rules regarding where abortions can take place to be relaxed.
The new policy will form the basis of the BMA’s evidence to the Commons science and technology select committee inquiry into scientific developments relating to the 1967 Abortion Act.
Oxford West and Abingdon Liberal Democrat MP Evan Harris, who is a member of the BMA medical ethics committee, said a woman’s decision to have an abortion should be made on informed consent following a consultation with one doctor.
‘Why on earth should women seeking termination – often distressed and anxious – be faced with irrational barriers, perceived or real,’ Dr Harris told the meeting.
‘Why should patients face potential delays leading to later abortion when first trimester abortion, and in particular early medical abortion in the first nine weeks, is known to be safer and easier.’
York consultant in obstetrics and gynaecology David Pring led arguments against allowing other medical professions to carry out abortions.
He said: ‘The operation is timely, is technically very difficult, especially in young women and sadly these make up a significant number of our clientele.’
Dr Pring said it was often only the most experienced surgeon who picked up problems with the procedure.
London consultant in obstetrics and gynaecology Melanie Davies said the earlier an abortion was carried out, the safer the procedure.
She added that terminations carried out before nine weeks were less invasive than traditional surgery and so could be carried out by trained medical professionals other than doctors.
The RB rejected calls for the BMA to survey all members on all aspects of the Abortion Act before submitting evidence to the select committee inquiry.
Speaking outside of the meeting, MEC chair Tony Calland said some women waited up to 13 weeks to have their abortion approved by two doctors and removing this requirement would reduce such a wait and the associated risks.
Main points:
- Two doctors' signatures should not be necessary for abortions within the first trimester, the RB said.
- The BMA will recommend the double medical approval is removed when it makes its submission to a Commons inquiry on the Abortion Act 1967.
- Doctors rejected calls to consult the BMA membership on its submission to the inquiry.
- Calls for midwives and nurses to carry out first trimester abortions were also rejected.
- The RB also rejected suggestions to relax the rules relating to approved premises with regard to first trimester abortions.