16 July 2012
Mark Porter talks about his path to becoming chair of BMA council, and what he hopes to achieve during his tenure
Newly elected BMA council chair Mark Porter knows something about social mobility.
The Coventry consultant anaesthetist was the first member of his family to go to university.
A beneficiary of a time when student grants were more freely available, Dr Porter says he has been able to pursue a career in which he has been a clinical director involved in building the new University Hospital in Coventry, as well as a key BMA negotiator for the current consultant contract, and he has faced no personal struggle against adversity in doing so.
Dr Porter concedes that someone living today in the neighbourhood where he grew up would have to ‘think quite a lot harder’ about pursuing a career in medicine.
He says: ‘At the time, the social environment was different. If you applied yourself, if you were reasonably good at sciences and you turned in your exam results, there were no bars put in your way as there are now.
‘There were student grants; tuition fees were paid upfront; there was a means-tested student grant, but nevertheless there was a student grant. When I graduated from medical school, I had nothing remotely like the debts that a medical student today would expect as a matter of course.
‘In those days, in the 1980s, the state generally covered many of the costs. You knew you wouldn’t be going to the Student Loans Company or anything like that.’
Despite more than 20 years of involvement in the BMA, which have included chairing the BMA consultants committee from 2009, being a member of BMA council for several years, and chairing and deputy chairing the BMA junior doctors committee in the 1990s, Dr Porter says it was only about a year ago that he began to think about standing for BMA council chair.
He says: ‘I’m not one of those people who had a career path mapped out.
‘Without doing it consciously or setting out to do so, I found myself having what would be the right BMA experiences to be chair of council. At the same time, I have also maintained my clinical practice.’
He adds: ‘It is of fundamental importance that the premier representative of doctors actually maintains an active practice — otherwise, we might as well call it a job, call for applications, and not have elections.’
Dr Porter says he sees the council chair role as ‘coordination, leadership and inspiration’. He says he hopes to draw upon the advice and assistance of fellow BMA council members, BMA staff and a new deputy council chair; the election of a deputy will be considered at the next council meeting on July 18.
His immediate priority is pensions. Dr Porter will be meeting health secretary Andrew Lansley before the council meeting.
He says: ‘One important thing to do is to sound out and see what leeway or room for manoeuvre there might be — whether there is a way in which the BMA and the government can reach any form of meeting of minds on this, or whether the dispute will remain exactly as it is.’
He adds: ‘The position is hugely complex. It is not as if we were arguing about the difference between a 2 per cent or 3 per cent pay claim. We are looking to engage with the government on any potential room for manoeuvre within that entire package.’
Another important issue facing the association is revalidation. Mr Lansley is expected to deliver a state-of-readiness report this summer.
Dr Porter says he has ‘genuinely enjoyed’ the role he has played in influencing the revalidation process, and counts securing significant changes to initial plans as something he was ‘proud to be involved in’.
‘Anybody who remembers the initial version of revalidation that was piloted two years ago will realise what a huge change there has been, and what a huge reduction on the burden of doctors there has been,’ he says.
Remediation and appraisal
Remediation remains the single biggest sticking point with revalidation but not the only important one, he says. Another is the state of clinical governance information to ensure that appraisals are based on proper clinical outcomes data, although he says there is a ‘trajectory of improvement’ on this.
Dr Porter says: ‘I think there has to be a point at which we say we have come as far as we can in terms of making it a good process [and] in terms of making sure that no doctor will be adversely affected by the process not being perfect from the start. Let’s go.’
He says the ‘final backstop remains what it always was’ — the only way doctors can have their licences removed is if after the GMC has brought fitness-to-practise proceedings.
Dr Porter adds: ‘That provides an enormous reassurance to doctors. The system is being designed to be facilitative and to take people through it, rather than according to some of the wilder quotes of 10 or 15 years ago, which were about identifying the “bad apples”.’
Beyond this there are clear priorities for the BMA. There is a lot of work to do on NHS reform in England, especially monitoring the roll out of the any qualified provider policy, which poses real threats to integrated care.
Dr Porter believes that one of the biggest challenges faced by the profession is considering how the workforce needs to evolve in the future — how doctors can shape the right roles, accountabilities, training and education.
Freedom of speech
Another issue that Dr Porter says he hopes to continue to champion is the ability of doctors to feel that they can speak out against poor-quality care.
In 2011 he appeared as a witness at the Commons health select inquiry into the professional responsibility of healthcare practitioners. The Mid-Staffordshire NHS Foundation Trust public inquiry report is also due to be published later this year.
He says: ‘If there is one thing I would like to achieve it would be … to be able to re-craft what the NHS does in order to make sure that no doctor is ever in the position to feel that they cannot speak out.’
Dr Porter has been married for 23 years, after meeting his wife — an operations director at a clinical trials unit — while they were at Leicester University. They have a daughter, 18, and a son, 15.
Asked how he would unwind while juggling clinical practice with BMA political activity, Dr Porter says he is reminded of a phrase from former Labour chancellor Denis Healey’s autobiography, The Time of My Life. The book says every politician needs a ‘hinterland’ where they can take refuge.
Dr Porter, says his hinterland is a love of classical history, particularly that of the Roman empire, science fiction and political dramas.