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Medical students were represented at Junior Doctors’ Conference this year by Vicky Theakston, Brendan Donnelly, Gurdas Singh and I. I made a few amendments and Points of Information for the benefit of student members, and spoke with my own opinions on Brexit. Brendan spoke on BMA communications with members, details of which I haven't included here. My report follows.
In 2016, a new contact for junior doctors was imposed. We remained in dispute. On Saturday morning, Chair of Junior Doctors Committee, announced that we would enter the 2018 Review of the contract as equal partners, meaning that any outcome will need to be agreed between the BMA and the government/NHS Employers to be valid.
At that stage, the BMA will put the outcome to a referendum of members, including final and penultimate year medical students, or if the outcome is not satisfactory, a ballot for industrial action.
Several issues for the review were brought to conference and we agreed to seek these priorities:
Conference also voted to elicit members’ views, demands, and expectations. I was able to amend this motion to ensure penultimate and final year medical students were included in this survey. Student voices will be heard in this process.
We agreed to explore further development of the rota checker, to incorporate pay calculation, compliance checking and other useful tools.
There has been substantial progress on several education and training issues over the year, due to the work of Sarah Hallett and the JDC sub-committee. Notably for medical students, a system has been agreed for flexibility in specialty applications, to allow re-ranking as circumstances change – for example if a partner accepts a job. This is a different system than the ‘linking’ used for the Foundation Programme applications, but should enable a broader set of people to fit their work to their lives. They also won a change in study budget allocations.
However, many issues have arisen too. Conference discussed the Bawa Garba case and voted to work to protect doctors from self-incrimination through reflective pieces, and to ensure the use of reflection is professional development. In an extension of our work on Bullying and Harassment, we asked the BMA to work with Education Providers to ensure that trainees are removed in a timely fashion from units or senior clinicians who have bullying, undermining, or harassment claims repeatedly lodged against them.
Work will start on lobbying to protect teaching time, including details in rotas and work schedules, ensuring pro-rata opportunities for LTFT trainees, providing compensation for any additional educational costs incurred when teaching is missed for service provision, and supporting the removal of trainees from sites where their needs are not met.
We also voted to lobby for improvements to the Academic Clinical Fellowship application system, and for doctors to be allowed to attend their ARCP.
The most controversial issue in this section was that of Medical Associate Professionals and their growing impact on health service provision. After some debate, conference voted against opposing their use in ‘senior decision maker roles’, but in favour of seeking concrete limits on their scope of practice. Conference also sought a review of the effects of the roles on junior doctor’s experience of training.
As the Physician Associate workforce grows, this is an increasingly contentious issue. I contributed one result from a limited survey of student PAs studying at Manchester University: the vast majority had wanted to study a graduate-entry medicine course, but were unable to, or chose to become a PA instead, due to cost. I will write more about this issue and my suggested (but currently unpopular) solution soon.
Conference continued its long-standing no-confidence in the GMC, but more controversially voted in favour of lobbying for its funding to become public. Many doctors wish to keep the GMC funded by the profession as a self-regulation body, and believe that keeps it relatively free of political interference.
A motion about domestic abuse allowed some incredibly powerful speeches and was successful in mandating the BMA to research whether members are at increased risk, as nurse are; offer specialised support for members affected by domestic abuse, including mental health support and emergency legal and financial assistance; publicly increase awareness of the risk affecting health professionals and formulate resources for doctors and medical students to improve the ability of the profession to recognise domestic abuse in patients and colleagues.
I would recommend watching the webcast of motion 46 here.
Conference also voted to act on the dangerous fatigue by compiling a list of non-essential duties that should not be required on night shifts.
There was universal support for a motion addressing the currently obscene system for equipment and support for doctors with disabilities:
Motion by WEST MIDLANDS RJDC That this conference believes the current system of funding for equipment and support for doctors with disabilities and health needs is confusing, inefficient and unfair to the doctors affected. Conference therefore:
Conference also agreed to gather data on how mental health illness, stress and burnout are related to increased pressure in the workplace and on sick leave rates, how employers support doctors on sick leave and on return to work, produce best practice guidance and lobby for workplace improvement.
We passed a motion demanding that healthcare workers are exempted from the ridiculous and arbitrary monthly quota of Tier 2 visas, and that F2 should be counted as meeting the salary threshold and as time towards an indefinite leave to remain application.
We also passed a very important motion to generate action around long-standing policy against the use of doctors to enforce the hostile environment. Yannis Gourtosyannis gave a storming speech detailing the horrendous effects of the so-called ‘overseas visitors’ charges, and the coercion doctors are under to comply, against our professional ethics. We will now launch a national campaign on the issue and consider all options, including industrial action short of a strike, to empower doctors to resist the implementation of this policy.
Juniors mirrored students by discussing drug policy and demanding an evidence-based approach, alongside demanding that PrEP prescriptions become available free of charge to ask-risk groups across the four nations.
Brexit produced a good debate, with Will Sapwell of Yorkshire RJDC proposing that the BMA support remaining in the European Single Market and maintaining free movement; oppose any deal that lacks formal agreement with Euratom on medical isotopes; support for the principle of a referendum on the final deal; and opposition to Brexit as a whole. I spoke in favour of this motion and I will write more about why we as trade unionists must fight for free movement specifically ahead of the ARM discussion on the issue. All but the final part were passed, with members expressing a fear of alienating BMA leave voters.
Overall, it was very successful, and good from a student perspective. Dr Gerard Miller, the Conference Chair, and the Agenda Committee can be proud. The Chair for next year will be Dr Gursh Johal. We will be organising the student and junior delegation and social events at this year's Annual Representative Meeting, details of which can be found here.
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