Giving his final keynote speech at a BMA annual representative meeting, days before his five-year term comes to a close, Dr Nagpaul warned that doctors were exhausted, with thousands of vacancies, and many more planning to retire early.
With 6.5 million patients on the waiting list, the Government should not be risking losing even more doctors from the workforce with derisory pay awards, long and unpaid overtime and no hot food or free parking.
‘Doctors will, and are, walking away,’ he told the meeting in Brighton.
Two and a half years into the COVID pandemic, with more than 190,000 deaths in the UK, Dr Nagpaul said lessons needed to be learned now, rather than having to wait years for a public inquiry to report.
He said: ‘We took matters into our own hands with our lessons-learnt review. We’ve published the most comprehensive account of the lived experience and testimonies of tens of thousands of doctors. It unequivocally concludes that the UK Government failed in its duty to protect its workforce. The lessons from our review demand action today – not sometime in the future – given that a new surge, variant or virus could strike at any moment.’
Dr Nagpaul said there should be guarantees that the ‘brutal’ pre-pandemic cuts to public health would be reversed, that there would be no repeat of the failed, private, test-and-trace service and bed numbers would be brought up to the level of European neighbours.
And he called for ‘fairness for the front line’, as junior doctors struggled to pay basic living and accommodation expenses while being saddled with tens of thousands of pounds of debt, while others were falling into a pensions’ ‘tax trap’ which forced them to leave their jobs.
‘It’s the height of irresponsibility that the Government is wilfully shrinking the workforce and harming patient care, when we’ve given them solutions on a plate that will result in an overall positive balance for the Treasury, while retaining doctors at a time when the NHS desperately needs each of us.’
Reflecting on his 30 years representing his fellow doctors, he said it was painful that the founding principle of the NHS, to treat people equally whoever they were, was not being applied to the NHS workforce.
He said: ‘We simply must not accept a health service where a Black doctor is six times less likely than a White colleague to be offered a job in London. Where bullying, harassment and disciplinary referrals continue at twice the rate for doctors from ethnic minorities, with differential attainment of postgraduate exams, poorer career progression and an ethnicity pay gap.’
Face of the BMA
Dr Nagpaul said the BMA also needed to work to make itself more representative of the profession it served. He said that while ethnic-minority representation on BMA council had grown, the percentage of women recently elected was, at 38 per cent, scarcely more than at the previous election.
He called for a ‘complete overhaul’ of the GMC referral pathway, saying it was ‘structurally biased, lacks timeliness, and is manifestly unjust’. He said GMC investigations should always judge the system, and not the individual in isolation, and ‘hold accountable the systemic root causes that compromise patient safety including the Government’s lack of resources for our health service’.
He said he had always tried to ‘view the world through the lens of every sector of our profession’, and he called for unity, longing to see the day ‘where we stop workload shifting between sectors driven by organisational interests and polarised budgets’.
Dr Nagpaul was given a standing ovation as he closed the speech by telling doctors that being BMA council chair ‘has quite truly been the greatest privilege and the proudest moment of my professional life’. His successor will be elected on Wednesday.