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Silver service

Philip Banfield 04
BANFIELD: 'Discussions have been about patients and not politics'

The holder of the office of chair of the BMA Welsh council, by tradition, has to look after a sterling silver claret jug named in honour of Henry Naunton Davies – a founding member of the South Wales and Monmouthshire branch of the BMA formed in 1852.

Phil Banfield, who stepped down as chair on 1 September, will duly present the jug to his successor David Bailey at the BMA's triennial dinner in October.

While he admitted that, given its age, he would never drink from it, the jug and the role it represents is far from a poisoned chalice.

Speaking before he stepped down after a maximum permitted term of five years, the consultant obstetrician and gynaecologist from north Wales described holding the position of chair of the BMA Welsh council as an 'honour and a privilege'.

He said: 'We set out a very simple agenda, which was to make the health service about patients. To narrow, not widen health inequalities and to re-establish the professional voice of doctors as the experts the NHS needs.

'It's been a very exciting and busy five years lining up everything that's gone into putting these at the top of the agenda. For example, at a point at which the health service was under challenges it had never faced before, I was determined that people would not say 'where were the doctors?'.

'We've made it very clear on where the doctors stand and it has enabled us to be, as the first minister said, the critical friend of Welsh Government – and we've reorientated our relationship with [it] to be one of cooperation and collaboration.'


'Imminent meltdown'

A major turning point in that relationship, as Dr Banfield freely admits, was in September 2014.

BMA Cymru Wales called a press conference and stated publicly that the NHS in Wales was facing 'imminent meltdown' if things did not change.

The remarks had the desired effect and, from that point onwards, BMA Cymru Wales has enjoyed a better relationship with Welsh Government – in stark contrast to the BMA in England and the UK Government.

Dr Banfield said: 'That took us into a dialogue with the first minister and Welsh Government that allowed us to play out politically the means that got the voice of doctors heard at the highest level – and that's been the case ever since.

'The working relationships have been unprecedented. A part of that is that [former health minister] Mark Drakeford and [current health secretary] Vaughan Gething are intelligent politicians who care about their NHS.

'There has always been a sense that the discussions have been about patients and not politics – and that has made it really easy to do business.

'The culmination of that was the way we were able to keep Wales out of the junior doctors' dispute.'

The ostensible reason for that press conference three years ago was to launch a new report calling for changes to the NHS. One of which was to create a more open and transparent culture.


Concrete principles

BMA Cymru Wales was central to developing a new set of core principles for healthcare workers launched by the Welsh Government – one of two things Dr Banfield is most proud of. The other was a charter for staff and associate specialist doctors to support and develop them.

He explained that, with both in place, health boards can now be challenged to deliver something concrete in valuing staff rather than 'a vague promise'.

In changing the culture of the NHS, Dr Banfield concedes that while there has been change, some health boards have been quicker than others to adopt more openness, but that those doing better can show the others a way forward.

And it wasn't just the culture of health boards that Dr Banfield set out to change.

'The characteristic of Welsh Council has been its inclusiveness,' he said. 'We took a conscious decision to make sure everyone's equal on council and that we value all of the branches of practice.

'What I asked people to do on Welsh council was to represent the whole of the profession, rather than who they were, or where they came from. That's worked, I think, really well.

'That's because we've let members identify what the tasks are and then we've gone about trying to achieve them.'



While the core principles and the SAS charter are the two pieces of work Dr Banfield feels most proud of, there is still a huge amount that has been achieved by the BMA during his time.

The Public Health (Wales) Act, which brought Health Impact Assessments on to statute books in Wales; The Trade Union (Wales) Act, which repealed 'draconian' restrictions on trade unions in devolved areas; and of course the changes to deemed consent with organ donation are all major  pieces of legislation for Wales which BMA Cymru Wales had a huge influence over. The same can also be said of the upcoming bill to introduce minimum alcohol pricing in Wales.

There was also a successful BMA-backed judicial review launched after Betsi Cadwaladr University Health Board wanted to end consultant-led care at Ysbyty Glan Clwyd in north Wales.

BMA Cymru Wales has managed to achieve all of this with major changes to its staff in its Cardiff Bay office. BMA Cymru Wales secretary Richard Lewis left for a new challenge in Welsh Government while his deputy Stephen Jones also left.

That vacuum has since been filled by national director Rachel Podolak, who's been in post for almost a year.

Dr Banfield said: 'The changes in the office have been the greatest challenge with Richard and Stephen going – that left a big gap. The remaining staff were great at pulling together. We've now got people in post and so it is a very exciting place to be.'

Members of Welsh Council, he added, have also been very generous with their time and knowledge of how the BMA works – especially to someone who was 'relatively new'.

But does he have any advice for his successor David Bailey?

He said: 'I wouldn't dream of giving him any advice at all, he's politically much more experienced than I am. I know he will continue the cross-branch of practice working that we've started.

'GPs by their very nature are more collaborative as a group and therefore the future of Welsh Council and its ability to influence the health service in Wales has never been better.

'The Cardiff office staff work above and beyond what is reasonably expected and they do it with such great energy and humour that it's made my life as chair possible in a way that would otherwise would have been challenging.

'Being chair is a 24/7 task and you need good people around you to be able to do this. That includes having an enormous support network at home and in your NHS work. The reality is there are too many people to thank who keep me going.'

While his time as Welsh Council chair has come to an end, he is still an elected member and has no plans to lessen his involvement with the BMA.

'I’ve got BMA through me like a stick of rock,' he added.

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