Author: Broad Left

BMJ Independence – ARM

Conferences, News, Opinion, Reports, reflections and accountability

Author: Chris Smith

This is the first of many pieces arising from the ARM 2019, explaining our positions on the debates which occurred there.

Motion 55 ARM 2019. 55a and 55b are for reference and were not debated.

We are delighted that this motion fell. Several Broad Left members had submitted speaker slips against the motion.

The proposer argued that the BMJ was damaging the BMA by publishing information about Spousal Expenses, sexism and so on. He argued that our members saw the BMJ as the ‘official mouthpiece’ of the BMA and that we therefore needed a Memorandum of Understanding to limit their editorial independence.

We believe it is the behaviours of members and representatives that has damaged the BMA, not the reporting of these issues. These issues show how completely necessary it is for the BMJ to be empowered to investigate and report on our shortcomings and failures, both for transparency of the union and so we can reflect and change when appropriate. The free press is important: it provides the disinfectant of sunlight.

The BMJ is internationally respected, with the 4th highest impact factor in the world. It is also a great boon for our members – the surplus provided to the BMA is in the millions. If the journal is sullied around the world by a memorandum which forces it to be a vehicle for BMA propaganda it will diminish trust in the journal and trust of the association.

The BMJ is, and should remain, a critical friend. This motion argued against a free and impartial press- a right enshrined internationally by documents such as the United Nations Convention on Human Rights. We believe the integrity of the BMJ should remain intact and will continue to argue that our trade union should not be meddling with a prestigious and editorially independent publication.

BMA Council Report May 2019

Council Reports, Reports, reflections and accountability

Apologies for the lateness of this report – Junior Doctors Conference and issues around the junior doctors’ contract and lots of student issues have slowed us down.

The meeting on 15th May was reasonably productive. There was significant anger from some members of Council at the recent leaks surrounding spousal expenses and the sexism allegations in the press. We do not share this. We applaud the bravery of those who have spoken out against poor treatment and rotten cultures in the BMA.

We received a confidential update on member support services, which the BMA is reviewing in detail. This includes the First Point of Contact, Employment Advisers and legal support given to members, which we aim to continually improve. The Broad Left welcomes the review, and hopes it will highlight solutions for the problems members face when engaging with us.

We discussed guidelines for the process of selecting members to European Medical Organisations. This aims to make it a more accountable process. The highlights are: a selection committee would select suitable candidates based on role criteria, representatives must demit office if they are no longer a member of the relevant branch of practice, and that records will be kept of meeting purpose and expense. Council approved these guiding principles with immediate effect.

The Working Together Better task group has been considering a definition of the role “Chief Officer”, which is a term frequently used in the organisation’s articles and byelaws but with no universal understanding of what this means. A definition was proposed to council in a paper, however concerns were raised as to the wording. It was also considered that it would only apply for a short time – until the completion of a review by the appointments oversight sub-committee. Some concerns were expressed that defining a “Chief Officer” beyond the actual role title could lead to power grabbing and increased control by a few senior elected members. It was resolved that the definition would be altered to reflect comments made by members, and subsequently recirculated to council for consideration at a later date.

A motion was brought to council to change the agreed process for hustings at the ARM for the roles of Treasurer, Chair of the Representative Body and Deputy RB Chair to include questions to candidates to be permitted at the hustings. The proposer explained that the motion aimed to give us a better chance of getting the best people into roles, by allowing for a more accountable and informative election process.

Several concerns were raised by council members including issues with time, and that not all candidates would perform well under questioning (and indeed this may put some people off applying). A representative from the ARM agenda committee explained that it would be very difficult to facilitate extra time for questions, and that we would potentially lose a significant amount of debates as a result. They were also concerned that long hustings may disengage representatives.
The motion was not carried, and it was decided that hustings would take place as agreed by Council in January.

Council received an oral and written update from the Audit and Risk Committee.

A discussion regarding membership of LNCs was held in private. Current rules can exclude non-BMA members from LNCs due to the BMA staff and resources they rely on. A paper presented by the Secondary Care Forum was agreed upon. We will update this report at such a time as the resolutions from this discussion are made public.

Another confidential update was made to Council about work ongoing to improve the code of conduct and resolutions processes. This is very necessary work in the context of both tight political control and increasing awareness of sexism in the BMA. Confidence must increase if the system is to work well.

Council received a brief update from Jeeves Wijesuriya, chair of JDC, about the junior doctor contract negotiations. He shared with council the successes so far which include shared parental leave, child bereavement leave, and money for junior doctor facilities. As negotiations are still ongoing there was not much more that could be shared at this time.

A discussion was had about how best to approach two unfilled council seats, following the resignation of two members. It was decided to leave the national UK seat unfilled (given that the total number of council members is comfortable above the minimum at present), and that the next highest candidate from the West Midlands region is elected as a non-voting member for the remainder of the Council term. Although we would want as many voting members representing regions as is possible, the cost of running new elections at each resignation is prohibitive.

Council received a confidential update from the board of directors, addressing matters of finance and governance. Many broad left members spoke up in support of transparency and accountability in this area and called for investigation into previous lapses in internal governance. The funding for Spousal expenses and the Lock Club has now ended, but we feel there are further questions to be asked.

We keep working hard on Council and in various other roles in the BMA. Working with some other members, we have assurances that Place of Work Accredited Representatives (POWARs) and the training for that will be reintroduced. This is one step towards the rank-and-file trade unionism we need.

Spousal Expenses – Update

Council Reports, News, Reports, reflections and accountability

We have received an update from the BMA Board of Directors on the actions that have been taken on the matter of claims for spousal travel expenses. We share it in full below. The inquiry represents progress in resolving the governance issues highlighted by the discovery of the spousal expenses payments. We are also beginning to ask questions about the Lock Club, a dinner club for ex-Chief Officers of which we were initially not aware, and are supportive of other Council members asking legitimate questions.

Update

“An inquiry of the matter is underway.  It is being conducted by Jacques Cadranel, who is a non-executive member of the BMA Audit and Risk committee.  It is planned that the findings of the inquiry will be reported back to the Board of Directors by Friday 10 May, and (through the Board) to Council by Wednesday 15 May.

The inquiry will examine the historic expense payments made by the BMA to chief officers to fund the attendance of their spouses at oversees events at which the chief officers were representing the Association.  It’s scope will include a review of:

  • relevant BMA policies to establish whether any permit/permitted spousal travel claims and, if so, who developed and approved them.
  • current expenses policies to determine if spousal travel claims are permitted or whether any previous policies that permitted them have been superseded.
  • chief officer role profiles relating to spousal expenses, including an account of any inconsistencies between them.
  • expense claims to examine compliance with policies and contracts, both by claimants and those who processed and approved claims.
  • the role of “custom and practice” in the payment of these expenses.
  • the cost to the Association resulting from the payment of these expenses, including the potential tax (and any other) liability.
  • the role of internal and external auditors in identifying liabilities and, if failings are found, recommendation for ensuring they are not repeated.
  • the decision to pay the tax liability when it was recently identified and the process that was followed.

The findings of the enquiry will feed into a wider of review into BMA policies, practices and processes that is to begin shortly.

In addition, to the inquiry, we have already taken the following actions on the matter:

  • Ceased any claims for or payments of spousal expenses.
  • Procured specialist advice on the legal basis for repayment and the associations tax liability. 
  • Written to eight past chief officers to inform them of the concerns raised and publicity and to invite them to make full or partial repayments or equivalent donations to BMA Giving.
  • Ceased funding of the Lock Club, a dinner club for past Chief Officers.”

—Update ends—

BMA Medical Students Conference Report 2019

Conferences, Reports, reflections and accountability

Author: Grace Allport

This year the BMA Medical Students Conference was hosted on the 12th and 13th of April, and an enormous number of progressive policies were passed. Organisation among Broad Left students helped us to win support for our position on several issues and ensured important motions were discussed.

Student Welfare and Finance

Conference committed to several new policies aimed at improving conditions for medical students, such as lobbying medical schools to reduce travel time to help ease time pressure, promoting communal spaces on regional placements, allocating time for physical activity and establishing mental health services for medical students. These motions are important to continuing the vital work the BMA does in supporting medical students and advocating for conditions which allow them to study medicine without compromising their mental and physical health.

A motion about performance enhancing drugs was opposed by the Broad Left. The motion called for BMA investigation into the use of illegal recreational and performance enhancing drugs, as well as the implementation of drug testing systems at medical schools. The proposal would have discriminated against students who took some drugs for medical reasons by forcing them to disclose their condition and treatments to the medical school and any agencies involved in the testing. We do not believe that the BMA should be advocating testing and punishing students in this way. After a short debate, the motion fell.

Conference also committed to lobby for maintenance loan access for students who chose to intercalate with a Master’s course rather than a Bachelors. This policy aims to increase the accessibility of intercalated Master’s degrees, especially to students from less economically privileged backgrounds. Kirush Naguleswaran, who spoke in favour of the policy, said, “Intercalation is a valuable part of a medical degree. Studying a Master’s degree equips you with additional skills and knowledge that is not necessarily covered in a Bachelors. Lack of financial support denies deserving candidates the chance to study subjects at a Master’s level.” She argued that the lack of financial access whilst a student lasted beyond university, highlighting the points awarded for Master’s degrees at specialty application.

Education

The UKMLA remains highly controversial and the Broad Left opposes its implementation in 2023. A proposal to recognise that it is too late oppose the UKMLA’s introduction was so unpopular that the conference voted, by an overwhelming majority, to have it removed from the agenda. Instead, the conference agreed to maintain its position of opposition and engagement to the UKMLA and restated its support for the red lines proposed by the Medical Students Committee.

Further policies were agreed by conference, including opposing the use of UKMLA scores in the application process for foundation training, seeking to prevent additional burdens on finals students in 2022 when the assessment will be trialled and seeking assurances that students could abstain from the trial without punishment. These are crucial to the role the BMA has of advocating for students and ensuring that their welfare is not compromised.

Equality and Access to Medicine

Unanimously, conference voted to support policies to address the Black, Asian and Minority Ethnic (BAME) attainment gap. The evidence that the gap is not due to ability, but systemic racism, has already been heard and accepted by the BMA. Majd Albakry said, “Although this matter has been addressed previously, we need a more action-specific plan as outlined by motion 52 that incites organisational and social change.” These measures included creation of an annual conference to tackle the issue, school-specific plans of action, and positive action to increase the number of BAME staff working in medical schools. The Broad Left supports these actions as part of our fight to ensure that all students receive fair education and assessment, and to end disadvantage on the grounds of race.

Conference also voted to establish liberation networks within the BMA. These networks aim to provide representation for members of minority groups. Each branch of practice would elect officers who identify as women, LGBTQ+, BAME or as living with a disability, who would then meet to discuss policy and representation. The motion was proposed by the Deputy Chair for Welfare of Medical Students Committee (MSC), Stephen Naulls, who said, “In situations where the BMA advocates for members with protected characteristics, I believe the voices of those members – and their lived experience – is pivotal to the discussions. I hope this just one step along the pathway to creating a more representative and member-led BMA.” While similar motions on liberation networks and officers have been proposed by Broad Left members in previous years, its passage now represents a win for the left and a reflection of the changing values of Medical Students Conference. The policy will now go to ARM to allow for the establishment of liberation officers across branches of practice beyond MSC.

After a passionate speech by Alessia Waller, of Swansea Medical School, conference supported lobbying the UK Foundation Programme to extend special circumstances applications to students who are pregnant or whose partner is pregnant. Although a protected characteristic, the UKFPO currently excludes pregnancy from special circumstances, which can cause a significant conflict in work-life balance of newly qualified doctors. “It negatively impacts students, mostly graduate students, and their ability to plan families,” Alessia said, “I know of two students in the year above me who’ve been affected.”

Conference voted unanimously in favour of a motion tackling sexism and sexual harassment within the BMA. This comes after sexist remarks were made by a member of the BMA towards a GP speaking at a national conference. Ella Burchill, of Kings College London, proposed the motion, giving personal examples of the sexism she has faced as a woman in medicine. “This is an issue very close to my heart,” she said, “I hope in the future, we can all be proud to work in an NHS which values the work we do as doctors and scientists, regardless of gender.”

Christine Cadman, a Bristol student, won strong support for a motion advocating Widening Participation in medicine measures for care leavers. “Care leavers face challenges that other students may not face, from financial difficulties, the lack of support from home or educational unit, to not having accommodation during summer holidays. This motion will ensure that care leavers will not only get the support and advice required to apply to medicine, but also the chance to thrive whilst studying medicine by offering information on summer time accommodation, bursaries and scholarships and summer school programmes.”

BMA and Union Policy

The conference committed to lobbying the BMA internally to affiliate with the Trade Unions council. Ciaran Kennedy, who proposed the motion, said, “I proposed the motion after seeing how the TUC lobbied for the 2007 smoking ban. I believe that with solidarity from the BMA, the TUC can further improve the health of all workers.” Despite being an organisation set up to collectively bargain for doctors and improve the conditions their employment, the BMA resisted the trade union label until 1971. The BMA has, at times, organised alongside the unions of the TUC, but it is not currently an affiliated union.

Additionally, conference voted to support recruiting physicians associates (PAs) into the BMA. Broad Left students argued in favour, recognising that unions should represent those who are alike in need, not just in qualification. Working together, we can ensure we can successfully advocate for both groups and seek safe staffing. Brocha Goode of the University of Manchester, who proposed the motion, said, “We shouldn’t leave PAs to seek piecemeal representation; we should seek national recruitment, organisation and bargaining for PAs through the British Medical Association. What we need is to work together with PAs, organising to define their role, solve problems and strengthen our union.”

Healthcare and Society

Conference committed to lobbying to ensure training of medical students to provide healthcare for the homeless, as well as lobbying health boards to ensure higher standards of care for homeless patients are introduced. The policy aims to improve the care that this highly vulnerable group in society receives. David Clayton of Glasgow University, who proposed the motion, said, “The BMA needs to be at the forefront of tackling the public health emergency of homeless deaths and healthcare exclusion and I’m glad to see the BMA support the recommendations from the Faculty for Homeless and Inclusion Health in our motion.”

Additionally, conference supported a motion which targeted homelessness more directly, supporting recognition of homelessness as a crisis manufactured by the housing industry and lobbying for more social housing, as well as taxes on the creation of luxury homes. These measures seek to end the crisis caused by the housing market, which creates an artificial scarcity of housing in order to inflate the value of property investments at the cost of the health of the economically disadvantaged.

The conference voted to support free movement for all workers, inside and beyond the EU, extending well beyond previous policy which called for maintenance of free movement for healthcare workers after Brexit only. Giancarlo Bell, whilst advocating EU free movement, told conference that the EU border was responsible for the deaths of thousands in the Mediterranean, and we should respond by making a different political choice. The policy is a significant commitment to an internationalist principle of free movement and a humanitarian response to the crises across the world. Its passage at conference reflects the increasing support the ideas of the left are gaining.

All quotations were received after the conference and represent the opinions of the individuals quoted. Not all quotes are from Broad Left members.

BMA Ambassador Scheme

Opinion, Organising

Emma Runswick

BMA ambassadors receive:
− £30 GiftPay vouchers for every new member
− 25% off your annual membership (if you recruit 6 new members)
− a new ambassador welcome pack
If you would like to become a BMA ambassador click below, send the email and we’ll do the rest.

BMA email 10th April

I’ve been a rep for 6 years and now sit on BMA Council, one of two medical student members. I have a trade union background before that, and have been busily recruiting and organising for the BMA since I joined medical school.

When I first heard about the ambassador scheme, I found it distasteful. I don’t require an incentive to recruit to our union. I have an ideological commitment to trade unionism – we have to fight together to win together. I encourage others to join because I think it is in their interest to do so. The scheme was set up by the commercially named Marketing Department 🤮 without consultation with representatives.

However, there are positives to the ambassador scheme. I joined because it gave me easy access to all the materials like leaflets, pens and the BMA tablecloth that I had previously been unable to get access to. I had been nicking these from the BMA staff at some events, but always rapidly ran out.

It also gave us a bigger say in what went ON the leaflets – we got the marketing team to come to Medical Students’ Committee as part of the ‘membership challenge’ 🤢 and we made changes – to promote the work of the union for both individual members who need help and members as a collective.

I used the Amazon voucher they gave me (it used to be amazon, no longer because of tax dodging and bad employment practices) to buy my BMA medical school branch a tripod and other equipment for recording and webcasting our events.

I use the ambassador scheme enough that they know I am recruiting, but I don’t use the ‘official link’ that gives me a voucher unless we know collectively what we are going to spend it on. I may use it again for leafleting for medical students about the new junior doctor contract, as at the moment it’s unclear what funding there will be for specifically penultimate and final years who have a vote.

I have encouraged other medical student representatives to join the scheme for these reasons, and most of Medical Students’ Committee are on the scheme. I hope that in time, the ambassador scheme will die out and become a basic and essential part of the rep’s role.

Ideally, there would be an easier way for medical student reps and activists to get access to materials, and I think it’s likely that my use of the scheme is the exception rather than the rule, but I reckon I’ve recruited ~60 members alone, and many more at designated events, where BMA send staff to support recruitment. I have gained £0 financially.

BMA Expenses

Council Reports, News, Reports, reflections and accountability

This post was authored by Emma Runswick

After confidential information we heard at Council was leaked to the BMJ, some members of the Broad Left were asked to comment. Chris Smith [not included by editor error] and I provided the comment included in the article.

This leak, whilst not our choice, resolves to some degree the problem in telling you about our activities on Council. You can be assured that we have asked for increased transparency with members, and we have sought information where it was lacking. We have written to the Chief Officers and Board of Directors on multiple occasions. I have been arguing for repayment of spousal expenses, and we have asked for further investigation with the aim of uncovering and tackling any other problems.

I have submitted a motion to the Annual Representative Meeting:

“This meeting agrees that senior BMA representatives should not claim expenses beyond what policy allows, including to pay for spousal or partner expenses, and instructs BMA Council and the Board of Directors to:
i) recover any such expenditure and any tax burden borne by the BMA where appropriate
ii) ensure all expenses policies exclude payments for spousal or partner expenses”

We have a track record of supporting good use of members’ money and transparency with it. Last year, I proposed a motion at the Annual Representative Meeting as detailed below. In the Treasurer’s response, he implied that I had been the only person to request to scrutinise expenses for 2 years. More recently, I have requested to view expenses and honoraria under the current system and have been unable to due to staff sickness. In my opinion the situation would be greatly improved by more, and not less, openness with members and representatives at all levels.

“ARM 2018 Motion by NORTH WEST REGIONAL COUNCIL: That this meeting instructs that:-
i) votes of committee and council members should be recorded and published for members to enable informed voting in elections;
ii) council members who wish to publish their own voting records and arguments should be free to do so;
iii) there should be a dedicated contact point for those wishing to scrutinise expenses and honoraria.”

At the 2017 ARM in Bournemouth, I supported parts i) and ii) of the composite motion below, which was proposed by Dino Motti. I argued that the expenses should be put in context (eg number of journeys and distance) for members. Dino faced a significant backlash for proposing the motion, including abuse from one of the previous senior officers.

We have ongoing concerns about governance but little information and evidence. We have submitted other motions to ARM on these issues and will continue to fight your corner at Council.

BMA Council Report March 2019

Council Reports, Reports, reflections and accountability

Four Broad Left members attended Council on Wednesday 13th March. The agenda was dominated by discussion of our legal action on pensions and a confidential item about internal governance matters. If you have any specific questions, or issues we can help you with, please contact us.

The union has continued work on Brexit and Safe Staffing which you can engage with.

Pensions

We are supportive of the BMA action on pensions, in which we are supporting members bringing age discrimination claims in an employment tribunal in respect to the discriminatory impact of the 2015 NHS Pension Scheme. Judges and firefighters have taken successful legal action over similar schemes, and the government is seeking to appeal. Our case is likely to be ‘stayed’ (delayed) pending the result of that appeal, and it is possible that if the judges and firefighters win, the whole public sector will feel the benefit without the need for further legal action.

The result would be that all doctors would benefit from 5 years accruements from the previous pension scheme, and that a new non-discriminatory pensions agreement would have to be made. This could result in a further attack on pensions by the government and we are arguing that the union and Trade Disputes Preparedness Group should be prepared for that. The letter has been very well received by members, and could contribute towards an appetite for action over pensions in future.

We also discussed the lobbying that is being undertaken to redress the pension discrimination suffered by Less Than Full Time doctors, who suffer from current annualization arrangements. The Broad Left are supportive of this also.

Some members of Council expressed concern that legal action against the government might harm the relationships built during contract negotiations. The Broad Left believes that action by the trade union on pensions, and an engaged and supportive membership, strengthens the hand of negotiators.

Confidential Item

A large proportion of the meeting was taken in private and concerned governance issues. We advocated for members’ interests as best we could. We are not delighted with the outcome, but we are confident that the issues will be resolved going forward. We have asked the Board of Directors for further information where necessary, to ensure accountability where possible, and for further investigation with the aim of uncovering and tackling any other problems. The issues seem to be known amongst some of the national branch of practice activists without us telling them. We are sorry we cannot tell you more at this stage. We will consider what we can do to resolve this.

Member Support Services Review

The BMA is undertaking a wholesale review of our member support from First Point of Contact to the legal teams. We are supportive of the review – although our BMA Employment Advisers and other staff are brilliant, there is a discrepancy between the feedback we get from members and the feedback the BMA collects internally – and look forward to seeing the results. If you have received the survey, please fill it in!

International Medical Organisations

We have been asking questions about the cost, ethics and risks of our continued membership of the World and European Medical Associations. These have now been largely answered, and oversight of who attends which international meetings and the value of each has been tightened. We have supported continued membership of the World Medical Association (WMA) on an interim basis for 1 year, whilst we push for reform. The WMA is reportedly keen for us to stay. We have offered to host the WMA General Assembly in 2021 at large cost to the association, and although we think this was a poor decision, the legal, financial and reputational costs of withdrawing are too great. We have instead supported measures to make the event more relevant to members, with fringe events taking advantage of the many international delegates from doctors’ trade unions and professional associations around the world.

. These have now been largely answered, and oversight of who attends which international meetings and the value of each has been tightened. We have supported continued membership of the World Medical Association (WMA) on an interim basis for 1 year, whilst we push for reform. The WMA is reportedly keen for us to stay. We have offered to host the WMA General Assembly in 2021 at large cost to the association, and although we think this was a poor decision, the legal, financial and reputational costs of withdrawing are too great. We have instead supported measures to make the event more relevant to members, with fringe events taking advantage of the many international delegates from doctors’ trade unions and professional associations around the world.

Regional Elections

We argued for a change to the timetable of the Regional Council elections, which in the current form would practically exclude thousands of final year medical students and rotating junior doctors from standing, being elected, voting and engaging. The argument was won and JDC is arranging for a more appropriate timetable.

The issue was raised to us by Dr Becky Acres, a member of Organisation Committee and a junior doctor working in East Midlands. If you have issues we can help with please get in touch. We will raise them and fight for you.

UK Medical Licensing Assessment

News, Uncategorized

On Tuesday, Broad Left student activists from all over the country attended the General Medical Council-Medical Schools Council meeting about the UK Medical Licensing Assessment (UKMLA), in order to hear an update on and ask questions about the important issues and concerns we have about the upcoming changes.

The day was aiming to demystify the exam and allow students a chance to speak. There was some more transparency around the assessment, but unfortunately, we are still a long way from total understanding and are hopeful for more open, transparent and informative communication. The mood of the room became progressively more anxious, confused and dissatisfied with the answers that the GMC were giving. As the Q&A session continued, students in the audience appeared increasingly aware that the plans in their current format are full of inconsistencies- the aim of certifying a minimum common standard is moot if exam conditions, resit opportunities and their integration into local finals are all carried out differently. The GMC seems happy to implement the exam but keen to wash its hands of the logistics of implementation and the impact it may have on medical students’ wellbeing.

The BMA has been feeding back to the GMC for the past few years on the development of the exam from a position of opposition; our union is against the imposition of the UKMLA. We believe the exam is unnecessary, adds extra burden to our members and have concerns over the resit policy, the impact on equality groups, and the financial disadvantage the exam and preparation for it will put on some students, particularly those who have to travel.

Despite these concerns, we have already won significant concessions: the exam will not be paid for by medical students, we made the GMC scrap their plans to centralise the exam regionally and we believe that we have recently secured the guarantee of free revision materials and practice software.

We in the BMA have the option of taking action to boycott or disrupt implementation if our concerns aren’t addressed and our members agree. This position was advocated for and won at Medical Student Conference by many students including the Broad Left. In the first instance, however, we have decided to engage with the GMC and Medical Schools Council initially to ensure the voices of medical students are considered and the exam’s negative impacts are as small as possible.

The Student Left and our colleagues in the BMA Medical Student Committee will continue to push for the best possible outcome for our members, and we will not shy away from action if necessary to achieve that.

 

UKMLA Main Points:

  • The UKMLA will be a requirement for students graduating from 2023 onwards
  • The UKMLA will come in two parts:
    1. An Applied Knowledge Test (AKT)
    2. Clinical and Professional Skills Assessment
  • Dates:
    • 2021 – Pilot Exam
    • 2022 – First sitting of the examination (unsure if this will count)
    • 2023 – Full UKMLA implementation
  • AKT:
    • Will only have SBA’s (short answer questions) initially
    • 150-200 questions long
    • Between 1-2 Papers
    • Will be PASS/FAIL
    • Will be 4 dates to sit this exam per year (will be up to the medical school)
  • Clinical and Professional Skills Assessment:
    • This will involve adjustments to clinical exams that are already running

Uncertainties:

  • Resit policy will be determined via the university
  • GMC would discourage ranking – unsure how universities would use the data
  • Will be alongside normal medical finals (for now)
  • Reasonable adjustments
  • Appeals Process

See the BMA blog on the UKMLA here

World Medical Association Questions

Council Reports, Reports, reflections and accountability

In light of the Canadian Medical Association’s (CMA) withdrawal from the World Medical Association (WMA), we have been asking questions about the BMA’s involvement. Our questions are detailed below, and we are now awaiting a response in the form of a report to Council. We will update the site as we have answers, and continue to press the issues we have concerns about.

____________________________________________________________

Background

The World Medical Association was established in 1947 in the wake of war crimes by doctors in Hitler’s Germany, two years after the BMA proposed the idea. It hosts biannual international meetings, lobbies significantly at UN bodies, and has a controversial history as a major contributor to issues of medical ethics.

We have a large input into the WMA, for example the BMA policy on the TTIP trade deal became the policy of the WMA, BMA work on ethical procurement is now WMA policy.

The current WMA president, Dr. Leonid Eidelman, clearly plagiarised his inaugural speech from a prior Canadian president’s speech and other sources, resulting in the CMA resignation from the WMA. The explanation, which blames speech writers, and apology of Eidelman, did not satisfy the CMA, who expected further action, perhaps including resignations and policy change. “Eidelman apologized to the WMA council and assembly, saying that he had originally written the speech in Hebrew and was unaware of any plagiarism during the translation into English. But Damji said that explanation was not convincing and did not include an apology to the CMA or Simpson, nor an acknowledgement that as president he is the arbiter of ethics for the WMA.” 

_____________________________________________________________

Representatives:

The BMA is currently represented on the WMA Council by Mark Porter, who hasn’t been a Chief Officer for well over a year, and Andrew Dearden, BMA Treasurer and WMA Treasurer, who is shortly resigning his BMA post. It appears that our representatives to international medical associations, of which the WMA is just one, report to our international committee. However, the process for appointment and accountability of the representatives is unclear to us.

We are told that BMA sends Chief Officers to WMA. The 2017 WMA Council guide states that members of council are chosen by the National Medical Association (NMA) elected to occupy a particular seat.

“Members of the Council are individuals chosen by the National Medical Association (NMA) elected to occupy a particular seat. The NMA may choose to change or substitute its individual representative at its own discretion, informing the Secretary General as soon as it wishes to make a change. It is generally expected that the Council member will represent the views of his or her NMA or the region they have been elected from rather than his or her personal views, however this is a matter to be decided between the NMA and its chosen representative”

We believe that representatives do not have to be Chief Officers, but that if BMA appointments are on that basis explanation is required for deviation from policy, and accountability must be ensured. Mark Porter’s term will end in April 2019, and we should consider our processes before this date.

What was our position on the CMA resignation?

Cost to BMA:

What is the WMA membership fee paid by the BMA? Are there any other costs as a result of our membership?

What are the expenses incurred by the BMA for BMA representatives to go to WMA Council, events and conferences? Where members of the BMA hold office in the WMA (the Council or an officer role), which organisation meets the costs?

We are told that the WMA conferences have registration fees which cover travel between locations, some meals and the costs of the conference.  Representatives from BMA who are WMA Council members have travel and accommodation covered by the WMA, but the BMA pays under our usual policies for other representatives and BMA staff.

Value:

The BMA has significant influence on the WMA which produces international policy. However, it is important that we, as reps accountable to the membership, ensure this is worth the cost. From some information, provided below, you might get the impression that the WMA is a corrupt and ineffective organisation. We are very concerned our members money is being used in this way & would like reassurances.

The reputation & ethical principles of the WMA are important to consider when considering the value of our relationship. The plagiarism incident and the lack of action in the aftermath is one issue. However, it is not the first. In 2017 the BMA requested a suspension the 2016-2018 president of the WMA pending a resolution of corruption charges which were not known to Council. This was rejected & Dr Desai remained in post. His case was never heard as the government denied ‘sanction to proceed’…On this we agree with Dr David Berger: “The WMA council’s rejection of the BMA’s proposal to suspend Desai pending an investigation into his appointment shows that the organisation is not serious about ensuring the probity of its own senior officers. The WMA claims to set the global standard in medical ethics, but it is ignoring the justifiable concerns of those who believe that it is wrong to appoint a president who is disbarred from practising medicine and who has criminal charges against him for corruption. Any fair minded person can see that this casts the credibility of the WMA as the world’s peak medical body into serious doubt.”

Other issues are more longstanding, such as the concerns highlighted in this 1994 BMJ article. It highlights membership & votes effectively being up for sale to the highest bidder, a wasteful ‘ceremonial circus’ of meetings and complete inability to communicate with the average doctor.

The WMA lists it’s important corporate partners as Bayer AG, Eli Lilly and Company, GlaxoSmithKline and Pfizer, Inc. These companies appear to sponsor projects but it unclear what they get in return. 

“Advocacy for physicians’ and patients’ rights” is listed as a service of the WMA. However, we believe the average UK doctor is unaware the WMA exists. What is the WMA doing for the rights of doctors? Has this been hindered by “the registration of the WMA in New York, where it is subject to antitrust laws”? This article states it has raised problems in formulating some declarations, notably one on medical manpower.

We note with interest from the same article that the BMA has left the WMA on more than one occasion. Notably, in 1984 it “supported a breakaway group made up of the medical associations of Denmark, Finland, Iceland, Ireland, the Netherlands, New Zealand, Norway, and Sweden, joined later by Canada and Jamaica. The group met annually and flirted with the idea of establishing a rival international body before opting to campaign for four key changes: firstly, that member associations of the WMA should be truly representative of the medical profession in their country; secondly, that member associations should be politically independent of their own government: thirdly, that the WMA should adopt a more democratic voting system; and, fourthly, that any barrier to the association adopting and publishing its statements should be removed.”

We would like to see that these have been met, and that no further concerns have been raised.

 

Council Discussion on Pay Strategy

Reports, reflections and accountability, Uncategorized

The BMA member survey (criticised in a previous post) came back with predictable results – the profession in England is angry at continued pay cuts. Perhaps due to the lack of campaigning on the long-term impacts of pay cuts, our original pay demand (RPI+2%) or the context of the DDRB recommendation; or perhaps because it was better than the government attempt, members considered the DDRB recommendation to be a more acceptable option.

Whilst we have used the survey results to express our anger, we are now concerned that it will now be used to justify asking for only backdating of the government offer, or that, even worse, the BMA will use the delay to justify doing nothing.

The responses of the Branch of Practice committees are very important, along with the responses of the devolved nations, who have had different offers, or lack an offer yet. However, these have largely focused on the question of the DDRB itself, and whether to engage with the process of ‘independent’ pay review in the future.

At Council today, we will argue for an indicative ballot of our members, preceded and accompanied by a strong communication campaign to engage and inform members on pay.