News

Rest & Recuperation – Gains During Coronavirus Crisis

News, Organising

Author: Giancarlo Bell

National Change in Crisis

The coronavirus crisis has exposed the flimsy foundations upon which many seemingly immutable truths were built. Millions who begrudged the chore of the commute and the tyranny of the office find themselves writing emails and filling in spreadsheets from their living rooms. Accommodations long deemed impossible to find for disabled people became commonplace.  In cities across the UK, thousands of homeless people were housed overnight, albeit in temporary accommodation. After a generation of “necessary” austerity, the Conservative government has injected billions of pounds into the economy and launched the unprecedented furlough scheme, alongside several more targeted economic interventions. In light of these nationwide upheavals, as we recover from the strange and emotional experience of working through the crisis, it is useful for doctors to look at what has changed in our own workplaces, and to consider which innovations we should keep.

Glasgow Royal Infirmary

The Glasgow Royal Infirmary campus is a strange collision of imposing Victorian façades and concrete modernist monstrosities, spattered around a labyrinthine link corridor. Despite the architectural delights of the site, when I started FY1 there in August, I was bitterly disappointed by many practical aspects of the physical work environment. The hospital canteen closed at 2pm and didn’t open at all on Sundays. After 2 o’clock, there was nowhere to get hot food, or even a ready meal. The tiny WHSmith, stocked with a limited selection of expensive sandwiches, would also close in the early evening. When an unfortunate junior left their prepped meal in the fridge at home or didn’t find the time to throw food together before an on-call shift, as is often the case, the only options were vending machine crisps. In the general surgery department, where, due to the crisis, I have been working for almost a full year, the FY1 workspaces were less than ideal. A handful of computers and chairs were squeezed into cramped alcoves on the wards. In terms of rest facilities, while I have heard tell of a doctors’ mess, this is located on the opposite side of the campus, and not a practical place for a surgical FY to retreat with a pager. My medical colleagues tell me that I’m not missing anything, that the mess is a small room with a couch. In place of a mess, in surgery we only had a few small break rooms shared between nurses, healthcare assistants, catering staff, and doctors. These spaces, inevitably, became crammed at peak times.

The Victorian Façade of Glasgow Royal Infirmary

While I have heard of and been placed on sites with superior facilities, having recently engaged in a Scottish Junior Doctors Committee (SJDC) discussion about improving break facilities across Scotland, I also know that our situation was far from extraordinary.

Looking After Staff

As rotas changed and new staff appeared on the wards, it became clear that the cramped nooks and crannies of old were not pandemic-ready; social distancing was impossible. It did not take long for management and the facilities department to take note and act. The surgical secretaries migrated from the spacious offices adjacent to the wards to the relative safety of the University’s academic building. With the blessing of management, their vacant workspaces were seized by the FY1s. These were our first offices: rooms with good IT equipment and plenty of space to distance. Here we could discuss complex cases and write discharge letters in a position both far enough from the ward to instil an atmosphere of calm but close enough for nursing staff to reach us in seconds when required.

Other changes swept across the hospital. The canteen started to open for a night-time slot. Fish and chips at midnight! Even better, local businesses and Celtic Football Club began to donate food – at the peak of the pandemic we were provided with a free high-quality hot dinner every night.

Rest & Recuperation

The centrepiece of the innovations, however, was the “R&R Area”. Break areas bearing this title were implemented across NHS Greater Glasgow & Clyde overnight. In the Royal Infirmary, this took the shape of a spacious area in the academic building manned with redeployed NHS staff and volunteer flight attendants and pilots from “Project Wingman”. It is furnished with soft seats and stocked with tea, coffee, and snacks. The space allows for social distancing, even during the mealtime rushes. In the R&R, we are not segregated by profession; everyone from porters to Advanced Nurse Practitioners has a space to relax and sip coffee alongside consultants, cleaners, and HCAs. At their peak, NHS R&R areas also provided 24 Hour, in-person psychological support and featured food and goodies donated by the public to boost staff morale. At GRI, for a time, there was even a free gym in a repurposed lecture theatre, with exercise equipment and fitness classes.

Project Wingman at Glasgow Royal Infirmary

After several weeks on my new Covid rota, I was sitting in the R&R with two colleagues during a night shift. We got to speaking about how, despite the  tone of discourse suggesting that we were making a sacrifice for the country, many things at work were better than they had ever been. We were adequately fed and well-rested. We felt looked-after. In my time as a BMA Hospital Representative (on the Local Negotiating Committee) , I had never dreamed that we could demand such comprehensive services, especially with regards to the new mental health support. We noticed that night that they had already started stripping equipment from the new staff gym. Sensing that further rollbacks were imminent, I started to feel strongly that we should fight to keep as many of our new facilities as possible.

Trade Unions can Defend Improvements

That week, I sent around emails via BMA listserver (a group email list) and put out messages on various WhatsApp groups. Employment Advisors and more senior colleagues in the BMA agreed with the sentiment of my demands . Everyone felt from their own workplaces that support services, staff facilities, and catering were all drastically improved. I was assured that this would be taken to the next Local Negotiating Committee meeting to raise with management. However, several colleagues were sceptical about the feasibility of the demands; in the Royal Infirmary, for instance, the University would need its academic space back, the restaurants and football club would eventually stop donating food, and the airline staff would have to return to the skies. I was aware of these points, but I felt that, since the pandemic had demonstrated that these amenities are possible, we should take a hard line – we should view them as essential.

I also saw that this could be a campaign which would help us to recruit and organise doctors into the BMA. If we worked with other unions, we could increase union representation for all workers in the hospital. 

Unite with Other Workers

I have been a member of Unite for a year or so now. Until recently, I had never engaged with them directly on workplace issues. However, before Covid I had been in talks with the secretary of my local Unite branch, a consultant psychiatrist and union organiser, about establishing a Doctors in Unite Glasgow division. Furthermore, in the Winter I had been elected as health rep to the Scotland Unite Youth Committee. Having seen that Unite had recently won several victories for facilities and catering staff in my hospital, I thought it could be worth tentatively reaching out.

I sent an email detailing my thoughts. Two days later, I walked into the R&R Area in the middle of the night for a break.  On the walls and scattered across every table were dozens of Unite posters demanding the retention of our new services and a post-Covid 20% discount for staff at onsite catering facilities, along with leaflets seeking to recruit new members. I texted the phone numbers on the poster. Shortly after I got home that morning, I received a phone call – it was an enthusiastic Unite organiser. He was delighted that I had reached out and thanked me for raising the issue. The branch representative had already started working on such a campaign, and my email served as impetus to put a poster together and kick things into action. The organiser strongly encouraged me to get involved with the campaign and with the grassroots work going on in the branch.

I was taken aback with the warmth and passion of this reception. A few days later, I received another phone call, this time from the branch representative, who works in one of the hospital labs. As well as thanking me for reaching out and encouraging further participation, he informed me that most of the airline staff looking after the R&R Area were Unite members. In solidarity, they had assisted in the distribution of the campaign and recruitment fliers. The rep proceeded to give me a link to a survey on staff food and rest facilities, which I promptly shared on all my FY1 networks.

The BMA had never considered such an approach.

The Campaign

The campaign is ongoing. NHS Greater Glasgow & Clyde, my local health board, has promised that the spirit of the R&R Areas will continue after the pandemic. This is not a concrete win – many of our gains will disappear as students, academics and administration staff return to the hospital site. However, having shown that at times of crisis, Glasgow can do better for health workers, it is important that we retain, or have new, facilities for rest and recuperation. We will hold this commitment in hand when negotiating in the months ahead.

This experience has taught me that, as workers, we can achieve more together than we can as individuals. The new facilities at my hospital are used by everyone, not just by doctors, and we should defend them together. We all have a stake in our workplaces and our communities; doctors could learn a lot by engaging with the wider trade union movement and striving for better conditions with a united front.

The case of the R&R Areas is one example of how workers have come together to weather the Covid-19 storm. In hospitals and other clinical settings across the UK, as well as in shops and factories, on doorsteps, and on the streets, the same thing is happening every day. It has become abundantly clear that workers on the frontline, including local managers, know how to make the NHS work best for our patients and colleagues. We made rapid and excellent changes to our workplaces when free to do so, whilst national leaders and government dithered. Together, we should run the NHS all the time.

Pay When Rotation Has Been Cancelled

News, Organising, Pay

Author: Emma Runswick

For many doctors, the cancellation of April rotations did not just mean loss of training, it also represented significant loss of expected pay. Those doing jobs without out-of-hours work in March would lose thousands by not moving into high-intensity jobs, through no fault of their own.

Colleagues who made financial decisions on the basis of expected pay, or reliant on this for childcare, stood to be particularly badly affected.

Several Broad Left supporters who are Local Negotiating Committee representatives* have won pay increases for trainees at multiple hospitals and we are involved in helping other reps secure this.

In these trusts, doctors are being paid the highest salary from:

  • The rota they are working
  • The rota they were expected to be working from April and had a work schedule for
  • The emergency Covid rota

For some trainees, this is worth £3700. Many more have gained over £2000.

We have argued for this on the basis of Schedule 2 of our contract.

71. Where changes to the work schedule are required by the employer and total pay would be decreased as a result, the doctor’s total pay will be protected and so remain unchanged until the end of the particular placement covered by that work schedule. This protection will not extend to any subsequent placement, including a placement where the doctor returns at a later date to the same post.

2016 Junior Doctor Contact in England, Version 8

Or 21h in the 2002 Contract, which says similar.

If you had a work schedule for April-August rotation before they announced rotation was cancelled, then you have experienced “changes to the work schedule” “required by the employer” “and total pay would be decreased as a result”. As such, you are entitled to the pay “until the end of the particular placement covered by that work schedule” (April-August).

If some trainees in your trust had a work schedule and some did not – i.e. a department didn’t get their work schedule out in line with the guidelines – then you have an argument that the department’s failure to send out work schedules should not disadvantage those trainees.

We gained support by emphasising our contractual rights, sharing the stories of doctors who were badly affected, building alliances with supportive members of management, and later by using examples of other trusts who had agreed this.

If you would like support to negotiate with your workplace or want to know more about becoming an effective BMA representative, contact us!

*Local Negotiating Committees (LNCs) are your local BMA representation. We encourage all Broad Left supporters who are hospital doctors to become LNC reps.

Abortion in Northern Ireland

News, Opinion, Uncategorized

Marie-Claire Bradley, a Bristol-based medical student from Northern Ireland, discusses the ongoing issue of abortion in response to debate heard at the BMA’s Annual Representative Meeting 2019, subsequent court cases and imminent legislative change.

In June this year, I listened to discussion on the above motion at BMA ARM 2019 in Belfast for the pictured motion which clarifies and sets out a framework for the implementation of BMA’s 2016 policy that abortion should be treated in line with other forms of healthcare and decriminalized across UK and Northern Ireland and policy from 1984, 1985 and 2003 which specifically supports the reform of law in Northern Ireland. The air hung thick, humidity emanating from hot palms and from under stiff collared necks.

Since then, a number of momentous legal shifts towards the fulfilment of this motion have been achieved. In July, a majority of MPs backed the bill brought by MP for Walthamstow, Stella Creasy to repeal Sections 58 and 59 of the Offences Against the Person Act 1861 – which make abortion a criminal offence in Northern Ireland. As a result, the law governing abortion in Northern Ireland, the Offences Against the Person Act 186, is due to change three days from the time of writing (on 21st October), if the devolved assembly does not re-convene before then. Interim rules currently govern the care of those seeking abortions in the meantime – these rules allow doctors to finally at least allude to the possibility of treatment in England without fear of legal reprisal. (1)

On 3rd October 2019, Sarah Ewart, (who was denied abortion despite scans definitively showing that the foetus was in viable) brought her case before the High Court in Belfast. The court considered the archaic wording of the 1861 Act – a near-blanket ban on abortion, except in cases where continuing the pregnancy would cause ‘physical and mental wreak’, as highlighted by Dr Kerr- speaker for the motion and member of Medical Students for Choice- at ARM. The court ruled that such a ban breaches the UK’s human rights commitments.

Abortion will remain a criminal offence in England, Wales and Northern Ireland, although, Northern Ireland is the only place where women and pregnant people face lifetime imprisonment for terminating a pregnancy, even in cases of rape, incest and foetal abnormality, and doctors and medical professionals also face life imprisonment for assisting. The potential for such a win for human rights in Northern Ireland is, joyously, a result of local political stalemate and governmental disregard for the region.

This departure from current archaic rules to better represent the will and the needs of Northern Irish people is particularly welcome in a time of such paralysing political uncertainty – The writer notes that the Act came into force 20 years before it was legally possible for women to own property. (2) At ARM in Belfast, Dr Kerr explained the influence that the criminalisation of abortion has had upon medical education – while the procedure affects 1 in 3 women and pregnant people, education on the subject across the UK is poor and medical students in Northern Ireland receive “little to no” training in this regard. Dr Kerr commented that the unavailability of the procedure leads to “forced pregnancy” which is “an act of violence and assault” and indeed, as Dr John Chisholm, Ethics Committee Chair, later mentioned, the UN Convention on the Elimination of Discrimination Against Women Committee condemned the law on abortion in Northern Ireland as a “grave violation of rights under the Convention”. Dr Chisholm, also echoed the words of the proposer of the motion, Dr Anthony Lempert and Dr Noel Sharkey, speaking for the motion, in stipulating, “human rights are not a devolved issue”.

There was a common preoccupation amongst speakers against the motion who feared that any such legislative overreach may impact upon the peace in Northern Ireland:-

Speaking against, Dr Dominic Whitehouse opened with the phrase, “peace is precious and fragile” and subsequently brought to the attention of ARM; the lack of an active assembly at Stormont for two years, the murder of “female journalist reporting on riots in Creggan area of Derry” and “letter bombs being delivered by dissident republicans to London airports and Waterloo station” as evidence that peace in Northern Ireland is once again dwindling and implying that the enactment of the legislative changes laid out in the motion would amount to a return to “colonial rule” and thereby threaten the peace.

The unnamed “female journalist” to whom Dr Whitehouse refers is Lyra McKee, her tragic and untimely death highlighted the pertinence of her investigative work unpicking the stories of young people left behind by the Peace Process. Lyra McKee actively campaigned for LGBTQ+ rights, was pro-choice and in favour of the decriminalisation of abortion.

Dr Rachael Pickering, also speaking against the motion, emphasised that being “from Shropshire” meant that the legislative change suggested was “imperialist”. Dr Pickering told ARM that Northern Ireland is “politically conservative”. In fact, the writer notes that the fifth Northern Ireland Peace Monitoring Report, funded by the Joseph Rowntree Trust, lists the necessity of “reform of abortion law and equal marriage” alongside the potential impact of Brexit as issues that need to be solved in order to further secure peace in Northern Ireland, citing evidence from the Northern Ireland Life and Times survey and opinion polls which show that “the majority of the population in NI support liberalizing the law on these issues”. The odd notion that the backdrop of political instability in Northern Ireland which was originally caused by Direct Rule should be an excuse for further denial of human rights in Northern Ireland is somewhat absurd.

Dr Pickering, an English Representative, was correct in saying that English Representatives probably shouldn’t dictate the consensus of Northern Irish people. The fifth Northern Ireland Peace Monitoring Report notes that the views of socially conservative political parties in Northern Ireland “are at odds with” the view of Northern Irish people. (3) Indeed, as Dr Lempert notes, 59% of people in Northern Ireland have voted in favour of decriminalisation. The consensus of Northern Irish people is for the motion.

The voice of this much needed Northern Irish perspective, came when Dr Noel Sharkey spoke in favour for the motion stressing the need for legislative change to ensure that Northern Irish people have the same human rights as people in the rest of the UK, emphatically stating that, “As a gay man I cannot marry my partner.” He explained that the lack of devolved government was not a reason to stall reform of legislation as the underlying health issues are “becoming more toxic and dangerous” as a result. Closing the debate, he powerfully stated that, the “Criminal framework is not preventative, it simply exports the problem […] it is time to trust women. Human rights is not a devolved issue. Instead of giving women in Northern Ireland air-fares, it is time to give them healthcare.”

Threatening uncertainty surrounding the border in Ireland casts a heavy shadow over economic well-being and the maintenance of the hard-won peace in the region and the right to choose hangs in the balance until Monday when Secretary of State, Julian Smith, will be forced to legalise abortion and same-sex marriage before 13 January 2020. Smith’s video tweet on 14th October urged the devolved executive to sit and discuss the law on abortion before the 21st October deadline immediately followed sit down talks between the DUP and Cabinet. Accusations ensued from MP Stella Creasy that the right to abortion is being used as a “bargaining chip” by the Government in the scramble to bend the DUP over to accept their Brexit deal. Indeed, the next day a subsequent statement from the DUP called for Stormont to sit once again to “oppose the extreme liberalisation” of the law.

Climate Emergency ARM

Conferences, News, Reports, reflections and accountability

Author: Marina Politis

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

Motion 80 ARM 2019. 80a-e are for reference and were not debated.

Members of the Broad Left were in favour of this motion. We feel that it is very important for our union and the labour movement to to resist climate injustice and to take measures to halt our current climate crisis.

Between 2030 and 2050, there will be an additional 250,000 deaths a year due to malnutrition, malaria, diarrhoea and heat stress which can be attributed to climate change.[i] Since the 1960s, the annual number of natural disasters have tripled, resulting in over 60,000 deaths annually, the majority in developing countries. i Household and ambient air pollution cause a total of seven million deaths annually. i

These figures will only continue to rise. We cannot continue to sit back and be complacent when faced with a public health crisis of this magnitude. There are no innocent bystanders to ecocide.

Climate change is not the forlorn, emaciated polar bear who features as a cover star for the latest national geographic, but something that will affect all of us. It will disproportionately affect the most vulnerable members of society: children; the elderly; people with mental illness or physical disabilities; those who are less economically affluent and women. It will affect workers all over the world. Climate injustice is not just about equality for our planet, but concerns equality of all groups of people, and we must stop being silent.

The NHS is the UK’s largest public greenhouse gas emitter, which at four percent of emissions is equivalent to the UK airline industry.[ii] [iii] As our healthcare profession strives to save lives and improve quality of life, we need to make a significant contribution. Over a fifth of the NHS’ carbon footprint is contributed by pharmaceuticals, a significant proportion by Metered Dose Inhalers[iv]. Anaesthetic gases using CFCs could be switched for alternatives. The NHS has significant purchasing power which would enable it to influence change in the pharmaceutical industry and in many other sectors. Both products and practice needs to change.

In BMA lobbying and campaigning, we should consider how we can make a positive difference. The trust the public has in healthcare professionals, and the synergy between measures for public health and measures against climate change allows us to be leaders in this movement. Active travel, a reduced working week and high quality insulated housing should be on the priority list. We can also assist whilst seeking improved working conditions – could our work or university placements be organised better, to allow public or active transport? Could food provided for medical staff at night be locally sourced?

In our union, BMA expenses policies should be capped in terms of carbon emissions, rather than solely cost. The times of domestic flights to save a few hours on train journeys must end; and events such as the ARM too must reflect on the resources they use, from travel and food waste to disposable leaflets and power used for lighting.

Measures taken by the BMA, the NHS and the government must go beyond that what is currently being promised, and we can no longer say yes to tokenistic ‘tick-box’ policies and solutions. We need radical social reform instead of mere paper straws and graphic tees rebranded with “save the planet” slogans. Fundamentally, reorganisation of society is needed, with just transition for workers in the polluting industries. We must work with other trade unions to achieve this.

If change is not making us uncomfortable or challenging the way we currently go about our day-to-day lives, then we are simply not doing enough.

It is brilliant that this motion was heard, but we cannot let this close this pressing issue, but instead use it as a springboard to continue to demand more.

[i] https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health

[ii] https://www.kingsfund.org.uk/reports/thenhsif/what-if-carbon-neutral-nhs/

[iii] https://sustainablehealthcare.org.uk/blog/we-work-healthcare-%E2%80%93-course-we-care-about-carbon

[iv] https://www.kingsfund.org.uk/projects/time-think-differently/trends-sustainable-services

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.

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 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.

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

Medical Student Rep Training

News, Organising

This year, the BMA Medical Students’ Committee got a new style of training for the first time. Replacing the long lectures about the internal organisation of the BMA and the library were two sections devoted to trade union work.

First, we enabled new representatives to plan a little of their year: thinking about working as a team with their rep colleagues nationally and locally; planning events; meeting the staff who support them. Beth McMahon, Keele representative, talked about how to build a community and share information with your members and with the committee. MSC reps are representing and accountable to the members who elected them. Emma Runswick, BMA Council member, gave some training on recruitment, emphasising that high membership and density was the source of our trade union power, and that recruitment is not a one-step process, nor an advertising conversation.

We then ran a session called ‘problem solving’, a member casework task based on the representation experiences of Emma Runswick whilst a BMA activist. We covered exam failure, welfare and professionalism issues, and group campaigning.

Both sessions were well received and mark a significant departure from the service provision model of representation the BMA is committed to elsewhere in the organisation.

The changes were the result of heavy pushing from the student left working with BMA staff, and the contributions of many reps to the training day working group. We hope the changes will continue and spread into other branches of practice.

Pay and BMA Surveys

News, Pay, Terms and Conditions
The BMA does not have the best track record with surveys, or their response to them. We have been accused in the past of subjecting our members to death-by-survey, and of hiding results, or ignoring them where they are not convenient. It is difficult to know what is true without being on the inside.

Now, however, we have great need for a survey. At the Annual Representative Meeting, the BMA was instructed to ‘identify actions to reflect the feeling of the profession’ on pay.

When the government made the pay ‘award’ last week, the need to survey our members and their willingness to take action became even more apparent.

In order to do this well, we need to explain the effects of prolonged pay restraint and the current offer, then suggest actions and ask if members would be willing to take that action.

We also need to show some leadership – by educating our members, who have had a slow-acting pay cut of around 20% over recent years. To add insult to injury, the latest pay cut offer is less than half of its apparent value. All doctors will lose out due to inflation, and the lack of backdating makes us suffer more. This year’s NHS staff survey has laid bare the realities of working life for doctors in the NHS, as detailed in the latest report of the Review Body of Doctors and Dentists Remuneration (DDRB):
• 80% of medical staff report regularly working unpaid extra hours
• 60% of doctors don’t feel they have enough time to do their job properly
• 30% of medics report their work is making them sick

We should say that we were disappointed by the DDRB recommended rises of 2% to doctors’ pay, which was wholly insufficient to address pay erosion across all doctor groups. Our confidence in the DDRB’s continued independence and utility has been shattered. We are further dismayed that the government has – in bad faith – gone further and halved the DDRBs miserable recommendation. The situation is untenable. We need to officially assess what our members are willing to do about it.

The survey sent via email to members this evening to has failed to do that. Only asking questions that are already asked via the NHS Staff Survey and we already know the answers to. It is embarrassing that the BMA feels the need to ask members if they are angry. As this survey was not run past elected Council representatives before it was sent, we have been left out of the strategic planning of the BMA’s response to another real terms pay cut.

 

We are demanding better, perhaps with a further survey, but definitely with a clear call for genuine action in response to the DDRB and Government failings.

Here are the kind of questions we would like to be asking you now:

 Would you:

  • write to your MP asking them to support the DDRB recommendation?

  • want the BMA to disengage from the DDRB and negotiate directly with government?

  • take action short of a strike – working to contract, refusing overtime and refusing to fill rota gaps? For how long?

  • take action short of a strike – refusing to collaborate with coding practices to damage the financial flow of the hospital without affecting patient care? For how long?

  • take half-day or late-start strike action? For how long?

  • take strike action to end elective treatment? For how long?

  • take strike action to bank holiday cover? For how long?

  • take all-out strike action for just your Branch of Practice (allowing other BoPs to cover)? For how long?

  • take ‘rolling’ strike action where your branch of practice takes strike action one day, and another branch of practice does the next day, and another the next day and so on? For how long?

  • take all-out strike action alongside other branches of practice? For how long?

We recommend members fill out the survey and use the free text comment box to tell the BMA what action you would be willing to take. Lobby Council members and branch of practice reps for a determined response to the pay offer.

Email us at broadleft[at]doctorsbroadsheet.org  if you’d like to get more involved in our campaign.