Spousal Expenses – Update

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to determine if spousal travel claims are permitted or whether any previous policies that permitted them have been superseded.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

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

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

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

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

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

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 articleIt 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 changesfirstly, 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 governmentthirdly, 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.

 

BMA Council and more Report, September 2018

On 19th September the BMA UK Council convened for the second time of the 2018/19 session, with all Broad Left members in attendance. After welcomes and congratulations for newly elected members the session began earlier than usual in anticipation of the packed agenda. The first item was a presentation from the chair, Chaand Nagpaul, about the results of the BMA’s recently published all member survey. The survey was wide ranging, with topics including how meeting targets rather than patient care often drives clinical decisions, how doctors are increasingly afraid of making mistakes and that doctors want better IT systems, better levels of staffing and better pay. Emma Runswick spoke about how rota gaps and unsafe staffing levels are a composite issue: they ranked top of things affecting a doctor’s daily life (above T&C issues and pay) but these gaps do not exist in isolation or as an anomaly: they are strongly linked to poor terms and conditions, declining pay and, for non-EU nationals, issues with securing the necessary visas.

Council then discussed the issues of doctors’ pay and the BMAs response to this year’s DDRB recommendations and the wider implications of how the offer that they presented to the government should affect our relationship. This was held in a private, confidential session. Broad Left members Vicky Theakston, Emma Runswick, Yannis Gourtsoyannis and Chris Smith all contributed to the discussion in accordance with the views that we had previously expressed on Doctors Broadsheet. After considering the debate, we maintain our view that the offer was unacceptable and that the BMA needs to respond with a well resourced, comprehensive and continued comma campaign to inform members of the real-terms pay cut that has been forced on doctors over the past decade. This should be followed by an indicative ballot to gauge how members want to respond to the repeated and sustained degradation of pay across all grades and specialties. Significant time was devoted to these topics; the morning session was extended so that a range of views could be heard and the afternoon session began with continued discussion around non the DDRB and doctors’ pay.

Next, an update was given by the Trade Disputes Preparedness Group where it was discussed how they should present to Council in the event of escalating industrial action. Also discussed was the group’s responsibility to assess IA’s impact on other Branches of Practice and union as a whole, and the particular remit of each dispute committee in the event of future industrial action, including responsibility for communications planning and member mobilisation.

A shortened review of support for members was delivered to Council as the session was already overrunning, followed by an update on the independent review of the BMA’s Code of Conduct and, specifically, the resolution process therein. Council was informed of the 15 candidates for the 2 vacant South East seats and confirmed the appointment of members of the Occupational Medicine Committee.

Chris Smith and Emma Runswick co-signed a motion brought to Council stating concern with the appointment of Lord Prior to the Chair of NHS England on the grounds that there is a significant conflict of interest and that he does not show commitment to NHS values or the NHS constitution. The motion was carried nem con after discussion and a vote.

In preparation for a discussion of the BMA’s campaigning priorities to be held in November’s council session, the Director of Policy posted information on some workshops for Council members ahead of the November meeting on what made for good campaigning and how this could help council to structure the policy priorities to have maximum external impact.

After the conclusion of Council, 5 Broad Left members attended a scheduled presentation from the BMA’s legal team to receive updates and ask questions about important cases.

Council Discussion on Pay Strategy

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.

Organising 101: Recruitment

This is based on the training Emma Runswick delivered for BMA Medical Student Representatives. It has some use for all of us, but the chosen examples may not fit your environment.

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My name is Emma and I’m a Trade Union Activist. As elected representatives, you are too.

Our job is to build the strength of the union, so we can achieve more for our members. As students, we also have another job – to prepare our members for the challenges of work, and encourage them to stand up for themselves and become representatives as doctors.

We get our power from numbers, from the density of our membership. Like herd immunity, we are all better protected the more of us that are members. A representative of 98% of a medical school’s students has more clout than a representative of 65% of students. We also draw strength from the activity and engagement of our members. Where members tell reps about problems, and are prepared to act together to solve them, we have levers available that don’t exist with a passive membership. When there is competition for representative roles, reps have to show they are effective and accountable. So when we think about organising, what we aim for is full union membership, with significant activism and engagement of the ‘lay’ (not rep) members.

To achieve that, we have to stop thinking about recruitment and retention as something done by adverts and freebies. Recruitment is not a one-step job, nor one conversation. A rep may have to have several conversations over months to recruit somebody. More conversations would be required to recruit a member into activity. Other conversations are required to retain members when things inevitably go wrong, or when members have joined for free in freshers’ week and have no idea what the union does. Organising is an ongoing and constant process, which we all have to engage in all the time.

To assist you, it may be useful to develop a script. Mine goes something like:

*Pick something relevant to them – for pre-clinical students, a good example is UKMLA; for clinical students, travel bursaries, UK Foundation Programme Office, disability adjustment in exams; for junior doctors, contracts and training; etc.

Recruitment is not just a job for freshers’ week and inductions, though you should go to these. Like recruits like – you will recruit members far better and far more usefully than most BMA staff, because you know what it is like and what they need. Recruitment is also for teaching, grand rounds, medical formals, lunchtime, coffee breaks, and general conversations. Ask final year students if they have their contract or rota, if they have checked it using the BMA tools, if they are a BMA member. Ask your colleagues what they think of UKMLA, how much travel has cost them this block, whatever. Slip it into conversation. TELL PEOPLE YOU ARE THE BMA REP. Wear your lanyard and badges.

Organising is essential if we want our union to be strong. We can all play a part in that.

You can get materials for recruitment – leaflets, free stuff – from https://www.bma.org.uk/about-us/how-we-work/local-representation/local-negotiating-committees/promotional-materials

You can also access rewards for recruitment by joining the Ambassador Scheme: https://www.bma.org.uk/membership/bma-ambassadors

Those wanting to be active can have a look at this https://www.bma.org.uk/about-us/get-involved/represent-and-volunteer

 

Addendum Issues:

Junior Doctors’ Contract: sympathise! They are right, we didn’t do as well as we would have wanted in that dispute. However, we took an organisation that hadn’t struck in 40 years on strike, and we won significant concessions. If you compare the initial contract ‘offer’ to the one imposed, you can see how effective striking and negotiating was. We weren’t prepared for an industrial dispute that big, and if we want to do better, we have to be more organised, and we have to be stronger. We need you to be a member, and then people like us can change the union so we never give up a mandate like that again.

Chris Day/whistle-blowing: nobody really knows what happened there, even Council members like those on the Broad Left. However, everybody now agrees that we do have whistleblowing protection if needed from detriment by our training provider. Now, we need to be acting to make sure nobody has to whistle-blow. We work in understaffed and unsafe environments, and if we want to improve those, we have to break the locum cap, campaign for visa restrictions to be removed, win better policies for cover and training, fight for better pay, and ensure better workforce planning. Those are all things your union does with and for you, and we are stronger if we have more members. On Chris Day specifically, hopefully there will be a frank conversation when his personal Employment Tribunal case is concluded about what happened and the role of the BMA.