Pay restoration in Scotland: A Munro to climb

Conferences, Opinion, Pay

At the BMA’s Junior Doctors Conference this month (7th May 2022) members from all 4 UK nations voted overwhelmingly to demand full real-terms pay restoration to 2008 levels by supporting the motion COMP 1 (pictured). In real terms junior doctors working in England are paid around 25% less than their equivalent colleagues were 14 years ago. In nations such as Scotland where devolved governments set public sector pay policy, despite pay awards often being higher percentages than those given in England, pay erosion is actually even worse.

The reasons for pay parity with 2008 have been laid out before but, put simply, we all know in our gut that we are not worth only three quarters of what our colleagues were during the financial crash of the 2000s. If anything the job has got more technical and responsibilities have increased, even if what we take home at the end of the month hasn’t.

Demands for full pay restoration have not materialised overnight and come off the back of work that the Broad Left- and more recently and visibly the Doctors Vote campaign- have been doing. In May 2021 we achieved BMA policy of demanding a 15% pay rise to take us halfway there. But, in Scotland, we never even made it this far.

As pay is set by the government in Edinburgh, so is BMA policy for pay and negotiations in Scotland. The Scottish Junior Doctors Committee of 2020/21 voted not to adopt the 15% goal and instead decided to stick to the status quo that has already led to more than a decade of stagnant or swindled income. 

Traditionally, BMA Scotland presents evidence to the Doctors’ and Dentists’ Remuneration Body (DDRB) in a united, pan-Scotland way with a single pay demand. For the 2022 pay round this was “inflation plus 2%”. There are some positives to this: linking pay to inflation was a significant policy position made at this conference for UKJDC and, if permanently linked to RPI, would stop our pay being eroded by political choices that lead to high rates of inflation. 

However a pay rise of 2% in real terms is shamefully inadequate given the years of erosion already imposed. Our pay has dropped around 30% in 14 years and, with BMA Scotland’s current goal, it would take us 14 years again before our pay approached the 2008 baseline. This is longer than an entire training pathway for many juniors!

So, what do we do about it? There is something we can all do immediately, but more of the work needs to be done over the medium to long-term so we can build a movement capable of winning an ambitious- but ultimately achievable- demand. 

Bluntly, we are at least a year behind our colleagues south of the border in terms of securing our worth.  We have not invested the time or resources into educating our members about pay erosion that both UKJDC and grassroots online groups have done. We need regular and useful comms output to help bring Scottish doctors with us; this includes social media, physical media in workplaces, a pay loss calculator hosted on BMA sites.

A first step towards this is an online pay Q&A on June 8th (sign up here Online Event Registration Form). A high turnout will be noticed by elected reps and will be further proof that we want more radical action on pay and are willing to turn out and spend our time to make our voices heard. The new Email your MSPs template has space to customise the message, which we can use to wake up our Holyrood representatives to the fact they have been degrading our pay- and the health service as a result- for years. The analysis lined up for these two tools looks thorough and useful so engagement with them, viewing them as a launchpad for more, is worthwhile.

But beyond this we need to keep telling SJDC that pay is our priority. Email your reps, find them in your workplace and make it clear that our members support the conference position of seeking full pay restoration; it will help current reps deflect criticism that a focus on pay is unhelpful and not representative of our members, some of the critiques levelled at pro-restoration reps in Scotland.

Over the next year, we must re-examine our relationship with the DDRB. English junior doctors have not engaged with it for years as it is broken and in desperate need of reform. This year English consultants took this position too, striking another blow to the DDRB’s legitimacy in its current form. Scottish doctors still present evidence to the DDRB and turn up to talks with them. This undermines our English colleagues and wins absolutely nothing for us; the Scottish government has ignored even the paltry increases they’ve recommended in the past and probably will again. By walking away and eventually negotiating directly with the Scottish government until it is reformed, we reclaim power from the bureaucrats and send a message that our union is alive and kicking.

We do not act in a vacuum and SJDC need to be taking note of the mandate given by conference for planning radical action in England. We need to immediately commence a campaign to prepare, educate and organise rank and file junior doctors in Scotland so that we are adequately prepared to support our colleagues in the event of English industrial action. Besides being the right thing to do, winning in England will pile the pressure on the Scottish government to keep up, else they face an exodus of junior doctors southwards. Solidarity with any ballot and subsequent industrial action will give us a blueprint and help to inform any action Scottish doctors may need to take in the future, when nothing should be off the table.

But finally and imminently, you have the power to change all this. Across Scotland, regional BMA committees for juniors- LNCJDSs- are chronically underfilled as engagement is rock bottom. But who’s really surprised given the stresses of the pandemic and the seeming inertia in some crucial areas?

Stand for these committees and then stand for a seat on SJDC, or stand for one of the two seats in the upcoming national SJDC elections. Information about election timetables should be made available soon- they will open at the end of July, so follow your Broad Left reps and BMA Scotland accounts on Twitter.

Now is the time to take an active role in our union, or even to re-join it. If you’re excited by the progress being made in England, help us harness that momentum north of the border and make meaningful steps towards proper pay restoration. We are not worth less than our peers in England, so make sure we are not complicit in demanding any less than them- any less than we deserve.

Slowly Winning the Arguments on Pay

Pay, Reports, reflections and accountability

It has been almost a year since we won the NHS Pay 15 demand at Junior Doctors Conference last year (watch from 1.54 here). This was in the context of repeated below-inflation pay awards, minimal pay requests from the BMA, a growing NHS Pay 15 campaign across multiple unions, and heavy opposition within the BMA.

This year, our arguments about Pay Restoration have become more widely accepted on the Junior Doctors Committee, and our efforts with Medics4PayRestoration and then Doctors Vote have borne some fruit in terms of doctor-created graphics. We will be proposing a motion for full pay restoration at this year’s conference.

So why has the BMA been so slow to put this demand out on social media? Why have they not written to the government with this demand? What has the Broad Left been doing since it passed?

The BMA centrally is now doing some campaigning work, with a webpage, some graphics, a letter-to-MPs tool. Whilst we remain critical of the inadequacy of this work, it is a significant change. It is worth examining what had to happen to get here.

Sorry – this is a long read!

March 2021 Council Meeting

BMA Council has not withdrawn from the DDRB as ARM demanded in 2020, due to concerns about the impact on Devolved Nations and smaller Branches of Practice. Other elements of that motion have not had action taken on them. 

The Broad Left and some allies on Council submitted a motion and paper to March 2021 Council

Only parts ii) and iii-i) pass.

Junior Doctors Conference May 2021

The North West motion from Emma Runswick is composited (merged/compromised into one motion) with a Yorkshire motion to produce this (31 in the agenda here):

You can watch the debate from 1.54 here. It was proposed by David Smith from Yorkshire. Multiple Broad Left members spoke in favour. Part vi) fell due to a requirement to have a two-thirds majority on issues of significant financial cost.

June 2021 JDC Meeting

Broad Left members of JDC gathered the assent of one-third of JDC members to request an additional meeting of JDC to discuss pay strategy, as required in the Standing Orders. Without evidence or warning, we were publicly accused of including members’ names without consent. and a “Lessons Learnt” review was conducted. Despite requests, no evidence and no report from the “Lessons Learnt” review has been offered to members of the Broad Left. Over half of JDC members subsequently voted to have an additional meeting to discuss pay strategy when offered by the Chair of JDC. Two JDC meetings occurred in June, one wholly devoted to pay strategy discussion.

Usually the first meeting of JDC after the Junior Doctors Conference adopts the policies passed at conference. At this meeting, a motion to reject the pay motion was heard. Devolved Nations representatives made clear they would not uphold the policy regardless of whether it was adopted or not. We won the argument and the policy was adopted.

We voted on a series of options and agreed to survey the membership on industrial action if the DDRB and government gave us nothing additional in the 2021 pay round. 

October 2021 JDC Meeting

In October, we received the results of that survey. Turnout was ~6,000, and while 96% said the pay offer was unacceptable, that turnout didn’t show that we were yet ready for industrial action of the scale needed to win a 15% pay uplift for doctors in England. JDC outlined a good plan of what was required to build a pay campaign and readiness amongst our members, including education on the key issues, and training for reps and activists. This would draw comparisons to costs of living e.g. fuel and food costs to demonstrate losses against inflation. We agreed to discuss balloting again before the end of the session. We also agreed to withdraw from the DDRB process in England. 

December 2021 JDC Meeting

In December, despite the good work JDC and JDC executive had done in outlining what we wanted, the work completed was minimal. We received a short document from the communications team, an outline of a communication and industrial strategy. Key messages included the effect of the pandemic, the lack of award in 2021, and then the pay depreciation we have seen. It planned an activist training session in January, with heavy emphasis on lobbying; member webinars in late Feb/early March, including wider content on financial issues such as coping with higher cost of living and creation of a “strong visual look”; then a campaign for a specific pay ask to the DDRB, which we have withdrawn from.

We were asked whether we should ask the Government not to seek “comments and observations” from the DDRB, and what JDC’s £% ask was for 2022-2023.

We believe the questions were unnecessary and the outline plan misguided: we have withdrawn from DDRB and we knew our ask was 15%. We deserve pay restoration regardless of the pandemic, and many find this focus inappropriate given the widespread trauma. We want to win pay restoration, not just cope with a depreciated income. We know the DDRB will follow the government remit, which is why we have withdrawn from it and are choosing to focus campaigning on the government. Constantly having the same discussions is exhausting.

There were no materials drafted, no KPIs for comms, and no industrial strategy. The discussions at JDC and exec might as well not have occurred for how little there was of them. We did not want a public facing campaign, but assistance to engage our colleagues with a campaign for partial pay restoration. Members of the Broad Left criticised the ongoing “frontline” branding, the lack of materials and the plan for corporate branding. We requested that member-made materials could be checked and circulated by BMA, including infographics and memes which addressed our issues. We wanted shareable versions of our briefing papers which outline the numbers so members could read and make their own contributions on new/social media. We wanted an FAQ which could develop iteratively with activist feedback.

We needed to talk about the plan to win – the industrial action plan: what we are asking for; what the risks are and how we will mitigate them as a union; what taking action could deliver. We highlighted the complete lack of structure testing – i.e. there was no plan to check how ready we were before deciding whether or not to ballot.

We were told this was taken on board and that we would be closely involved with further development. JDC has seen nothing further.

In late January, Emma Runswick was asked if she was free on 15/2/22 for a planned pay activism webinar. She got more information about this the week prior, with suggestions that we discuss successful local organising in the round. 

The Webinar: mid-February

We promoted the webinar best we could – including on twitter, facebook, reddit, discord, whatsapp cohort groups. We believe the promotion was insufficient. Approximately 80 attended. Questions were understandably hostile given the lack of progress in the campaign, rising inflation and pay depreciation over the last 15 years. Staff worked to pass questions through that were upvoted, regardless of the hostility, which we believe was correct. We have not seen all the questions or comments, but JDC have since been informed that some were abusive. We have asked to see these.

Emma presented a brief upskilling session on Structured Organising Conversations, but the webinar was one-way in the context of mostly information giving. The website landing page has been created and an activism network set up, with materials for sharing with colleagues and educating promised soon. 

The website links to a good briefing and has clear infographics. Do have a look:

Fair pay for junior doctors in England

March 2022 JDC Meeting

In March, JDC was due to have an update on pay campaign activity, see feedback from the webinar event, and discuss what resources were needed. Survey data, requested by other branches of practice, was presented about the public’s view of doctors’ pay campaigning. Communications teams asked JDC some strategy questions about timing, separation from the broader BMA campaigning, straplines and similar.

There were still no materials, no KPIs, no plan for member-led resources, and so on. Industrial strategy is mostly absent from discussion, except to say that industrial action is a tool to get to negotiation. Criticism was heavy.

Now

We are getting progress – graphics with the graph have been released, posters, the webpage and the write-to-MPs tool. Broad Left members of JDC are happy that we are making slow progress and critical of shortcomings of the BMA output. This is now being received well. 

However, we continue to do our own work, which does not rely on the slow internal mechanics of the BMA. That work is primarily in our workplaces. We also continue work with Medics4PayRestoration and Doctors Vote, who have wonderful volunteer graphics-creators.

What Now?

Educating Colleagues Ourselves

  • Medics4PayRestoration has set up some social media and created infographics for sharing, discussing and building on. @Medics4PayRestoration | Linktree
  • Follow Doctors Vote on social media for good graphics to share

Changing policy

  • Junior Doctors Conference is coming up this Saturday! 
  • Please consider lobbying your JDC representatives to vote in favour of “Comp 1” and tell your colleagues about it in work. Having discussions and arguments about this, and convincing colleagues of the need for action on pay is crucial

Elections

  • JDC elections will happen at ARM in June and in regions and devolved nations in the summer

Completing our own Structure Test

BMA Council September 2019 Report

Council Reports, Reports, reflections and accountability

Member Support Services

We received an extended extract of the Member Support Services Review, an external look at our employment services for members. The aim is to learn and improve a range of processes, covering member experiences, ‘complex cases’, communications, and other issues. The content of the report is absolutely confidential and the discussion at Council was held ‘in private’, which means we are not allowed to share any of it with you. We are also not allowed to report what was said in the meeting. We are assured that Council will continue to have oversight of the implementation of the recommendations.

We believe that the report has evidenced many concerns that we as representatives have been highlighting for many years. It has highlighted some solutions, some of which are quick wins and others which require strategic and long-term change. We are supportive of many of these and have expressed concerns about some others. We will argue that any working groups set up to implement the findings include representatives. We are also arguing for some changes not recommended in the report:

  • Insourcing First Point of Contact
  • Recreating the Place of Work Accredited Representative role (POWARs)
  • Better local and regional staffing in Member Relations (Employment Advisors and Industrial Relations Officers, the staff that help with individual and collective cases respectively)

We consider this work to be our core trade union function and want it to link with our push for rank and file trade unionism. To that end, Emma met with the new CEO Tom Grinyer on Friday to discuss moving to an organising model of trade unionism and how that fits with the recommendations made in this report.

Pensions

Our members’ age discrimination claims are waiting for the Employment Tribunals in the four nations to work through the processes. We expect that we will get some remedy for all our members affected by pension changes in 2015.

We are also continuing to lobby on the disgraceful situation for Less Than Full Time and Locum doctors, who pay pension contributions as if they were earning a full time salary, or a locum rate for 365 days a year. We are exploring the possibility of legal cases around sex and disability discrimination to progress this issue.

The pension tax disaster rages on, as more consultants drop sessions due to the annual allowance taper. This taxes money which doctors have not received and may never receive. It also in some cases results in a tax bill larger than the additional pay earned. The only way to solve this problem decisively is to #scrapthetaper. For doctors caught by the taper, the only solution is to drop sessions, Clinical Excellence Awards or other income sources to get back under the threshold taper. Doctors are now doing this in large numbers. Wait list clinics, leadership roles and education are particularly affected. Members can access the BMA-Goldstone Modeller to work out the best course of action for them.

We have argued for increased communication with members, particularly targeted at younger members, on all of these issues.

Banding

If you were a junior doctor on the 2002 Contract in the last 6 years, and you did a monitoring exercise that used Allocate or Zircadian, you may be able to get pay for the time and money your employer didn’t pay you for. This could be thousands of pounds.

We want to help BMA members take legal cases against their employers. Read more about our first legal victory and the eligibility here.

Surveying Members’ Views on Assisted Dying

At ARM, Motion passed:

That this meeting notes the recent decision by the Royal College of Physicians to adopt a neutral stance on assisted dying after surveying the views of its members and:

  1. supports patient autonomy and good quality end-of-life care for all patients;
  2. recognises that not all patient suffering can be alleviated; and
  3. calls on the BMA to carry out a poll of its members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying. 

We were asked if the question must be as worded in the motion:

“should the BMA adopt a neutral position with respect to a change in the law on assisted dying?”

We believed that without a proposed change to the law, this question is unclear in meaning. The debate at ARM, and the RCP example in the motion, made clear that the proposers and Representative Body wanted to determine whether members believe the BMA should be neutral on Physician Assisted Dying, rather than on any changes to the law. We believe that asking the question as written would not achieve the aims and spirit of the motion, and we heard from the proposer to that effect. However, this kind of interpretation of a motion should be approached carefully. Council should not be able to substantively change the course of a proposal mandated by the democratic conference of the BMA. We should be vigilant to this and the Chair of the Representative Body (who Chairs the ARM and is the advocate and guardian of the policy book) was correct to raise the issue.

The Medical Ethics Committee will now consider all options around polling members and bring detailed proposals for Council to consider at its November meeting.

Resignation and Council Vacancy

Our colleague Yannis has had to step down from Council and Junior Doctors Committee for personal reasons. He has been an incredible asset over many years and we hope to welcome him back to activity in the future.

In cases of vacancy, Council can choose to fill the seat with the next runner up as a non-voting member, or to run a new election. The vacancy is for a Junior Doctor Branch of Practice seat. There are, due to qualification of three Council members originally elected as medical students, now more junior doctors on Council than in July 2018. In this context, an additional non-voting member appears unnecessary, and the cost of a national postal election extravagant.

Junior doctors on Council automatically get a seat on Junior Doctors Committee, where they are now the largest constituency, bigger than any regional representation. This poses a problem for the functioning of JDC.

Due to the gender constraints applied to Council, which do not allow more than two thirds of any group to be from one gender, the next elected junior would be a man. The make up of Council is almost two thirds men already.

For these reasons we voted to not fill the vacated seat immediately. We will support new elections in future if more vacancies arise. We are in favour of more frequent elections to Council.

Brexit

The BMA launched a major Brexit briefing ‘A health service on the brink: the dangers of a ‘no deal’ Brexit’ on 2nd September to coincide with Parliament’s return. The report reinforced the BMA’s concerns about the consequences of a no deal Brexit for patients, the health workforce and our health services. The report also cast significant doubt on the Government’s claims that the NHS was ready for a no deal Brexit, identifying over 40 unanswered questions on the NHS’ preparedness for this scenario. 

The BMA has also produced a member-focused resource, ‘Information for doctors if there is a no deal Brexit’ which aims to answer the questions we may have in the event of a no deal. This resource will be kept updated as developments occur and additional issues arise.

In a really positive move, the BMA joined a joint statement with 11 other health unions to warn that a no deal Brexit could devastate the NHS. We want to see more of this cross-labour-movement thinking.

Refugees – Motion not reached by ARM

According to section 89 of the ARM Standing Orders ‘should the representative meeting be concluded without all the agenda having been considered, the sponsoring constituency can request a motion to be pursued, it shall be entitled to submit a written memorandum for the consideration of the council or appropriate committee, and/or to submit oral representations.’

We were asked to consider Motion 66 from ARM on refugees:

That this meeting is appalled by the humanitarian crisis unfolding on the Greek islands, and elsewhere on Europe’s external borders, and the devastating impact this is having on the health of displaced people. We call upon the BMA to lobby nationally and internationally for:

  1. the establishment of legal routes for those seeking asylum in Europe, including the UK; 
  2. the protection of the human rights, specifically the health-related human rights, of all displaced people; 
  3. the UK to fully recognise its obligations under the 1951 Refugee Convention; 
  4. the UK to take a leading role in developing a humane international response to forced migration. 

We voted to pass this motion, to enable the BMA to lobby the UK government to use its considerable influence to establish a humane approach to migration to Europe, including by establishing safe, legal routes for seeking asylum and alternatives to immigration detention, which is damaging to health; and lobby for adequate protections for asylum-seekers who do reach the UK. 

Other Issues

We were updated on several other issues in the Chair’s Report, including that:

  • We have a new Code of Conduct support line managed by an external, independent provider which is staffed by accredited counsellors. The phone number is 033 3212 3618 and is open to both those raising concerns and those who are subject to complaints, to provide support and guidance in dealing with the situation.
  • We are taking our lobbying on a Caring, Supportive, Collaborative NHS to the party conferences in preparation for an early election.
  • The BMA is contributing to the Infected Blood Inquiry, with one Council member volunteering to work through thousands of pages of documents so that we can assist in finding the truth for those affected by infected blood.

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 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.