BMA Council September 2019 Report

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.

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