BMA Council September 2019 Report

Member Support Services

We received an extended extract of the Member SupportServices Review, an external look at our employment services for members. Theaim is to learn and improve a range of processes, covering member experiences,‘complex cases’, communications, and other issues. The content of the report isabsolutely 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 notallowed to report what was said in the meeting. We are assured that Councilwill continue to have oversight of the implementation of the recommendations.

We believe that the report has evidenced many concerns thatwe as representatives have been highlighting for many years. It has highlightedsome solutions, some of which are quick wins and others which require strategicand long-term change. We are supportive of many of these and have expressedconcerns about some others. We will argue that any working groups set up toimplement the findings include representatives. We are also arguing for somechanges not recommended in the report:

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

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

Pensions

Our members’ age discrimination claims are waiting for theEmployment Tribunals in the four nations to work through the processes. Weexpect that we will get some remedy for all our members affected by pensionchanges in 2015.

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

The pension tax disaster rages on, as more consultants dropsessions due to the annual allowance taper. This taxes money which doctors havenot received and may never receive. It also in some cases results in a tax billlarger than the additional pay earned. The only way to solve this problemdecisively is to #scrapthetaper. For doctors caught by the taper, the onlysolution is to drop sessions, Clinical Excellence Awards or other incomesources to get back under the threshold taper. Doctors are now doing this inlarge numbers. Wait list clinics, leadership roles and education areparticularly affected. Members can accessthe 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 last6 years, and you did a monitoring exercise that used Allocate or Zircadian, youmay 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 theiremployers. 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 RoyalCollege of Physicians to adopt a neutral stance on assisted dying aftersurveying the views of its members and:

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

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

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

We believed that without a proposed change to the law, thisquestion is unclear in meaning. The debate at ARM, and the RCP example in themotion, made clear that the proposers and Representative Body wanted todetermine whether members believe the BMA should be neutral on PhysicianAssisted Dying, rather than on any changes to the law. We believe that askingthe 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 ofinterpretation of a motion should be approached carefully. Council should notbe able to substantively change the course of a proposal mandated by thedemocratic conference of the BMA. We should be vigilant to this and the Chairof the Representative Body (who Chairs the ARM and is the advocate and guardianof the policy book) was correct to raise the issue.

The Medical Ethics Committee will now consider all optionsaround polling members and bring detailed proposals for Council to consider atits November meeting.

Resignation and Council Vacancy

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

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

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

Due to the gender constraints applied to Council, which donot allow more than two thirds of any group to be from one gender, the nextelected junior would be a man. The make up of Council is almost two thirds menalready.

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

Brexit

The BMAlaunched a major Brexit briefing ‘Ahealth service on the brink: the dangers of a 'no deal' Brexit’ on 2ndSeptember to coincide with Parliament’s return. The report reinforced the BMA’sconcerns about the consequences of a no deal Brexit for patients, the healthworkforce and our health services. The report also cast significant doubt onthe Government’s claims that the NHS was ready for a no deal Brexit,identifying over 40 unanswered questions on the NHS’ preparedness for thisscenario. 

The BMA hasalso produced a member-focused resource, ‘Informationfor doctors if there is a no deal Brexit’ which aims to answer thequestions we may have in the event of a no deal. This resource will be kept updatedas developments occur and additional issues arise.

In a really positivemove, the BMA joined a jointstatement with 11 other health unions to warn that a no deal Brexit coulddevastate 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 ‘shouldthe representative meeting be concluded without all the agenda having beenconsidered, the sponsoring constituency can request a motion to be pursued, itshall be entitled to submit a written memorandum for the consideration of thecouncil 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 crisisunfolding on the Greek islands, and elsewhere on Europe’s external borders, andthe devastating impact this is having on the health of displaced people. Wecall upon the BMA to lobby nationally and internationally for:

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

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

Other Issues

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

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