Latest posts by John Gee (see all)
- Calling off the strike shows the BMA leadership to be in tatters - September 8, 2016
– Jeremy Hunt (JH – Secretary of State for Health) wants to impose a new (worse) contract on junior doctors – currently set for imposition in October 2016.
– Doctors went on strike numerous times in late 2015 and early 2016.
– The old BMA (British Medical Association) junior doctor committee (JDC) led by Dr Johann Malawana had negotiated a contract with the Department for Health (DH) which was put to a vote to Doctors and Medical students and which was rejected (showing either Doctors were more militant and anti-Tory than first thought or this still was a shit, unfair, inequality promoting contract). – After the rejection, Dr Malawana resigned.
– A New BMA junior doctor committee chair was selected – Dr Ellen McCourt. The start was promising, but it’s all fallen to pieces (see below).
– Last week the new BMA JDC approved strike action with a severe escalation – 5 days of full walk out between 12-16th Sept (i.e. very soon) and then the 5-11th October (although the weekend will be covered), 14-18th November and 5-9th December.
– As of 5th September, the BMA called off the strike on 12-16th Sept but will continue with the strikes in October, November and December.
– The reasons for calling off the strike were intense pressure from NHS England over patient safety concerns that there wasn’t enough time for hospitals to plan for a 5-day full walk out. Hence patient safety would be compromised. This might well be the case, and patient safety is tantamount, but read on below to understand the hole which the BMA has dug itself.
But before you get there, some more background reading as I couldn’t slate the BMA without slating Jeremy Hunt as well;
Jeremy Hunt wants to impose a 7-day service of which this junior doctor contract is said to contribute to. On April 25th 2016 in his first 5 minutes of his speech in the House of Common he stated that the 7-day manifesto pledge (from the Tory election manifesto) is not about 7 day elective services but about delivering consistent urgent and emergency care at evenings and weekends. In the next sentence he said that in order to deliver this, 4 key clinical standards need to be met:
1) Seen by a senior decision maker no more than 14 hours after arrival
2) 7-day diagnostic services including 1-hour turnaround for critically ill patients
3) 24-hour access to Consultant directed interventions for Interventional Radiology and Endoscopy
4) Twice daily review in HDUs/ITUs
So what have any of these got to do with imposition of the new junior doctor contract Jeremy? Maybe I’ll address each of the above key standards in turn:
1) If senior decision maker includes senior registrars than this already happens
2) Nothing to do with junior doctor contract – more to do with the auxiliary staff
3) Nothing to do with junior doctor contract
4) Already happens in every HDU/ITU
Nope, still no clue how they link.
Current standpoint / BMA failings
1) Firstly by calling off the strike and bowing to pressure from NHS England it just gives the government confidence that they can ‘ride out the storm’ through continual pressure channelled through NHS England (who by my understanding support the contract) that this strike is too dangerous.
2) The new contract is imposed in October and once it’s imposed there is limited chance of reversal. The next strike dates aren’t due until after imposition/ the week of imposition. So the dates for these strikes seem to be a massive failing on the part of the BMA.
3) If the BMA leaders believed they could achieve a better contract they would have kept this strike next week and demanded that NHS England pressure Jeremy Hunt and the DH instead of doctors to re-negotiate which would avert the strike (instead of how things have unfolded). This pressure from NHS England which is very real could have forced the DH into action to avert this.
4) By calling off the strike and bowing to pressure from NHS England that this strike is too soon to plan for and hence unsafe, the BMA leaders are effectively agreeing that it is unsafe for patients (which it probably is). However, the government will spin this as being unsafe for patients over all strikes upcoming not just because it’s so soon and the hospitals can’t plan- i.e. 5 days of strikes is unsafe full stop regardless of timing. This begs the question of why the BMA leaders felt the need to escalate to 5 day strikes and why so soon (1.5 weeks after announcing new strike action). The answer is to pressure the DH and Jeremy Hunt and by the looks of it they had NHS England in a corner and it seems, backed down at the last minute. This leads me back to point 3 – this serious escalation has caused worry which could have been put onto JH and the DH but instead the BMA have absorbed the worry, cancelled the strike and now look incompetent with poorly planned decision making right from the top.
PS -Check out this link to learn about a day in the life of a Junior Doctor. It’s fun, I promise, and the pressures aren’t real so no excuses!