BMA Scotland newsletter
April 2007
Dear Colleagues,
Welcome to the April edition of the BMA Scotland newsletter providing you with a comprehensive view of what is happening at the BMA. This edition includes information on the health policies contained in the manifestos, which have been recently published ahead of the forthcoming Scottish Parliament elections on May 3. Whatever the outcome of these elections, we will seize the opportunity to continue to work with politicians across the spectrum to promote the medical profession, the NHS and health improvement in Scotland.
With the Scottish Local Medical Committee conference taking place at the end of April and the Scottish elections the week after, medico politics continues to take centre stage in the minds of the public and the media. If this makes you want to be involved in the BMA, go to the BMA Scotland webpages to see how you can stand for election to a committee or get involved locally.
Dr Peter Terry
Chairman of BMA Scotland
- Staff and Associate Specialists contract negotiations update
- Foundation programmes
- Board of Medicine
- MMC
- New Deal implementation and the new contract
- NHS pay awards
- Scottish Parliament Elections
- Smoke free Scotland –success one year on
- Review of distinction awards discretionary points schemes
- Senior academic GP contract
- Regulation of health professionals
- Events
The Scottish Staff and Associate Specialists Committee (SSASC) is considering the potential impact of the impending Scottish Parliament elections on the SAS grade contract negotiations. Since the 2 April 2007, which is when the pre-election period began, the Scottish Executive has been unable to make any significant policy decisions. There is also the potential for a change in administration in Holyrood after the elections.
SSASC is considering how such issues may affect the implementation of a new contract in Scotland. Dr Sally Winning, chairman of SSASC, has written to each of the main political parties in Scotland seeking their commitment to the agreed SAS contract, should they form part (or all) of the next Scottish Executive.
Delays beyond the control of the SASC (UK) negotiating team mean that the UK-wide contract agreement is still to be signed off by the Department of Health and the Public Sector Pay Committee. Once formal approval is received, the BMA will run roadshows across the UK, to give SAS doctors as much information as possible on which to base decisions in the eventual ballot. More information will be posted as soon as it becomes available and all SAS doctors are encouraged to regularly check the website for updates.
SAS Lanarkshire by-election
The Scottish Staff and Associate Specialists Committee (SSASC) is currently holding a by-election to fill a vacancy in NHS Lanarkshire. The previous representative, Dr Anne-Marie Flowers, has recently changed to another branch of practice, and has stood down from the committee. The new representative will be appointed shortly. In the event of an election, ballot forms will be sent out to all SAS doctors working in NHS Lanarkshire.
Foundation programmes
In February, Andy Kerr welcomed the new on-line application system for medical graduates. He announced that applications had been received for all 800 Foundation Programme places in Scotland and that graduates from Scottish medical schools had been successful in securing a place. Students have raised concerns about the lack of clear, consistent information they received about the application process to Foundation Programmes.
The BMA’s Medical Student’s Committee (MSC) has been raising these issues with the MTAS team at a UK level. While nationally, the Scottish Medical Students Committee (SMSC )has raised concerns about how applications to Scotland would be handled by the Scottish Foundation Allocation Scheme with NHS Education for Scotland (NES).
SMSC has also requested better feedback for students about their application and the score they were allocated. They have also called for data on the average score and score range for applications to be made available. SMSC is hoping to discuss in detail, proposals for improvements to next year’s application process with NES.
Board of Medicine
Representatives from the Scottish Medical Academic Staff Committee (SMASC) and the Scottish Medical Students Committee (SMSC) met with Sir David Carter, the Chairman of the Board, in February to discuss the transfer of St Andrews students to Scottish clinical medical schools. St Andrews and Manchester University are discussing the arrangements and both consider it important to maintain their link.
It has been agreed that the intake of medical students to St Andrews will increase to 180 a year (from 100) with 80 continuing to transfer to Manchester and 100 remaining in Scotland. In terms of the implementation timetable, St Andrews is currently in talks with the Scottish Executive and Scottish Funding Council (SFC) about funding for the additional students.
Sir David gave assurances that there would be funding for the additional students, but that medical schools would be responsible for determining how this was spent. Edinburgh, Glasgow, Dundee and Aberdeen have confirmed that they have the capacity for additional students.
SMSC and SMASC are continuing to highlight the need for long term career opportunities for the increased number of medical graduates in Scotland once St Andrews students are fully integrated into the system.
MMC
Scotland to interview all eligible applicants
The Scottish Executive has announced that all eligible applicants to Scotland will be offered interviews in all specialties to which they have applied. This move follows concerns raised by the BMA and junior doctors across Scotland regarding the shortlisting effectiveness of Medical Training Application System (MTAS).
BMA Scotland welcomes this solution and is pleased that the Scottish Executive has recognised the urgent need to address the disastrous MTAS process that has affected junior doctors across the UK. The Scottish Junior Doctors Committee considers that this solution is the only possible way out of the problems that exist and that Scotland is doing what is right for its junior doctors. The solution means that junior doctors will have an equal and fair chance and that the best candidates will be selected for the job, providing the best juniors for NHSScotland.
Round one will be extended with provision for the further necessary interviews. The original round one interview schedule continued as planned and all interviews which have taken place will count. From 7 May, run through specialty training job offers will begin to be made. All specialties should be in a position to issue run through offers by the week commencing 21 May. Following this, FTSTA offers will be made. Given that some may have applied for posts elsewhere in the UK, the final date for acceptance of Scottish offers will be 8 June, in line with the current UK timetable.
The full statement from Harry Burns on selection and recruitment is available on the MMC website. An FAQ on revised arrangements for specialty training recruitment in Scotland and further details on the timetable are also available online.
MMC across the UK
Wales and Northern Ireland are also offering interviews to all remaining eligible applicants to Wales and Northern Ireland in all specialties to which they have applied. The review group, led by Professor Neil Douglas, set up by the Department of Health to look into the issue of round one recruitment and selection into Specialty Training made through MTAS has recommended that in England any doctor already shortlisted and offered an interview(s) will still be able to attend them all.
They will be able to change their order of preference if they wish to in view of the competition ratios for each post and doctors not offered any interviews will now get the opportunity to revise their first preference and be offered an interview for their first preference.
Applicants to general practice
Recruitment and selection for general practice is regarded as working satisfactorily and will continue as far as possible as originally planned, although the timetable will be revised and will be published shortly.
Selection complaints
The Appeals and Complaints procedure about selection into Specialty Training has been published on the MMCScotland website.
Junior doctor rally
On Saturday 17 March thousands of junior doctors attended protests in London and Glasgow to express their anger with MTAS (the Medical Training Application Service). The march in London and rally in Glasgow, organised by RemedyUK with the support of the BMA, added to the mounting pressure on the government to come up with an adequate solution to problems with the system. Trainee doctors were joined by consultants, GPs, politicians, relatives, and other healthcare professionals.
New Deal implementation and the new contract
Health boards have been informed about the revised arrangements for future New Deal support. All New Deal partners (Scottish Junior Doctors Committee, Scottish Executive Health Department and NHSScotland employers) have agreed that the implementation of Specialty Training has the potential to disrupt compliance and there is concern about the financial risks to employers of non-compliance. Partners therefore want to retain the expertise of the New Deal Support Officers (NDSO). The arrangements provide for:
- NDSOs to continue to be integrated in the regions
- SEHD to fund 5.8 full-time equivalent NDSO posts, with provision for a further post to cover the North if expansion is necessary, and for support to stay in place until 2009 at the earliest
- The NDRB to continue until 2009 at the earliest
- An internal review to take place in 2009 to decide if arrangements should be phased out over an agreed period of time.
The Scottish Executive announced in March that it had accepted the 2007 pay review body recommendations for NHS staff and GPs. The main recommendations were:
A flat rate of £1000 pa for hospital doctors and £650 pa for hospital doctors and dentists in training
- 0% for general medical practitioners on the GMS contract
- 2.5% for nurses and other healthcare professionals
- 2% for general dental practitioners
Commenting on the 0% increase for GPs, Dr Dean Marshall, chairman of the Scottish GP Committee, said, “This is a slap in the face for all GPs who have worked hard to deliver high quality care and meet all of the government’s targets in the new contract. We are being punished for our achievement by the government which has introduced performance related pay with the new GP contract.”
In line with the rest of the public sector, the Department of Health announced that implementation of awards over 1.5 per cent would be staged, with 1.5 per cent paid from 1 April and the remainder being paid from 1 November. However, the Scottish Executive announced that it will introduce the pay awards in full in April this year.
Scottish Parliament Elections
The Scottish Parliament elections take place on Thursday 3 May. In this special feature, Beatrice Morrice provides an insight into the main parties election promises and how they relate to BMA Scotland policy. Key points relating to health from the manifestos of the main parties are listed below.
Labour
- Cut waiting times to 18 weeks from referral by GP to both in patient and outpatient treatment
- Introduce free health check MOTs for men over 40•Ban the sale of cigarettes to under 18s
- Increase entitlement to free school meals for an extra 100,000 children
- Increase the number of doctors in general practice
SNP
- Introduce new individual patient waiting time guarantees
- Protect local access to healthcare
- Replace current clinical negligence scheme with a no-fault compensation system
- Introduce elections to health boards
- Introduce annual health checks and MOTs for adults.
Liberal Democrats
- Introduce 100 local health centres to support GPs in primary care
- Take on 2,000 extra nurses and 200 dentists
- Implement new waiting time guarantees and faster diagnosis
- Introduce free fruit in primary schools and start more cookery lessons
- Establish a children’s health service.
Conservatives
- Give GPs a role in delivering more patient choice
- Reduce patient waiting times
- Improve mental health service provision
- Review NHS 24 looking into alternatives, including clinician-led local centres
- Introduce a “money-follows-patient” system, based on a national tariff scheme, which would allow patients to choose a hospital to perform medical procedures with the costs funded by the government.
Greens
- Conduct health impact assessments on all legislation
- Bring in legislation to ensure levels of freshness for food procured by the public sector, including schools and NHS establishments
- Rule out fluoridation of the water supply and focus on school-based tooth-brushing schemes
- Offer patients access to complimentary and alternative medicine through GPs and local health boards
- Raise the minimum age for buying tobacco to 18.
SSP
- Introduce free school meals
- Scrap all prescription and hospital car parking charges
- Introduce the option of single MMR jabs
- Establish a publicly owned pharmaceutical cooperation supplying cheap generic drugs
- End all PFI/PPP schemes, repeal legislation that extends private providers in general practice and ban consultants working in private practice.
The BMA Scotland Scottish Election webpages provide information, candidate lists, election guidance and polls.
BMA Scotland’s view on the party manifestos
BMA Scotland’s manifesto, published November 2006, focused on three areas: public health and health improvement; health services in Scotland and NHS reform; and medical workforce. The BMA is delighted that so many of its key policies have been included in the manifestos of the main political parties.
Public health and health improvement
Most of the parties are signed up to improving health by tackling problems with diet, alcohol, tobacco and exercise. People living in poverty or those from disadvantaged communities are more likely to experience poor health and the BMA is therefore pleased that so many parties recognise this and set out a commitment to reduce health inequalities. Priorities for Health, the BMA’s manifesto, highlighted the need to place health at the heart of political decision making in the next Scottish Parliament and therefore welcome the Green’s commitment to ‘health proof’ all policies. It is also touched upon in the SNP and Liberal Democrat manifestos.
Labour, SNP and the Greens pledged to increase the purchase age of tobacco to 18 and the Liberal Democrats, SNP and SSP will improve food nutrition in schools through either free fresh fruit or free school meals. The Conservatives highlighted an increase in mental health investment. All these policies are included in the BMA’s manifesto. The BMA however, criticised plans to create walk-in centres in commuter hubs and policies from both the SNP and Labour to introduce free full health checks as there is currently no evidence that such a scheme would deliver real improvements to patients. Instead, GPS would prefer that these types of health checks target deprived and disadvantaged communities where there is evidence that they would benefit from such interventions.
Health services and NHS reform
Labour, Liberal Democrats, SNP and the Conservatives all pledged to cut waiting times. However, the BMA believes that any new policy would have to comply with the principle that patients should be treated based on their clinical need not because of an obligatory target. The BMA also demanded that doctors be involved in setting targets that are evidence based and demonstrate a real benefit to patients and in developing services to achieve them. The Liberal Democrats, SNP, Greens and Labour all demonstrate support for the ongoing commitment to deliver care closer to patients’ homes. Community Hospitals are an essential part of this and the BMA reminded politicians that they must recognise and value the role of doctors and other health professionals working in these settings.
The BMA said that the Conservative’s pledge to review the service provided by NHS24 and replace it with local, clinician led units, was an interesting one that doctors would be keen to discuss their plans in greater detail. However, the BMA was critical of the tariff system, as proposed by the Conservatives, which would recreate an internal market in the NHS. The BMA believes that tariff systems generally ignore quality of care and would fail to protect rural healthcare services.
Medical workforce
Effective workforce planning is essential to the success of the NHS so the BMA was therefore disappointed not to see more of a commitment from all of the parties for the medical workforce. The BMA welcomed Labour’s commitment to increase the number of doctors in general practice and also supported the Greens’ promise to undertake detailed workforce planning required to deliver more care in local communities. The BMA welcomed the Liberal Democrat’s pledge to create more local health centres to improve access to diagnostic and treatment services. The BMA was keen to be involved in future discussions regarding setting a target of a maximum wait of five days to see a GP.
BMA Scotland health hustings
In the run up to the Scottish Parliament Elections, BMA Scotland hosted a health hustings at its Edinburgh offices in March. Over 60BMA members attended to hear the health policies being put forward by the main political parties and to take part in an open debate and over 50 people watched the webcast live.
The event was chaired by Dr Peter Terry, chairman of the BMA’s Scottish Council, and the speakers were: Andy Kerr MSP (Labour), Shona Robison MSP (SNP), Euan Robson MSP (Lib Dem), Dr Nanette Milne MSP (Conservative), Dr Eleanor Scott MSP (Green), Charlie McCarthy (Scottish Socialist Party). BMA members posed questions to the panel on a range of issues including general practice and private providers, sub-consultant grades, junior doctor training and alcohol.
An archive is available to watch online or you can read a written report on the BMA webpages. If you would like any further information on the Scottish Parliament Elections, or would like to meet with local candidates, please email or call 0131 247 3050
Smoke free Scotland –success one year on
March marked Scotland’s one year anniversary of the introduction of smoke free public places. However, a survey of BMA members in
Scotland revealed that nearly 70% of doctors said they still believed that tackling smoking was the most important public health issue for Scotland. Dr Peter Terry, Chairman of BMA Scotland, said:
“Scots have embraced the smoke free legislation and many have chosen to quit, however, much more must be done to reduce the number of smokers in Scotland, particularly among the young and pregnant women”.
Wales introduced smoke free public places on 2 April, Northern Ireland will introduce it on 30 April and England will introduce smoke free public places on 1 July 2007.
Review of distinction awards discretionary points schemes
The Scottish Consultants Committee (SCC) and the Scottish Medical Academic Staff Committee (SMASC) have both submitted supplementary evidence to the Review Group which is reviewing the distinction awards and discretionary points schemes in Scotland. The Review Group will now consider all evidence submitted, with the aim of making recommendations on the future of the schemes by Spring/early Summer 2007. A consultation on the recommendations will then take place, followed by negotiation with the BMA.
Senior academic GP contract
The new contract for senior academic GPs in Scotland has been agreed and has received Ministerial approval. It is based on the contract for clinical academic consultants in Scotland. The funding of the backdating of pay to 1 April 2004 for eligible current senior academic GPs has been secured and the intention is to implement the new contract as soon as possible.
Regulation of health professionals
The Department of Health’s White Paper, Trust, Assurance and Safety– the Regulation of Health Professionals, was published in March. It contains the government’s proposals on how to regulate health professionals and ensure patient safety in the UK.
Based on the Chief Medical Officer for England’s review of medical regulation, Good Doctors, Safer Patients, and the Foster review of the non medical professions, the main proposals in the White Paper include:
- Regulators led by an equal partnership of independently appointed professionals and members of the public
- All health professionals required to demonstrate periodically that they are fit to practise by revalidating their professional registration
- A move from the criminal standard of proof to the civil standard with a sliding scale in fitness to practise cases
- Introduction of a system of regional GMC Affiliates who provide support to local employers in addressing concerns about doctors and independently quality assure local revalidation processes.
- Removal of the adjudication function from the General Medical Council (GMC)
- Change to having appointed GMC Council members instead of elected doctors
- New composition of GMC Council with 50:50 lay and medical members
- Switch to a lesser burden of proof in fitness to practise hearings against doctors.
Events
The BMA comes to you!
BMA Scotland is launching a series of ‘BMA Days’ in selected hospital sites across Scotland to bring our expertise to you and promote the benefits of membership.
Members: Want to be reminded of the range of activities the BMA engages in on your behalf, or do you want to hear from some of our experts?
Non-members: Find out what you have been missing. We are sure that when you see the protection that being a member provides, together with the breadth and depth of our services to members, you will want to join. Our experts will give keynote topic talks at the beginning, middle and end of the working day and will be available for consultation and advice throughout the day. Specialists will be present from:
- Regional Services – advice on employment law
- BMAS – financial advice and signposting financial products of special interest and benefit to BMA members
- BMA Pensions department – advice on issues relating to retirement and pension arrangements
- BMA Scotland Public Affairs team – insight into the role of the BMA in influencing politicians, decision makers and the media in Scotland
- The BMA Ethics department, with the latest developments in the field of medical ethics.
Kerr in the Community: Delivering for Epilepsy?
Date: 24 May
Venue: Apex International Hotel, Edinburgh
Epilepsy Scotland is hosting a conference on the Kerr report and the Delivering for Health agenda. The conference is a must for those working with people with epilepsy or other long-term conditions. This event, which is RCGP accredited and is soon expected to be accredited by the RCPSG, is attracting wide interest. Places are limited, so register your interest and receive a booking form and programme by calling Sharon McCabe at 0141 427 4911 or email. For further details log on to the Epilepsy Scotland website.
Asthma and Respiratory Disease conference
Date: 2 May 2007
Venue: The Lighthouse, 11 Mitchell Lane, Glasgow
This conference is being organised by the University of Glasgow in association with the Asthma UK Scotland and the British Lung Foundation Scotland. It aims to provide health professionals and others working in the field of asthma and respiratory care with the latest updates and best practice. The conference will be delivered by key experts and will also provide an excellent networking opportunity. For further information email, call 0141 201 0674 or visit the website.
University funding
Last month, the Scottish Medical Students Committee and Scottish Medical Academic Staff Committee highlighted the growing fiscal pressure faced by universities at a time when medical student numbers are planned to increase in Scotland and medical academic staff numbers are falling. In a letter published in Scottish newspapers, they argued for an increase in funding invested in Scottish universities, but underlined that fees from students are not the answer to Scotland’s university funding crisis.
They called on the Scottish Executive, in its budget review later this year, to consider that English universities are benefiting from extra funding from top-up fees and that Scotland cannot afford to loose its reputation as a provider of world-class education.
Royal Medial benevolent fund
The Royal Medical Benevolent Fund is requesting applications for the Tod Endowment Trust which provides financial help for members of the medical profession, their spouses, partners and dependents who are in need of rest and recuperation in Scotland. Beneficiaries must have been in medical practice for a minimum of two years in Scotland. Widows, widowers and their dependents, who are financially eligible, can apply. If you know of anyone who may benefit form this Trust, please email or call 0208 540 9194.
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