BMA Scotland newsletter
August 2007
Dear Colleagues
Welcome to this edition of the BMA Scotland newsletter. In just one week’s time junior doctors, who have spent the last 10 months living amid the chaos caused by the online medical training application system, will begin their new rotations. For these doctors it will be a challenging start to their specialty training, in surroundings and posts unfamiliar to them. We must ensure that as they continue on their path to a career in medicine, we encourage and foster their skills, preparing them for the challenges of working in the NHS.
It is also a challenging time for Staff and Associate Specialists. These doctors are the only NHS staff group not yet working under reformed terms and conditions of service. UK-wide negotiations concluded last year but it cannot go to ballot until bureaucrats at Westminster approve the detail.
Meanwhile the SNP is settling into government. While it is still early days, I have been heartened by indications from the Cabinet Secretary for Health, Nicola Sturgeon, that she is determined to make decisions based upon what is best for Scotland’s NHS. In that regard, we share a common goal.
Dr Peter Terry
Chairman of BMA Scotland
- Staff and Associate Specialists - contract negotiations update
- Abolition of graduate endowment
- Modernising Medical Careers update
- GP earnings
- New agreement with the Scottish Ambulance Service for GP urgent requests
- BMA Scotland gives evidence to the Tooke Review
- Support your local division
- Scottish Cervical Call Recall System
- Distinction awards and discretionary points
- Presumed consent for organ donation
- Bringing the BMA to you
- Specialist financial advice for BMA members
- Judicial review of GP pensions
- Purchase age for cigarettes raised to 18
- NHS Pension Schemes review
- GMC and SPSO Memorandum
- ARM 2007
- Events
This month BMA leaders, including Dr Sally Winning, Chair of the BMA Scotland’s Staff and Associate Specialists Committee (SSASC), paid a visit to Downing Street to call on the Government to approve the staff and associate specialist (SAS) contract immediately so that the BMA can proceed to a ballot and let its constituents have their say without further delay. They delivered a petition with nearly 4,500 signatures to Prime Minister Gordon Brown to demonstrate the strength of feeling on the issue.
Seven months after the contract was submitted for governmental approval it is still awaiting authorisation and doctors and dentists are becoming increasingly demoralised and demotivated.
SSASC has also recognised that there is a need to clearly identify the position of its constituents in Scotland on the proposed contract in order to represent them fully and accurately. The BMA has agreed to allow a Scottish count when and if a UK-wide ballot is held on a new contract for SAS doctors.
SASC (UK) held an extraordinary meeting on 27 July to consider alternative options in the absence of any further progress on the proposed new contract. More information will be posted on the website as soon as it becomes available. Regular updates are available here.
Abolition of graduate endowment
Fulfilling an election promise, Education Secretary Fiona Hyslop last month confirmed the Scottish Executive’s intention to abolish the graduate endowment fee currently paid by graduates in Scotland. The move is estimated to apply to fifty thousand current students, including those graduating this year.
The BMA in Scotland welcomed the announcement as a means of reducing the burden of debt on students in Scotland. The BMA wants to see the removal of financial barriers such as these so that people from all sections of society, who have the ability, can study medicine.
The BMA’s Scottish Medical Students Committee is also calling for an independent review of higher education funding, with full student representation, to ensure that Scotland’s universities are appropriately funded to compete with universities in the rest of the UK and farther afield.
A consultation on the graduate endowment proposal is scheduled to take place over the summer prior to legislation being introduced to Parliament in the autumn.
Modernising Medical Careers update
Cabinet Secretary for Health and Wellbeing Nicola Sturgeon announced last month that junior doctors in Scotland who are without an offer of continued training from August 1 will have their contracts extended until 31October 2007.
She committed to ensuring that the terms being offered to junior doctors in Scotland will be consistent with those in England and to undertaking a further review of the situation towards the end of round two of the recruitment process in England. This review will consider what further measures might be needed to support doctors in Scottish training programmes who, at that stage, remain without an offer of a training post.
NHS Education for Scotland (NES) centrally ceased offering run through and FTSTA posts on 6 July. Deaneries are now coordinating any further recruitment into FTSTA posts, as well as assisting NHS Boards in identifying potential candidates for other roles. Candidates eligible for support had to register with their deanery by 15 July in order to access the support arrangements. NES and NHS Boards are advising applicants of relevant employment opportunities in Scotland and across the rest of the UK, and deanery staff are in regular contact with all eligible candidates who have registered to provide them with career advice and support. Posts will be offered as locum appointment service (LAS) posts for up to 3 months. These posts should be managed within educationally approved programmes and will be provided with the same support as other training posts. The specific role that individual doctors will undertake will depend on their competence and experience, and on service needs. Doctors may therefore need to work in different (but related) specialty areas. Further information regarding the eligibility criteria and support arrangements is available via a link from the MMC Scotland homepage.
GP earnings
GPs in Scotland are earning less on average than GPs in any other part of the UK according to figures published by the Department of Health this month. The average income for a GP in Scotland was £82.696, whereas average earnings for GPs in England, Wales and Northern Ireland were £103,564, £91,588 and £91,151 respectively.
Dr Dean Marshall, chairman of the BMA’s Scottish General Practitioners Committee, said he was disappointed that the historic earnings gap between Scotland and England had not narrowed. He added:
“GPs across the UK have achieved a well earned increase in income as a result of the new investment that accompanied the new contract. The new GMS contract was designed to redress decades of disinvestment in general practice, aid recruitment and retention of GPs, improve outcomes for patients and provide investment in primary care services to deliver more services closer to patients’ homes. If the earnings gap between Scotland and the rest of the UK is not addressed as a matter of urgency, then it is unlikely that Scotland will be able to recruit and retain the GPs it needs.”
More information on GP earnings is available here.
New agreement with the Scottish Ambulance Service for GP urgent requests
On 1 May 2007, a new agreement came into effect to improve the effectiveness of ambulance services provided to General Practitioners who request hospital admission for their patients. The agreement follows concerns raised by the Scottish General Practitioners Committee (SGPC) with the Scottish Ambulance Service (SAS) that there were unacceptable delays in the provision of this service as a result of the Ambulance Service struggling to meet demand.
The arrangements for the provision of this service have now been significantly revised to reflect the clinical need of the individual patient as assessed by their GP and sets out time factor options available to GPs for urgent ambulance requests. All GPs should have received a letter from the Scottish Ambulance Service detailing the revisions. If you have not received this letter, please email.
BMA Scotland gives evidence to the Tooke Review
Last month, BMA Scotland submitted its evidence to the independent inquiry into Modernising Medical Careers (the Tooke Review).
In its submission, BMA Scotland re-stated its criticisms of the way in which the system has been implemented and outlined potential improvements for the future recruitment and selection process. Whilst restating its support for the founding principles of MMC - to improve and streamline medical training - the evidence pointed to the fact that “the version of MMC currently being implemented bears little resemblance to the original proposals”, leaving many junior doctors facing an uncertain future.
Application process to be CV based and recruitment to include structured interviews with structured, honest, justifiable and accurate references.
Application process to start earlier to allow unsuccessful applicants time to plan for the future.
BMA Scotland’s evidence to the Tooke Review is available online.
The Scottish Junior Doctors Committee (SJDC) will be seeking the views of junior doctors in Scotland on what they want the future recruitment and selection process for specialty training to look like, drawing from their own experience. This survey will be used to inform SJDC policy. If you do not receive a copy, please email.
Support your local division
BMA Scotland is encouraging its members to come forward and get involved in the work of local divisions across Scotland.
Divisions provide an opportunity for members to discuss the issues which impact upon all branches of practice, as well as debate local matters with other members in their area. The divisions also provide a mechanism through which members can discuss and contribute towards BMA policy.
BMA Scotland is intending to host an event with the divisional chairs and honorary secretaries in the autumn where colleagues can gain peer support and learn how to promote a successful and healthy division. Details will be available soon.
If you are interested in taking up a rewarding role in your division, or perhaps you know someone who could take on this role on behalf of fellow members, please do not hesitate to contact BMA Scotland. The BMA is keen to ensure that it is best able to promote “cross-craft” local representation that reflects doctors’ changing lifestyles. The autumn meeting is sure to generate some ideas but, in the meantime, the BMA would welcome ideas and suggestions from readers on how to achieve this. These can be sent by email to Donald Harley.
Scottish Cervical Call Recall System
The Scottish Cervical Call Recall System went live in Scotland in May, despite a number of concerns raised by the Scottish General Practitioner’s Committee about its fitness for purpose. Implementation has been dogged by errors and problems which have included breaches of patient confidentiality and lack of GP access to their patient’s results. Most worryingly, 21 women in Ayrshire and Arran will need to have their smears repeated because a local laboratory refused to store samples during the introductory phase of the new system. SGPC has met with the Scottish Executive to make representations on behalf of Scottish general practice to demand reassurances that implementation issues have been addressed and resolved, and to insist that paper requests and results are available to all GP practices.
Distinction awards and discretionary points
The national group tasked with reviewing the Distinction Awards and Discretionary Points schemes in Scotland is now aiming to conclude its initial work by October 2007, marking a considerable delay from the original timetable. Since the election of the new administration in Scotland, there has been no indication how the Cabinet Secretary for Health and Wellbeing will react to the eventual recommendations from the Review Group.
The Scottish Advisory Committee on Distinction Awards has requested SCC representation on the Project Board that will oversee the development of an electronic application process for awards.
Presumed consent for organ donation
This month, to mark the launch of National Transplant Week 2007, BMA Scotland renewed its call for a public debate on the need for a system of presumed consent for organ donation. The CMMO in England and Wales, Sir Liam Donaldson, also announced his support for a review of the current system.
The BMA believes that the time is right to consider a review of the current organ donation system and look at new ways to improve donation rates. With waiting lists for organs at an all time high and with the gap between the number of organs available and the number of people needing a transplant showing no sign of narrowing, the BMA is calling on the Scottish Executive to assess the level of support for such a policy.
Surveys have shown that 90% of the population supports organ donation, yet only 23% have signed up to the organ donor register. The BMA believes that it is unacceptable to reject presumed consent without at least making a clear effort to determine what the public’s opinion is on this matter.
The move has been supported by George Foulkes MSP, who is considering introducing a member’s bill to Parliament.
Bringing the BMA to you
BMA Scotland held its first BMA Day event at Glasgow's Southern General Hospital last month in an effort to bring the skills and expertise of the BMA to doctors and to promote the benefits of membership. A team of experts was available to discuss subjects such as employment rights, ethics, public affairs, pensions and specialist financial advice. A varied programme of talks and discussions included contributions from the new chair of the Representative Body, Peter Bennie; the deputy chair of SJDC, Alan Robertson; and Jennifer Devine from SSASC.
BMA deputy Scottish Secretary Donald Harley, who attended the event, said: "The Association is only as strong as its membership and the event was a vital part of the BMA’s strategy of reaching out to, and engaging with, members, as well as finding out what their priorities are." Many of those who attended the event were kind enough to complete feedback forms. As well as providing vital information one form was drawn ‘out of the hat’ to receive £50 of Marks and Spencer vouchers. The winner was Dr Beatrice Bound.
The next BMA Day will be held in Aberdeen in Autumn. Details will be available soon.
Specialist financial advice for BMA members
BMA Services, the independent financial advisory service, is currently offering presentations to BMA members on a range of issues such as NHS Pension scheme consultation, retirement planning and inheritance tax planning.
If you feel your team/staff/members would benefit from a presentation on a specialist financial issue, whether on a formal or informal basis, then please do not hesitate to contact BMAS.
Judicial review of GP pensions
The BMA has been granted a Judicial Review of former Secretary of State for Health Patricia Hewitt’s decision to cap the dynamising factor for GP pensions despite agreement in the new GP contract on how pensions would be calculated. The capping of GP pensions will affect all GPs in the UK, especially those who recently have retired.
GPs have shown considerable discontent with the capping of their pensions because the government has effectively broken their agreement. The General Practitioners Committee is pleased that courts have allowed the challenge. It is expected that the judicial review will be fairly protracted and it seems that it will not conclude before the end of the year.
Purchase age for cigarettes raised to 18
Following the successful implementation of the smoking ban in Scotland, BMA Scotland is delighted that the Scottish Executive has announced plans to raise the purchase age of tobacco to 18 from 1 October 2007. Research shows that most smokers begin in adolescence and that the younger someone starts smoking, the less likely they are to give up. The BMA has been calling for this move for several years in order to decrease the number of young people smoking in Scotland by reducing the availability of cigarettes.
NHS Pension Schemes review
The ongoing reviews of NHS pensions across the UK are expected to reach a conclusion over the summer with Ministers looking to agree proposals for changes to the existing schemes and new schemes being introduced for new NHS employees.
Detailed work will then begin on implementing the changes and doctors will receive regular communications from the review partners during the coming months. The BMA pension department will be revising existing fact sheets and introducing new guidance. BMA members can access further updates on the website.
GMC and SPSO Memorandum
The General Medical Council (GMC) and the Scottish Public Services Ombudsman (SPSO) have taken a step forward in co-ordinating investigations into complaints about doctors by signing a Memorandum of Understanding on co-operation at GMC Scotland’s offices in Edinburgh. As the regulator of the medical profession the GMC’s role includes dealing with doctors whose fitness to practise is in doubt. The SPSO investigates complaints about public services where a complainant is not satisfied with the outcome of an internal investigation by that service. This includes the NHS.
The Memorandum of Understanding commits both organisations to co-operate around the investigation of complaints. It formalises the current arrangements where, if the GMC or the SPSO gains information which may assist in, or trigger, an investigation by the other, then that information is shared accordingly.
The MoU also commits the GMC and SPSO to share information on trends and issues in casework around complaints about doctors and to collaborate on informing other organisations about their work.
ARM 2007
Day by day reports from ARM2007 and a full list of all resolutions passed at conference, are available online.
Doctors from all branches of medicine across the country attended the BMA’s annual representative meeting in Torquay last month. With more than 800 motions on the agenda, the four-day conference provided a forum for a wide range of debates on a variety of subjects.
Reform
Topping the agenda and opening the conference this year was a debate on the reform of the NHS in England. Doctors voiced their dissatisfaction with the programme of reform underway south of the border and considered the BMA’s alternative “Rational Way Forward for the NHS in England”. Dr Peter Terry, Chair of Scottish Council, said: “While this debate doesn’t directly affect us here in Scotland, it should sound a very loud warning bell to Scottish politicians about the merits of involving the profession in the design and delivery of health service reform.”
The BMA’s report “A Rational Way Forward for the NHS in England” is available online.
Doctors under attack
Delivering the opening speech to conference, Sam Everington, then acting chairman, called on Prime Minister Gordon Brown to make a new start with doctors. He said:
“Doctors feel under attack, the government wants to turn everything into something that has just a monetary value. Vocation, dedication and lifetime commitment to patients and the NHS has little value in this new world – we are just financial commodities...”
He urged the incoming Prime Minister to listen to doctors:
“Not because we are doctors but because we have given a lifetime of service to patients in the NHS – we are their champions.”
He concluded: “The NHS is a fantastic idea, enormous sums of money have been put into it yet it faces one of the most serious crises in years with doctors and managers wondering whether it can survive with its present ethos beyond 2008… Everything we want to achieve in the next year will depend on us working and fighting together for a better future for our doctors and patients.”
The full text of Dr Everington’s speech is available online.
BMA’s action plan on alcohol generates widespread support in Scotland
On the eve of the Annual Conference, BMA Scotland published a 5 Point Plan to tackle Scotland’s alcohol problem. This proposal received widespread coverage in the Scottish and national press and was welcomed by doctors and politicians across the country.
BMA Scotland’s plan outlined five practical measures that could be taken by the Scottish Executive as part of a wider alcohol strategy, these were:
1. Utilise the legislative capabilities of the 2005 Licensing (Scotland) Act to end deep discounting of alcohol for sale in off licences, supermarkets and other off sales outlets.
2. Undertake research into the measures by which pricing mechanisms can be used in Scotland to discourage heavy consumption of high alcohol products.
3. End alcohol producers’ sponsorship of sporting and entertainment events with a young target audience.
4. Legislate for alcohol labelling rather than relying on voluntary agreements with the drinks industry.
5. Reduce the drink driving limit from 80mg to 50mg and introduce Random Breath Testing in Scotland.
Announcing the plan, Dr Peter Terry, chairman of the BMA in Scotland, said:
“The death toll from alcohol misuse is completely unacceptable and the government must take action. Our action plan sets out a range of measures that the Scottish Executive can take forward as part of a wider strategy.
“After smoking, alcohol is next big public health priority and I want Scottish Ministers to work with doctors to end Scotland’s drink problem.”
Detailed information on the BMA Scotland Alcohol Action Plan can be found online.
Devolution a reality that BMA must address
During his speech to the Annual Conference, Dr Peter Terry warned that the BMA should recognise devolution and the changing needs of doctors in the four nations of the UK. With different governments in power in Holyrood and Westminster it was likely that the NHS in the four countries would become increasingly divergent.
Dr Terry welcomed the new SNP government and called on the Scottish Executive to work with the medical profession. He also expressed support for some of the recent announcements made by Health Secretary, Nicola Sturgeon, particularly her commitment to do what is best for Scotland. He said:
“We very much welcome Nicola Sturgeon’s recent announcement that the Scottish Executive would oppose private sector competition within the NHS and her recognition that this destabilises local services and fails to improve health care.”
Dr Terry also urged the SNP government not to veer away from the long term strategy for health, which was introduced in 2005. He said:
“I would, however, urge our new government to follow the carefully developed long-term strategic plan known as ‘the Kerr Report’ which has widespread support. To selectively deconstruct any part of this plan will return us to ad-hoc, non-strategic, short term expediency – a situation in which we all lose.”
The full text of Dr Terry’s speech is available online.
Public support for BMA reform proposals in England
The BMA published findings from a survey of patients which found widespread support for the BMA’s rational way forward for the NHS in England.
Some of the key findings from the survey include:
- Three out of five respondents (60%) agreed that the NHS should be run by an independent board of governors, accountable to Parliament.
- Seven out of ten respondents [70%] said that decisions about local health services should by made by bodies elected by the local population.
- Over eight out of ten respondents (82%) agree that doctors should have a major role in deciding how money is spent in the NHS locally and what is best for their patients.
- Nine out of ten respondents (93%) believe the NHS should continue to be funded from UK taxes and remain free at the point of use, BUT when asked whether a small charge should be made for some services where resources are limited, just over half (53%) agreed that this should be the case.
- Two-Thirds (66%) said that private companies should provide care only when there is an identified need or gap.
New Chairman of BMA Council
Dr Hamish Meldrum, a GP from East Yorkshire, has been elected chairman of the BMA Council. Dr Meldrum, who has been chairman of the BMA’s GPs Committee since 2004, was elected in a three-way contest at a meeting of the BMA Council, following the Association’s annual meeting in Torquay. He will now stand down as the GPC Chairman.
ARM in brief
Doctors rejected calls for childhood obesity to be considered a child protection issue.
Doctors voted in favour of a review of the 1967 Abortion Act and supported calls to remove the need for two doctors’ signatures to authorise early abortions.
Staff and associate specialist doctors warned they will seek an alternative way forward on pay and working conditions if the Treasury does not release their proposed new contract for ballot in July.
Doctors condemned discrimination against women academics, who earn five per cent less than their male colleagues. Fewer than 10 per cent of medical professors are women and some universities have none.
Doctors agreed that students on electives where HIV/Aids are endemic should be given drugs by their medical schools to protect them after needle-stick injuries.
Events
Festival Art at the BMA
Date: Saturday 4 – Saturday 25 August (open Tuesday to Saturday 1200 – 1800hrs, closed Friday 10 August, open 1430 – 1800hrs on 22 August)
Venue: BMA Scotland Office
As part of the Edinburgh Fringe Festival, the Strathearn Gallery is returning to the BMA Scotland office this summer to host an exhibition of contemporary art.
Seminar - Becoming a Consultant
Date: Tuesday 6 November 2007
Venue: BMA Scotland Office
This half day seminar, aimed at SpRs who are looking to take the next step in their career, will offer advice on negotiating the contract, job planning, financial considerations and pensions advice.
Cost £20 for BMA members £35 for non members (including VAT). To request a registration form please contact Gillian Fordyce by email.
Physician Assisted Suicide – a good death?
Date: Wednesday 3 October 2007
Venue: Royal College of Physicians of Edinburgh, 9 Queen Street, Edinburgh
Some of the most poignant stories in the media are from people with terminal illness who do not want to continue living and appeal for help to those whose vocation is to save life. How do health professionals cope with this dilemma? In some countries, it is legal for doctors to assist a person to commit suicide and there are calls for the law to be changed in the UK. How do we hold together the difficult knowledge we have about life-threatening disease, the better understanding we have about palliative care, our hesitancy in speaking about death and a ‘rights culture’ where people want to be in control of their lives? What is a good death today?
The College invites you to consider this important and solemn question in the company of physicians, lawyers, ethicists and people for whom this is a very personal issue.
Full details of the programme and registration form can be obtained from the RCPE website.
Further details available from: Margaret Farquhar, Symposium Co-ordinator Royal College of Physicians of Edinburgh, 9 Queen Street, Edinburgh, EH2 1JQ Tel: 0131 247 3636, or by email.
Obesity and the Prevention of Coronary Heart Disease - A One Day Conference
Date: Thursday 13 September 2007
Venue: Hilton Coylumbridge, Aviemore
This conference, organised by the University of Glasgow, will feature experts from Scotland and the UK talking about the latest research in the field of obesity and coronary heart disease. Gain practical advice on how you as a professional can influence the disease rates and change the attitudes of general public. To book please telephone 0141 201 9353/9264 or go online here.
Scottish Health Awards 2007
The Scottish Executive is calling for nominations for ‘healing heroes’ for the Scottish Health Awards 2007. The awards recognise and reward Scotland’s most caring and committed NHS workers who dedicate their time and care above and beyond expectations. There are 16 award categories aimed at representing all NHS workers across Scotland.
Nominations will be accepted until 14 September 2007. If you would like to nominate someone you know or would like further information on the awards, please contact the Public Affairs Office.
The Awards ceremony will be held at the Corn Exchange, Edinburgh on 8 November 2007.
BMJ Masterclasses
Leading experts at BMJ Masterclasses will give you an overview of the latest evidence, highlight the crucial aspects of recent guidelines and give you the tools to put them into practice. Register today to stay at the forefront of clinical practice using the latest evidence confidently to make better decisions.
BMJ Masterclass for GPs: General Update
Friday 8 June 2007, International Convention Centre, Birmingham SOLD OUT
Monday and Tuesday 17-18 September 2007, New Connaught Rooms, London new 2 day programme
Tuesday and Wednesday 30-31 October 2007, The University of Manchester Conference Centre, Manchester new 2 day programme
Further information is available online.
BMJ Masterclass for GPs: Paediatrics & Women's Health
Wednesday 12 September 2007, International Convention Centre, Birmingham
Further information is available online.
BMJ Masterclass for GPs: Cardiology & Diabetes
Tuesday 2 October 2007, New Connaught Rooms, London new programme
Thursday 6 December 2007, The University of Manchester Conference Centre, Manchester new programme
Further information is available online.
BMJ Masterclass for GPs: Mental Health
Monday 1 October 2007, Royal College of Physicians, London
Wednesday 5 December 2007, The University of Manchester Conference Centre, Manchester
Further information is available online.
BMJ Masterclass for Physicians: Neurology
Thursday 27 September 2007, Goodenough College, London
Tuesday 20 November 2007, The University of Manchester Conference Centre, Manchester
Further information is available online.
BMJ Masterclass in Paediatrics
Friday 28 September 2007, Goodenough College, London
Wednesday 21 November 2007, The University of Manchester Conference Centre, Manchester
Further information is available online.
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