Saturday, 26 September 2015

Junior Doctors deserve better from the government



So here we are. Junior doctors across England are to be balloted by the BMA (the doctors union if you like) over potential industrial action in response to the Government’s plans to impose a new contract on junior doctors from August 2016.  So how did we get here? Let us be clear. This isn't simply about pay.  It is also about patient safety.

Last month the BMA’s UK junior doctors committee rejected the Government’s attempts to force through a new contract over fears for patient and doctor safety, and opted not to re-enter contract negotiations. The decision was made after it became clear that junior doctors would not be able to negotiate over proposals the BMA believes are unsafe for patients, unfair to doctors and undermine the future of the NHS.

The BMA say it has always wanted to reach agreement on a new contract that protects patient safety and doctors’ wellbeing, but rather than work with junior doctors to address their concerns the government has confirmed that it will impose a new contract on doctors in training from August 2016. The Department of Health has it will look to introduce a new contract by August 2016 for new junior doctors and new appointees when they move to new positions but remain as junior doctors. NHS Employers will continue work to prepare a new contract for August 2016.  They say they will impose this new contract whilst calling on the BMA to negotiate.  

In order to re-enter negotiations, the junior doctor committee is demanding that the Government and NHS Employers withdraw their threat to impose a new contract, and that they provide the following concrete assurances: 

  • proper recognition of antisocial hours as premium time
  • no disadvantage for those working antisocial hours compared to the current system
  • no disadvantage for those working less than full time and taking parental leave compared to the current system3
  • pay for all work done
  • proper hours safeguards protecting patients and their doctors4

Commenting on the decision, the newly elected chair of the BMA’s UK junior doctors committee, Dr Johann Malawana, said:

“Today’s decision is a reflection of the anger felt by the thousands of junior doctors who have told us that the Government’s position is not acceptable.

“The BMA has been clear that it wants to deliver a contract that protects patient safety and is fair to both junior doctors and the health service as a whole. We can only do this if the government is prepared to work collaboratively in a genuine negotiation. Unfortunately, they have chosen to ride roughshod over the concerns of doctors with their threat of imposition.

“Instead of proper negotiations, the Government has insisted that junior doctors accept recommendations made by the DDRB without question. This would not allow the BMA to negotiate over proposals we believe are unsafe for patients, unfair for doctors and undermine the future of the NHS.

“The contract they want to impose will remove vital protections on safe working patterns, devalues evening and weekend work, and make specialties such as emergency medicine and general practice less attractive even though the NHS is already struggling to recruit and retain doctors to these areas of medicine.

“We remain committed to agreeing a contract that protects against junior doctors routinely working long hours, delivers a fair system of pay and does not disadvantage those in flexible working and we will not stand idly by as the Government imposes a contract which undermines that.

“We’ve already seen reports of high numbers of doctors considering leaving the NHS to work abroad6. These figures should serve as a serious wake-up call to the Government that there is a real risk that junior doctors will speak with their feet. To lose a large swathe of doctors in the early stages of their careers would be a disaster for the NHS.

“We have been clear. Junior doctors are not prepared to agree contract changes that would risk patient safety and doctors’ wellbeing. This has been our position all along and in the absence of any attempts by the Government to address our concerns remains our position today.”

The government has picked an unnecessary fight with junior doctors.  The call on the BMA to negotiate and yet hold a gun to their heads.

Saturday, 19 September 2015

Foolish to write off Jeremy Corbyn

As I mentioned in my last article, I did not support Jeremy Corbyn for the leadership of the Labour Party, but Jeremy Corbyn has already shaken the political establishment. He may not look like a Prime Minister in waiting, but he may change the face of British politics for the better - substance and passion may win out over spin.

He has an uphill task made more difficult by a hostile press and a puzzled media.  Here is a bloke who answers questions with some degree of sincerity.  When he doesn't know, he disarmingly says so. He has none of the slickness of the political elite. He is rough and ready in sound and appearance. Somehow, the political establishment have found themselves with an outsider.  Already they are writing him off, but I detect a bit of hedge betting.  Even the gainsayers have a niggling question - is he for real? The answer, of course, is yes.

Politics in Britain hasn't encountered a conviction politician at the helm of a major party since Margaret Thatcher.  It is worth remembering that Margaret Thatcher was rarely popular - more admired than liked by voters.  She won three general elections almost in spite of her own unpopularity.  In 1979 she had been consistently less popular than Prime Minister James Callaghan, yet her party won the election that year.

My feeling then is that Labour should not worry at this stage about a popularity contest with Prime Minister Cameron.  Leaders of the opposition rarely look 'like a Prime Minister in waiting' as the pollsters like to put it. How could they? What does a Prime Minister look like? Well, he/she looks like somebody who is prime minister.  Little wonder then that Leaders of the Opposition, unless they have been Prime Minister, are rarely judged to look Prime-ministerial.  The more this would be so for someone who bucks the trend and looks decidedly anti-establishment such as Jeremy Corbyn. No, he won't win on that kind of popularity contest. So what is the prospect?

The prospect for Labour depends I think on three things.  The first is whether  he can change the narrative of British politics.  The second is events.  For the first he can at least have a good try, and has made some progress in his first week.  The second he has little control over.  The third is party unity. He needs to develop a consensual approach which does not simply look weak. He will have to give up some of his positions to build that consensus.  His trick must be to do so without losing his unique strength.

I have warmed to Jeremy Corbyn. He appears to many as a genuinely nice bloke.  In these troubled times of politics that may be his greatest asset.  Just as many underestimated his ability to become leader of his party, so many might underestimate his resolve and strength of character to lead his party.  They would be advised to give him time and support.

The canvas of British politics has changed substantially since the financial crisis. A new picture is emerging. It would be foolish to write off Jeremy Corbyn.

Friday, 18 September 2015

Storm in a tea cup?

Regular readers will know that I did not support Jeremy Corbyn in the Labour leadership elections. I said he appealed to my heart but not my head. Since then he has won a handsome victory.  The media say his start has been chaotic.  It is difficult to see how it could have been different.

Of course he could have sung the national anthem and not given ammunition to the right wing press.  My advice would have been to have sung it, but it raises an important issue. Do we really judge that those who would wish not to sing the anthem are being unpatriotic? I cannot see the logic of that.

I am not strongly republican, but nor am I a monarchist. I live with the constitutional monarchy but with little enthusiasm for it.  Of course it works - or at least it seems to work.  It works so long as we don't question it too much.  When we do that we open a can of worms. So best keep a lid on it. The truth is that it is part of a system that maintains the privilege of a few. Now I don't expect you all to agree with that even though I said it was the truth.  Some don't mind that it maintains such privilege.

It works so long as we have leading politicians whose opinions cannot contradict it. Jeremy Corbyn is a republican - or at least that is what we are told.  He like me probably doesn't regard it as the most burning issue at this time.  Nevertheless it is an issue.  It is an issue most leading politicians don't like to address.  It isn't just a question of whether we have the monarchy.  It is a question of how we reconcile that with our democracy.

A democracy cannot be founded on the idea that we must all behave as monarchists.  It cannot be founded on the idea that all leading politicians should sing an anthem the words of which pledge allegiance to the monarch.  This would rule out any republican being a leader of a main political party. That would not be democratic.

But it gets worse.  The media have questioned whether Jeremy Corbyn will kneel to the Queen when he is made a member of the Privy Council.  It is widely accepted that the leader of the opposition should be a member of the Privy Council, although it is possible for Jeremy Corbyn to turn down an invitation to join.

It is said that the benefit of being a member of the Privy Council is that it enables the leader of the opposition to be consulted on matters of security.  It is a compelling reason.  But even more compelling would be the argument that the leader of the opposition should be so consulted regardless of whether  he or she is a Privy Councillor.  He should be so consulted because he IS leader of the opposition.

Jeremy Corbyn has now indicated that he will be singing the national anthem in future. That at least should put the matter to bed.  It is all a bit of a storm in a tea cup. But we should not ignore the fundamental questions it raises about our democracy.

Parents back calls for all UK academies and free schools to meet same healthy food standards as state schools



As children across the UK settle back into school, a new online survey from the BMA reveals that the majority of parents (77 per cent) back calls to ensure food served at academies and free schools meets the same healthy standard as other state schools.

Despite strict food regulations for local authority schools in England, more than 3,500 academies and 200 free schools do not have to meet the same standards, raising concerns that children in these schools are more likely to be served poorer quality food.

In the survey of 2,000 parents of children aged four to 16 across the UK, eight out of 10 (79 per cent) also support calls for a free, daily piece of fruit or vegetable to be provided to UK school children up to the age of 114.

This comes amid accusations of a government U-turn over plans to tackle obesity, and as the government cuts another £200 million from the public health budget which will undermine efforts to protect and improve the nation’s health and wellbeing.

The survey follows the recent publication of the BMA’s ‘Food for Thought’5 report , which also included recommendations to prohibit the marketing of unhealthy food and drink in schools, and called for local authorities to work with schools to promote healthier diets.

Commenting on the findings, Professor Sheila Hollins, BMA board of science chair, said:

“Doctors are increasingly concerned about the impact of poor diet; a significant cause of ill health, leading to around 70,000 deaths annually and costing the NHS £6 billion every year.

“It’s incredibly concerning that a third of UK children leave primary school overweight or obese. Eating a balanced, healthy school meal helps pupils to learn, improves their academic performance, and uses the closed school environment to promote healthy behaviours in young people.

“Worryingly, other research suggests that pupils in academy schools may be consuming significantly higher levels of fat, calories and saturated fatty acids, compared to those at other state schools, highlighting the importance of a whole-school approach to promoting healthy diets, with food standards an important aspect of this.

"We also know that the majority of people in the UK, particularly low income households, are not consuming enough fruit and vegetables, so providing them free to primary school children across the UK is an important way to support healthier diets.”