Annual Representative Meeting 2004
Stories from the meeting
Wednesday 30 June
Copy supplied by the staff of BMA News
Tony Blair given a prescription to ban smoking in public places
Doctors had a prescription for prime minister Tony Blair this week – a prescription to improve the health of the nation by banning smoking in all enclosed public places.
The ARM overwhelmingly demanded that the UK follow the Republic of Ireland which banned smoking in all enclosed workplaces at the end of March on the same day that it emerged Labour was considering including a ban in its next election manifesto.
County Down consultant anaesthetist Peter Maguire produced a mailbag of letters from 4,500 doctors calling for such a ban in the last two weeks and signed a giant prescription for the government.
Milton Keynes GP Michael Cassidy said it was a simple move that would make a big difference.
Advert ban call to protect children's health
Junk food adverts aimed at young children must be banned, doctors have insisted.
The ARM agreed that such a move would be useful in the war against obesity.
BMA committee for public health medicine and community health chairman Peter Tiplady said the way the food industry targeted young children with adverts for high-fat, high-sugar and high-salt foods was ‘unwelcome, unjustifiable and absolutely unforgivable’.
Northampton consultant paediatrician Keith Brent backed the calls. He said he could tell the parents of overweight children what to do about diet but ‘how good do I look compared to Gary Lineker telling them to eat crisps?’
Liverpool senior house officer in paediatrics Andrew Rowland told of an 11-year-old patient who weighed 13 stones (85kgs) and could not walk from the waiting room to the consulting room without becoming breathless. He said: ‘We demand commercial food advertising is banned before it is too late.’
Over-the-counter drug addiction action call
Action needs to be taken to tackle the increasing problem of addiction to over-the-counter drugs, doctors have agreed.
The ARM heard how an estimated 30,000 people are currently addicted to an over-the-counter drug in the UK and the problem is set to worsen as a greater variety of OTC drugs become more widely available.
Edinburgh University medical student Jonathan Beavers said: ‘Many people assume that these drugs are safe because a prescription isn’t needed – this is not the case. The fact is that over-the-counter drugs such as painkillers, cough medicines and sleeping medication contain addictive substances such as codeine.’
Doctors agreed OTC medicines containing such substances should be clearly labelled and health professionals should have training on the issue.
Mr Beavers said people addicted to OTC medicines were treated alongside people addicted to illegal substances and clear clinical health departments guidelines on managing OTC drug dependent patients were needed.
Regulator must justify decisions, doctors agree
The new regulatory watchdog is demonstrating an anti-doctor agenda and must justify its decision-making processes for sending GMC decisions to the High Court, James Johnson has said.
The BMA council chairman was sharply critical of the Council for the Regulation of Healthcare Professionals in response to calls that the BMA should monitor the overarching body’s performance.
The CRHP has so far referred the GMC decisions relating to six doctors to the High Court and recently had its rights to challenge GMC not guilty verdicts confirmed by a legal ruling.
London consultant histopathologist Anne Thorpe said doctors faced double jeopardy and even if cleared by the GMC could be struck off by the High Court.
Mr Johnson said he had written to the CRHP asking what criteria they used in deciding to send decisions to the High Court and had been told that there were currently no guidelines, but they were being developed.
He said: ‘The behaviour of this body has been quite extraordinary. Without any guidance they are referring doctors to the High Court. It is national disgrace and we taxpayers are paying for it.
‘It is high time they did design some rules for themselves and we could see them.’
Urgent support call for sick doctors
Sick organisations create sick doctors and the culture of punishing ill health among the medical profession needs to change, doctors said.
West Drayton GP Anthony Grewal, who has been involved in supporting doctors in difficulty, said: ‘I’ve been disappointed to see how seamlessly primary care organisations move from a supportive role to a punitive role. You should treat the offer of support from PCOs in the same way you would treat the offer of fellatio from a crocodile.’
Bristol consultant psychiatrist Robin Arnold said that because of the increasing prevalence of multidisciplinary work, and collaborative work between trusts, doctors were less inclined to feel able to approach services in a neighbouring trusts.
Representative body chairman-elect Michael Wilks said the NHS was ‘not particularly good at looking after its own.’
He attacked the GMC for being ‘deficient’ and ‘discriminatory’ in the way it dealt with sick doctors. He said doctors were driven underground through fear of facing disciplinary procedures.
He said the BMA would argue with the GMC about how its procedures were undertaken but added that doctors themselves had to change. Doctors must start registering with GPs rather than taking part in ‘corridor consultations’, start sharing problems more with colleagues and make active choices about restoring work/life balance.
Government's medical training plans could endanger patient care, doctors warn
Government proposals to shorten medical training and introduce a generalist certificate of completion of training would effectively create a sub-consultant grade, produce ill-equipped doctors and endanger patient care, doctors said.
And in a further attack on the government’s training shake-up, Modernising Medical Careers, they expressed no confidence in its implementation.
They called on the BMA to seek to delay the implementation of foundation programmes, which would replace the pre-registration and first senior house officer year, until pilots have been properly evaluated and standards, assessment criteria and educational objectives have been defined and agreed.
While the programmes were welcomed as a potential improvement in the structure of training, there were deep concerns at the lack of explicit information for students who are already applying for them. Doctors called on the health departments and royal colleges to provide more information as a matter of urgency.
Under the government proposals, doctors would gain a ‘generalist’ CCT first before going onto higher specialist training.
Edinburgh consultant radiologist Maeve McPhillips said: ‘I am concerned about a reduction in the duration of training. I am concerned about the erosion of the high standards of specialist training. I am concerned that specialists will not be allowed to develop the required breadth of experience needed to deliver consistently high quality general care.’
Sheffield consultant physician Paul Anderson said it was clear that rather than increasing quality, the government’s paramount intention was to increase the number of doctors on the specialist register by shortening training. He said this would create a European-style ‘chef de service’ system and condemn doctors to carrying out very specialised tasks with no opportunity for career progression.
Cardiff consultant neurologist Trevor Pickersgill said: ‘Unless the direction of travel is changed and changed soon the quality of British medicine will be compromised and the course of thousands of careers will be blighted forever.’
Backing the concerns, BMA council chairman James Johnson said: ‘We are taking this extremely seriously, a lot of lobbying is being done and I can assure you we are making considerable progress. We are not going to have a dumbing down of the training of doctors in this country, it would be wholly unacceptable.’
News in brief