Annual Representative Meeting 2005
Agenda for Monday 27 June
STANDING ORDERS MONDAY 9.15 -9.50
1 Motion by THE CHAIRMAN: That the Standing Orders (Appendix I), be adopted as the Standing Orders of the Meeting.
2 Motion by THE CHAIRMAN: That the Standing Orders be amended as shown in appendix I.
PRECINCTS OF THE MEETING
3 Motion by THE CHAIRMAN: That for the purpose of Standing Order 76 the precincts of the Meeting be regarded as the whole of the Manchester International Convention Centre, Manchester.
RETURN OF REPRESENTATIVES
4 Motion by THE CHAIRMAN: That the return of election of Representatives for 2004-05 and members of Council (ARM 3 and 4) be received.
APOLOGIES FOR ABSENCE
5 Motion by THE CHAIRMAN: That apologies for absence from (a) Representatives and (b) members of Council be received, taken as read, and entered on the Minutes.
ELECTIONS
6 Motion by THE CHAIRMAN: That the timetable for elections to be carried out during the meeting, as set out in ARM 5, be approved.
REPORTS OF CRAFT COMMITTEES
7 Receive: Reports of the General Practitioners Committee, the Central Consultants and Specialists Committee, the Committee for Public Health Medicine and Community Health, the Junior Doctors Committee, the Medical Students Committee, the Medical Academic Staff Committee and the Staff and Associate Specialists Committee for the session 2004-05.
MINUTES
8 Confirm: Minutes of the Annual Representative meeting held on 28 June 2004 to 1 July 2004 (ARM 12, 2004).
REPORT OF THE AGENDA COMMITTEE
9 Receive: Report that in accordance with Standing Order 37, a ballot of Representatives will be held on the first morning of the ARM to enable them to choose motions, amendments or riders which should be given priority (“C” motions). A ballot paper has been circulated with the documents for the Meeting which should be returned to the enquiry desk in the entrance foyer by 12 noon on Monday 27 June 2005.
NB: Motions in the shaded area throughout the agenda are unlikely to be reached.
10 Receive: Report that the Committee has arranged in groups certain motions and amendments which cover substantially the same ground and has selected in each group one motion or amendment (marked with a star) on which it is proposed that discussion should take place. Motions or amendments prefixed “A” will be dealt with in accordance with Standing Orders 38 and 39.
11 REVISED ORDER OF BUSINESS
Motion by THE AGENDA COMMITTEE: That the business be taken in the order and at the times indicated below:
Monday 27 June 2005
9.15 am Formal business (Items 1-15)
9:50 am Introduction – Video
10.00 am Report by the Chairman of Council (Item 16)
10.20 am National Health Service
NHS Improvement Plan (Items 17-19)
10.30 am Private provision in primary care (Item LM4)
10:35 am Payment by results and independent sector treatment centres (Items 20-25)
10:45 am Patient choice and booking systems for NHS appointments (Items 26-30)
10:55 am Out-of-hours care (Items 31-32)
11:10 am Primary and secondary care (Items 33-48)
11:15 am Targets (Items 49-52)
11:30 am NICE (Items 53-55)
11:35 am Hospital cleanliness (Item 56)
11:45 am Other motions (Items 57-111)
12:05 pm Contingency time
12:15 pm Open debate - Overseas recruitment (Items 112-116)
12:45 pm Lunch
2:00 pm Training and Education (Item 117)
2:05 pm Undergraduate education (Items 118-128)
2:15 pm Undergraduate education - admissions (Items 129-133)
2:30 pm Financing undergraduate education (Items 134-136)
2:35 pm Modernising medical careers (Items 137-146)
2:55 pm Postgraduate Medical Education and Training Board (PMETB)
(Items 147-149)
3:05 pm Postgraduate training (Items 150-157)
3:15 pm Medical Students (Items 158-165)
3:25 pm Medical students’ finances (Items 166-173)
3:35 pm Medical Academic Staff (Items 174-178)
3:50 pm Consultants (Items 179-181)
4:10 pm Junior Hospital Doctors (Items 182-185)
4:25 pm Staff and Associate Specialist Doctors (Items 186-192)
4:45 pm Public Health Medicine and Community Health (Items 193-195)
4:55 pm General Practice (Items 196-199 and 236-237)
5:15 pm Contingency time
5:25 pm Q & A Chairman of Council
5:45 pm Session closes
Tuesday, 28 June 2005
9:00 am Professional Self Regulation
Council for Healthcare Regulatory Excellence (Items 200-201)
9:05 am General Medical Council (Items 202-224)
9:25 am Revalidation and appraisal (Items 225-232)
9:40 am Retired doctors (Item 233)
9:50 am British Medical Journal (Items 234-235)
10:00 am Science (Items 281-300)
10:25 am Medico-Legal Affairs (Items 301-304)
10:45 am Finances of the Association (Items 327-334)
11:00 am Secretary of State
12:00 pm Pensions (Items 305-308)
12:10 pm Pensions review (Items 309-312)
12:30 pm Q & A Treasurer
12:45 pm Lunch
2:00 pm Open debate - Assisted Dying (Items 314-326)
2:30 pm Private Practice (Items 335-337)
2:40 pm Structure and Function of the BMA (Items 338-349)
2:50 pm Council (Items 350-351)
3:10 pm Local representative structures (Items 352-356)
3:30 pm Annual Representative Meeting (Items 357-362)
4:00 pm Technical and enabling motions
4:15 pm Communications (Items 363-367)
4:30 pm Annual Report of Council (Items 368-371)
4:35 pm Representation of specific groups (Items 372-378)
4:50 pm Regional services (Items 379-381)
5:00 pm BMA staff (Item 382)
5:10 pm BMA services (Items 383-384)
5:15 pm Contingency time
5:25 pm Doctors’ Pay (Items 385-388)
5:40 pm Doctors’ Performance (Items 389-390)
5:45 pm Session closes
Wednesday, 29 June 2005
9:00 am Community Care (Items 464-471)
9:15 am Professional Fees (Items 392-397)
9:30 am Scotland (Items 398-403)
9:45 am Northern Ireland (Item 404)
9:50 am Wales (Item 405)
9:55 am Medical Ethics (Items 406-410)
10:20 am End of life issues (Items 411-420)
10:30 am Asylum and immigration (Items 421-427)
10:40 am Contingency time
10:45 am Medical Workforce (Items 428-443)
10:55 am European Working Time Directive (Items 444-445)
11:05 am Working conditions (Items 446-450)
11:20 am Child care (Items 451-453)
11:30 am Doctors’ health and morale (Items 454-458)
11:35 am Flexible training and working (Items 459-463)
11:45 am Contingency time
11:55 am Charities (Item 313)
12:00 pm Armed Forces (Item 391)
12:15 pm AGM
12:25 pm Health Information Management and Confidentiality of Personal Health Information (Item 472)
12:30 pm Open debate - Patient confidentiality (Items 473-489)
1:00 pm Session closes
Thursday, 30 June 2005
9:00 am Occupational Health (Items 490-499)
9:15 am International Affairs (Items 500-505)
9:30 am Overseas and refugee doctors (Items 506-510)
9:40 am International conflicts (Items 511-514)
9:50 am Open debate - Abortion Act (Items 515-519)
10:20 am Chosen Motions
10:50 am Contingency time
11:00 am Protecting and Improving Health (Items 238-251)
11:15 am Nutrition and health (Items 252-258)
11:25 am Drugs of addiction (Items 259-273)
11:45 am Cycling (Items 274-280)
11:50 am Contingency time
12:00 pm Motions arising from the ARM
12:40 pm Closing business
12:50 pm Approval of the Annual Report of Council (Item 520)
12.55 pm Provisional Approval of the Minutes (Item 521)
1:00 pm ARM ends
PRESIDENT 2006-07
12 Motion by THE CHAIRMAN OF COUNCIL: That Parveen Kumar CBE be elected President of the Association for 2006-07.
ARTICLES
13 Motion by THE CHAIRMAN OF THE ORGANISATION COMMITTEE: That the Representative Body approve the amendments to the Articles of the Association as set out in Appendix II to this agenda and commends them to the Annual General Meeting for approval.
BYE-LAWS
14 Motion by THE CHAIRMAN OF THE ORGANISATION COMMITTEE: That, subject to any amendments arising out of the decisions of the meeting, the bye-laws of the Association be amended in the manner shown in Appendix III to this agenda.
BMA POLICY
15 Motion by THE CHAIRMAN OF COUNCIL: That the Meeting approves the recommendations for policy passed in 2000 to be lapsed or retained as indicated on document ARM 1B.
REPORT BY CHAIRMAN OF COUNCIL MONDAY 10.00 – 10.20
16 Receive: Report by the Chairman of Council, James Johnson.
NATIONAL HEALTH SERVICE MONDAY 10.20 – 10.35
NHS Improvement Plan
* 17 Motion by THE AGENDA COMMITTEE: That this Meeting believes that:
(i) more emphasis should be placed on collaboration as opposed to competition in health care delivery;
(ii) the health service should be based on the NHS as the main provider of health care;
(iii) the new competitive market must not prejudice the NHS through any guaranteed flow of income to the private sector;
(iv) the BMA should join with other unions to campaign for the restoration of public and planned provision of the NHS as the only way to maintain a universal equitable health care system.
The above Agenda Committee composite motion will be proposed by Newcastle and North Tyneside LMC.
17a Motion by NEWCASTLE AND NORTH TYNESIDE LMC: That this Meeting believes:
(i) more emphasis should be placed on collaboration as opposed to competition in health care delivery;
(ii) the health service should be based on the NHS as the main provider of health care;
(iii) the new competitive market must not prejudice the NHS through any guaranteed flow of income to the private sector.
17b Motion by LONDON NORTH EAST RCSC: That this Meeting believes that the NHS Improvement Plan will end the public delivery and planned provision of healthcare in this country, through private sector involvement, payments by results, and conversion of all NHS hospitals to foundation trusts. The configuration of services will be decided by commercial interests not clinical needs, leading to the fragmentation of care and failure of NHS hospitals and GP services. We call on the BMA to oppose these developments and to join with other unions to campaign for the restoration of public and planned provision of the NHS as the only way to maintain a universal equitable healthcare system.
17c Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting opposes the NHS plans that will end the public delivery and planned provision of healthcare in the country through private sector involvement, payments by results and conversion of all NHS trusts to foundation trusts, and to join other unions to demand restoration of public planned provision of the NHS as the only way to maintain a universal equitable health care system.
17d Motion by EDGWARE AND HENDON DIVISION: That this Meeting reaffirms its support for an NHS provided by NHS providers driven by the ideals of a National Health Service, and demands that the government invests to provide such an infrastructure, rather than current policy to divert funds to the private sector.
17e Motion by BUCKINGHAMSHIRE DIVISION: That this Meeting believes that the government in long term will privatise the NHS.
17f Motion by BUCKINGHAMSHIRE LMC: That this Meeting believes this government will eventually privatise the NHS.
17g Motion by BARNET AND FINCHLEY DIVISION: That independent healthcare companies competing with well-planned NHS services under the bogus pretext of “patients choice” and “competition” will destroy the NHS, as successfully as the destruction of British Rail.
17h Motion by BRISTOL DIVISION: That this Meeting should call upon the Government to review its policies so that they can deliver stability and equity of services for all conditions wherever people live. The present stream of initiatives such as Payment by Results, Practice Based Commissioning, PFI and Choose & Book all form a confusing and often contradictory management environment which threatens to destabilise the National Health Service and enhance the marked disparity of services across the country.
17i Motion by EDGWARE AND HENDON DIVISION: That this Meeting is dismayed by the government’s commitment to the private sector as an end in itself, and demands:
(i) the removal of the arbitrary NHS Improvement Plan target of commissioning up to 15% of care from the private sector;
(ii) removing the compulsion to offer a private provider under the “Patient Choice” initiative.
17j Motion by EDGWARE AND HENDON DIVISION: That this Meeting affirms its support for an NHS provided by NHS providers driven by the ideals of a National Health Service, and deplores the government’s proposals to divert taxpayers funds into the private sector at the expense of NHS trusts.
The motions below are unlikely to be reached:
18 Motion by EDGWARE AND HENDON DIVISION: That this Meeting is dismayed that the government is intent on resurrecting the same “cancer of the internal market” it pledged to destroy when it took office in 1997.
19 Motion by BRISTOL DIVISION: That this Meeting believes that “plurality of provision”:
(i) is privatisation reframed;
(ii) threatens the structures in the NHS that maintain the stability of safe, integrated clinical services.
Payment by results and independent sector treatment centres MONDAY 10.35 – 10.45
* 20 Motion by THE AGENDA COMMITTEE: That the BMA should vigorously oppose Payment by Results because:
(i) low cost private treatment centres will cherry pick uncomplicated cases and leave more complex cases to comprehensive NHS hospitals;
(ii) NHS trusts are threatened by diverting funds to the private sector;
(iii) strategic planning of health services based on need will be undermined;
(iv) it will increase bureaucracy and management costs.
The above Agenda Committee composite motion will be proposed by Edgware and Hendon Division.
20a Motion by EDGWARE AND HENDON DIVISION: That this Meeting is deeply concerned that as currently proposed in the NHS Improvement Plan, Payment by Results will:
(i) result in fragmentation of the NHS with a system based on competition not co-operation;
(ii) threaten NHS trusts by diverting funds to the private sector;
(iii) undermine strategic planning of health services based on need;
(iv) increase tensions between primary and secondary care;
(v) focus on activity rather than quality;
(vi) increase bureaucracy and management costs.
20b Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting opposes the new funding system of payments by results whereby every healthcare procedure has a tariff and is bought and sold on the new market which makes the secondary care-providers compete with each other for contracts from PCTs which favours high productivity, low cost private treatment centres over comprehensive NHS hospitals and will drive the latter out of business.
20c Motion by ISLINGTON DIVISION: That this Meeting believes that the BMA should vigorously oppose “payment by results”, as it will lead to distortions in clinical case mix, with non NHS providers cherry picking uncomplicated cases and leaving the more complex cases to the NHS.
20d Motion by OXFORD DIVISION: That Council should take every opportunity of pointing out to government, and to the media, the folly of pursuing a policy of “Payment by Results” in the NHS.
20e Motion by THE CONFERENCE OF HONORARY SECRETARIES OF BMA DIVISIONS: That this Meeting believes that financial chaos will result if the Government introduces a system of payment by results (PbR) by April 2005.
20f Motion by EDGWARE AND HENDON DIVISION: That this Meeting believes that as currently proposed, Payment by Results will result in perverse incentives, threaten strategic planning of health services, and result in a health service driven by market forces rather than health needs.
20g Motion by EDGWARE AND HENDON DIVISION: That this Meeting is deeply concerned that in the operation of Payment by Results and the National Tariff, that there is no recognition of the extra remit of care and responsibilities of acute NHS providers compared to the private sector.
20h Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that the NHS could breakdown if ISTC’s were allowed to cherrypick patients requiring straightforward operations leaving NHS hospitals to deal with the more complicated problems.
20i Motion by CORNWALL AND ISLES OF SCILLY LMC: That this Meeting deplores the damaging long-terms effects upon acute trusts of the cherry-picking of "easy" cases by ISTC’s.
20j Motion by AVON LMC: That private hospitals or other third party providers, encouraged by government proposals to provide treatments in competition with NHS providers, shall do so on a level playing field and not be permitted to ‘cherry pick’ less complex or more profitable patient treatments.
*21 Motion by THE AGENDA COMMITTEE: That, with regard to independent sector treatment centres (ISTCs), this Meeting:
(i) demands a robust independent monitoring system to compare clinical outcomes from ISTCs and NHS establishments;
(ii) insists that the health departments must ensure that ISTCs will not be detrimental to the training and experience of junior doctors;
(iii) calls on the health departments to engage in meaningful discussion to enable this welcome increase in capacity to be planned into the needs of each health economy.
The above Agenda Committee composite motion will be proposed by West Berkshire Division.
21a Motion by WEST BERKSHIRE DIVISION: That this Meeting believes that the expansion of ISTC’s, as currently implemented:
(i) will potentially destabilise NHS provision of services;
(ii) threatens the present continuity of care for patients;
(iii) will be detrimental to training and future expansion of career grade doctors;
(iv) benefits the independent providers at the potential expense of the NHS
and calls on the government to engage in meaningful discussions on this policy to enable this welcome increase in capacity to be planned into the needs of each health economy for the greatest benefit of patients now and for the future.
21b Motion by BUCKINGHAMSHIRE DIVISION: That this Meeting with regard to private diagnostic and treatment centres:
(i) believes they will destabilise NHS secondary care;
(ii) demands that the DoH provides validated evidence of their cost effectiveness;
(iii) demands a robust, independent monitoring system that will compare ISTC and NHS trust outcomes;
(iv) insists that these organisations prove that they are providing appropriate experience and training for junior doctors.
The motions below are unlikely to be reached:
22 Motion by ISLINGTON DIVISION: That this Meeting believes that “payment by results” should include a tariff for any aftercare provided by community services.
23 Motion by NEWCASTLE AND NORTH TYNESIDE LMC: That this Meeting deplores the use of independent treatment centres because:
(i) the compulsory level of contracting removes funding from local hospitals
(ii) it applies capacity “solutions” across the country to problems that exist only in certain areas
(iii) it deflects attention away from the real capacity problems in the NHS
(iv) it is further privatising the NHS.
24 Motion by SHEFFIELD DIVISION: That this Meeting believes that the Government has not understood the risks inherent in payment by results and calls for piloting and analysis before full implementation.
25 Motion by SOMERSET DIVISION: That this Meeting believes that payment by results will not work in a system that is cash limited and that the Department of Health should be pressed to ensure that the expansion of services will not be limited by shortage of funds, rationing of services, or the whims of commissioners.
Patient choice and booking systems for NHS appointments MONDAY 10.45 – 10.55
*26 Motion by THE AGENDA COMMITTE: That this Meeting:
(i) believes that the “Patient Choice” initiative does not incorporate the actual choices desired by patients and offers no additional choice to those requiring non-operative medical care for chronic illnesses or cancer;
(ii) calls for the “Patient Choice” initiative to be abandoned, and for the Department of Health to work with patients’ representatives and the BMA to identify the real needs of patients.
The above Agenda Committee composite motion will be proposed by Waltham Forest Division.
26a Motion by WALTHAM FOREST DIVISION: That this Meeting believes that the notion of patient choice that is hectically promoted by the government does not incorporate the actual choices desired by patients, and insists that the DOH must work with the BMA and patient bodies to identify the real needs of patients.
26b Motion by EDGWARE AND HENDON DIVISION: That this Meeting highlights that the government’s Patient Choice initiative is restricted to patients referred for elective surgery, and offers no additional choice to the millions of patients with long term chronic illnesses, or those receiving cancer care, or those under medical specialties.
26c Motion by WEST BERKSHIRE DIVISION: That this Meeting believes that the public should be enabled to have true choice of provision of health service free at the point of delivery and with equity of access and adequate capacity.
26d Motion by CORNWALL AND ISLES OF SCILLY LMC: That this Meeting believes patients should be consulted before so-called patient choice is imposed upon them at great expense and to no perceivable benefit.
26e Motion by CORNWALL AND ISLES OF SCILLY LMC: That this Meeting believes that the imposition of choice, on both patients and professionals, is a contradiction in terms.
26f Motion by LOTHIAN DIVISION: That this Meeting believes that proposed systems of clinic booking involving “patient choice” do not result in improved efficiency of clinic booking or an improved clinical service, are a waste of money and should therefore be abandoned.
26g Motion by EALING DIVISION: That the profession should say “no” to the “Choose and Book” scheme between GPs and patients.
26h Motion by MID SURREY, KINGSTON AND ESHER DIVISION: That this Meeting deplores the undue haste of the attempted imposition of the current choose and book system.
26i Motion by AVON LMC: That this Meeting while supporting patient choice, challenges the government to demonstrate the evidence that shows Choose and Book will improve the quality of patient care.
The motions below are unlikely to be reached:
27 Motion by WEST HAMPSHIRE LMC: That this Meeting believes that patients are at risk in the referral process if received referrals are prioritised by non-clinical staff. We demand that the Health Department issue advice to all forms of referral management centre that prioritisation of referrals must be undertaken by specialist medical staff.
28 Motion by EAST YORKSHIRE LMC: That this Meeting believes:
(i) initiatives to give patients more control over the place and time of their hospital appointments are to be supported
(ii) the process of arranging appointments should not impose on the clinical consultation
(iii) there should be no requirement for a private provider to be offered the option to refer to an individual consultant rather than a department should always be available to the referring clinician.
29 Motion by EDGWARE AND HENDON DIVISION: That this Meeting requires clarification regarding the legal and clinical responsibility for patients waiting for and undergoing treatment, subsequent to onward referral by patient referral centres under the Patient Choice initiative.
30 Motion by ISLINGTON DIVISION: That this Meeting supports the principle of choice but deplores the Government’s version of choice as a proxy for promoting private health care.
Out of hours care MONDAY 10.55 – 11.10
*31 Motion by DUNBARTONSHIRE DIVISION: That this Meeting considers that the NHS Direct/NHS 24 Service is seriously flawed, particularly with regard to ease of access for the genuinely sick, and to other issues of clinical safety in relation to triage: the system requires radical rethinking to clearly improve safety mechanisms and also restore a responsive local aspect to out-of-hours care.
31a Motion by EAST LANCASHIRE LMC: That this Meeting has no confidence in the NHS Direct triage service in particular their inappropriate use of ambulances and the poor clinical advice given to patients.
* 32 Motion by THE AGENDA COMMITTEE: That this Meeting believes that the changes to out-of-hours primary care services have resulted in poorer care for patients and increased demand on A&E departments. The health departments must re-evaluate the system and develop national standards for out-of-hours primary care, in partnership with the BMA.
The above Agenda Committee composite motion will be proposed by Herefordshire Division.
32a Motion by HEREFORDSHIRE DIVISION: That the devolution of responsibility for out of hours primary care to primary care trusts has led to a deterioration in the service provided.
32b Motion by LINCOLN DIVISION: That this Meeting is alarmed at the lack of a national model or standard for out of hours primary care, and calls on the Department of Health urgently to develop one.
32c Motion by HEREFORDSHIRE DIVISION: That the devolution of responsibility for out of hours primary care to primary care trusts has resulted in an unreasonable and inappropriate demand on accident and emergency departments.
32d Motion by HOLLAND DIVISION: That there should be a national model for out of hours cover in primary care.
32e Motion by PRESTON, CHORLEY AND SOUTH RIBBLE DIVISION: That the BMA should push the government to re-evaluate the workings of the out of hours, weekend and bank holiday care for people instead of blaming GPs for the increased workload in accident and emergency departments.
Primary and secondary care MONDAY 11.10 – 11.15
* 33 Motion by THE AGENDA COMMITTEE: That, in order to improve patient care and the interface between primary and secondary care, this Meeting believes that hospitals and secondary care clinics must:
(i) provide prescriptions to patients whenever appropriate, rather than expecting the GP to do so;
(ii) ensure safe transfer of the care of patients being referred back to the GP;
(iii) arrange any appropriate referral to another secondary care department, rather than requiring the GP to arrange this.
The above Agenda Committee composite motion will be proposed by Manchester LMC.
33a Motion by MANCHESTER LMC: That this Meeting demands that secondary care clinics be staffed by health care professionals who are able to prescribe to stop patients being inconvenienced by returning to their GP for their prescriptions and to stop this increasing and inappropriate burden on general practice.
33b Motion by MORGANNWG LMC: That this Meeting deplores the failure of many NHS trusts to ensure the safe transfer of the care of patients from secondary to primary care.
33c Motion by DERBYSHIRE LMC: That this Meeting believes the increasing practice whereby when a patient is seen in one hospital department and found to need either the services of another specialty, further investigation or immediately necessary monitoring, and is referred back to their general practitioner solely for these to be arranged:
(i) is wasteful of NHS appointments
(ii) is inconvenient to patient and permits more opportunities for mistakes in care
(iii) misconstrues the role of general practitioners and primary care
(iv) encourages financial gaming by hospital trusts against PCOs
(v) reduces specialists to the role of technicians by denying them the opportunity to deal with the whole patient.
The motions below are unlikely to be reached:
34 Motion by EDGWARE AND HENDON DIVISION: That this Meeting supports the creation of a BMA working group to develop and propose to government a model of an integrated approach to health care commissioning and provision across primary and secondary care, based on values of co-operation, strategic planning and equity.
35 Motion by MILTON KEYNES DIVISION: That in order to avoid distortion of clinical and public health priorities that this Meeting urges the DOH to ensure that PRACTICE BASED COMMISSIONING is developed in an evidence based manner.
36 Motion by SHEFFIELD DIVISION: That this Meeting believes that PCTs and general practices do not have the skill, knowledge or manpower to undertake commissioning in secondary care and calls for the return of commissioning on a larger geographical basis, by personnel with continuity of office, for example by a district health authority.
37 Motion by WEST SUSSEX DIVISION: That this Meeting is concerned about the lack of input of stakeholders (both professionals and patients) into the commissioning of services by primary care trusts and calls on the BMA to urge transparency in this process.
38 Motion by BRISTOL DIVISION: That this Meeting is increasingly concerned at the crisis faced by primary care trusts in trying to commission safe services in the face of substantial deficits.
39 Motion by SOUTH WEST RCSC: That this Meeting remains concerned at the crisis faced by Primary Care Trusts in trying to commission safe services in the face of enormous deficits
40 Motion by GREATER GLASGOW DIVISION: That this Meeting deplores the continuing trend towards generic referral from GPs to anonymous hospital allocation committees, and would encourage the strengthening of direct GP to consultant referral, thereby minimising “REFERRALS INTO THE VOID”.
41 Motion by DUNBARTONSHIRE DIVISION: That this Meeting strongly supports work to develop integrated primary and secondary models of care than can safely and appropriately sustain local access to the majority of healthcare for the majority of patients.
42 Motion by REDBRIDGE AND STRATFORD DIVISION: That this Meeting recognises the unnecessary burden placed upon general practitioners and their practices by methods operated by secondary care provider trusts in order to meet waiting time targets that result in the removal of patients from waiting lists, and demands that patients so removed should have the right to reinstatement at their own request and without the need for another referral.
43 Motion by EDGWARE AND HENDON DIVISION: That this Meeting deplores the haste by which some NHS trusts remove patients from waiting lists on the basis of failure to follow the bureaucracy of partial booking systems, or following a single DNA appointment, or failure to positively respond to a waiting list initiative letter.
44 Motion by EDGWARE AND HENDON DIVISION: That this Meeting supports national standards of maximum waiting times for access to diagnostic services, and physical and psychological therapies, after referral from a primary care or secondary care practitioner.
45 Motion by NORTH AND MID STAFFS DIVISION: That the BMA should ask the Department of Health to review the numbers and affordability of primary care trusts as a matter of urgency.
46 Motion by JUNIOR MEMBERS FORUM: That this Meeting recognises that a significant proportion of palliative care occurs in the out-of-hours setting and therefore demands that:
(i) all providers of out-of-hours services receive regular training in palliative care;
(ii) there are formal mechanisms for handover between daytime and out-of-hours services;
(iii) there is easy access to essential medications out-of-hours.
47 Motion by HEREFORDSHIRE DIVISION: That unless there is significant investment in diagnostic services doctors will be unable to treat patients in a timely and appropriate manner.
48 Motion by GLOUCESTERSHIRE DIVISION: That this Meeting condemns the practice of deferring waiting list admissions for months on the most spurious of reasons.
Targets MONDAY 11.15 – 11.30
*49 Motion by THE AGENDA COMMITTEE: That this Meeting deplores the negative impact on patient care caused by imposition from the centre of inappropriate targets and calls for an independent review of the advantages and disadvantages of targets.
The above Agenda Committee composite motion will be proposed by Worcestershire Division.
49a Motion by WORCESTERSHIRE DIVISION: That this Meeting deplores the negative impact on patient care caused by imposition from the centre of inappropriate targets.
49b Motion by CONFERENCE OF LMCs AGENDA COMMITTEE: That this Meeting deplores the adverse effects that politically motivated directives are having on patient well being and:
(i) calls for an independent review of the advantages and disadvantages of targets;
(ii) believes that ministers should set policy and not directly or indirectly control NHS operational matters;
(iii) believes that there should be a halt to the issuing of further NHS initiatives until doctors have been able to properly assess those already heaped onto the profession;
(iv) deplores the lack of evidence base for major service reconfiguration and calls for the GPC to seek to redirect the funding into primary care services that are evidence based;
(v) demands that future health strategies are based on health needs.
49c Motion by OXFORD DIVISION: That the ARM regrets the erosion of the founding ethos of the NHS as a supportive service, when targets and a production line culture are enforced by management at the behest of Government.
49d Motion by BRISTOL DIVISION: That this Meeting is concerned at the power of target driven commissioning to impoverish non-target services.
49e Motion by SOLIHULL DIVISION: That this Meeting believes that the government should be asked to adopt an honest approach to the setting of realistic targets for NHS trusts.
49f Motion by BROMLEY DIVISION: That this Meeting believes that the setting of targets by the government has reduced the effective delivery of patient care.
49g Motion by CROYDON DIVISION: That this Meeting should denounce politically driven target agenda in delivering health care which is proving dangerous and intolerable, ie waiting list or four hour A/E.
49h Motion by EAST SURREY DIVISION: That this Meeting deplores short term target driven policies in the NHS which lack clinical priorities and demoralise NHS staff.
49i Motion by DUKERIES DIVISION: That this Meeting considers that targets kill patients.
* 50 Motion by BURY DIVISION: That this Meeting believes that achieving a target of 98% for waiting times of 4 hours in Accident and Emergency departments is unsustainable and unsafe and urgent negotiation with the profession is needed to reduce this target to 95%.
50a Motion by JUNIOR DOCTORS CONFERENCE: That this Meeting is alarmed at the levels of bullying of junior clinical staff around the 4-hour A&E target, and deplores the abuse of patient safety by the department of health in its creation of a climate where junior doctors are pressured to do their jobs badly, so that trust managers can be said to have done their jobs well.
50b Motion by BURNLEY, PENDLE AND ROSSENDALE DIVISION: That the target hours at the A&E department are flexible according to patient needs.
50c Motion by AVON LMC: That this Meeting opposes the re-designation of long-wait A&E cases into so called ‘zero day admissions’ as a paper exercise just to meet government targets.
A 51 Motion by THE OCCUPATIONAL HEALTH COMMITTEE: That this Meeting believes that in the current financial and political climate, positive incentives are much more likely to help health service employers achieve compliance with government guidance and targets, than negative ones such as threats of prosecution and fines.
A 52 Motion by EDGWARE AND HENDON DIVISION: That in comparing performance between NHS trusts or services, this Meeting requires that the context of demographic data, baseline resources and casemix is fully accounted for.
NICE MONDAY 11.30 – 11.35
* 53 Motion by THE AGENDA COMMITTEE: That this Meeting believes that NICE:
(i) undermines the clinical freedom of doctors to implement treatments that they believe to be in the best interests of their patients;
(ii) has been completely discredited as an independent adviser;
(iii) must remain advisory rather than regulatory.
The above Agenda Committee composite motion will be proposed by Bristol Division.
53a Motion by BRISTOL DIVISION: That this Meeting is concerned about the growing imposition of some service modules at the expense of others through such processes as the National Service Frameworks, NICE guidelines, and targets. This is undermining the freedom of doctors to pursue treatments that they believe to be in the best interests of their patients.
53b Motion by BUCKINGHAMSHIRE DIVISION: That this Meeting believes that the National Institute for Clinical Excellence has been completely discredited as an independent advisor.
53c Motion by BROMLEY DIVISION: That this Meeting believes that the role of NICE is only advisory and not regulatory.
A 54 Motion by WEST BERKSHIRE DIVISION: That this Meeting is not convinced that the postcode lottery is resolved and urges our government to fund NICE recommendations fully.
A 55 Motion by CROYDON DIVISION: That there should be more co-ordination and communication between NICE, academics and voluntary organisations eg, British Heart Foundation, Diabetes UK, British Thoracic Society in producing consistent guidelines to assist professionals.
Hospital cleanliness MONDAY 11.35 – 11.45
* 56 Motion by THE AGENDA COMMITTEE: That this Meeting deplores the high rate of hospital-acquired infection and the lack of cleanliness in NHS hospitals, and
(i) believes that high bed occupancy contributes to the problem;
(ii) believes that contracting out of hospital cleaning services contributes to the problem;
(iii) deplores “naming and shaming” of hospitals with high infections rates;
(iv) believes that scrubs should be provided to all healthcare professionals and students, and should be the only clothing they are permitted to wear in clinical environments, other than garments necessary for religious observance;
(v) calls on the government to provide adequate new resources to tackle these problems.
The above Agenda Committee composite motion will be proposed by Leicestershire and Rutland Division.
56a Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that the drive for efficiency in the NHS which requires high bed occupancy with compromised cleaning of wards has contributed to the prevalence of MRSA and urges the BMA to ask the Government to take more positive action to eliminate these hazards.
56b Motion by GREATER GLASGOW DIVISION: That this Meeting deplores the lack of cleanliness in NHS hospitals of the United Kingdom.
56c Motion by OXFORD DIVISION: That Council should be asked to draw attention to the unsatisfactory practice of contracting out services such as catering and cleaning. Out-sourcing of cleaning is one cause of hospital infections due to workers being untrained and unsupervised in hospital hygiene.
56d Motion by JUNIOR MEMBERS FORUM: That this Meeting deplores the politicisation of hospital-acquired infection rates and the “naming and shaming” of hospitals with high infection rates and demands that unanonymised league tables be abandoned immediately.
56e Motion by JUNIOR MEMBERS FORUM: That given the current epidemic of MRSA in hospitals the BMA should lobby the governments to require trusts to provide scrubs for all healthcare professionals and students and that these be the only clothing permitted in clinical environments, other than garments necessary for religious observance. Further to this trusts would be required to provide changing facilities for this purpose and be solely responsible for laundering these items.
56f Motion by CORNWALL AND ISLES OF SCILLY LMC: That this Meeting calls on the government to give adequate new resources to tackle the issue of MRSA, and not to rely on the appointment of "matron" as their sole contribution to solving this major public health problem.
Other motions MONDAY 11.45 – 12.05
* 57 Motion by THE AGENDA COMMITTEE: That this Meeting believes that doctors should only be required to cross-cover specialties in which they have relevant competencies and calls on NHS Employers and/or postgraduate deans to ensure this.
The above Agenda Committee composite motion will be proposed by Junior Doctors Conference.
57a Motion by JUNIOR DOCTORS CONFERENCE: That this Meeting believes that junior doctors should only be required to cross-cover specialties in which they have relevant competencies and calls on NHS Employers and postgraduate deans to ensure this.
* 58 Motion by THE AGENDA COMMITTEE: That this Meeting deplores the lack of foresight of the health departments in out-sourcing imaging investigations to private companies rather than funding NHS radiology departments to use their equipment to maximum capacity. This fails to recognise the role of the reporting radiologist in the multi-disciplinary team and compromises quality control and integration of imaging.
The above Agenda Committee composite motion will be proposed by Scottish Council.
58a Motion by SCOTTISH COUNCIL: That this Meeting deplores the lack of foresight of the departments of health in precipitously outsourcing imaging investigations to private companies without recognising the role of the reporting radiologist in the multidisciplinary team.
58b Motion by OXFORD DIVISION: That the BMA urges the Secretary of State to instruct Trusts employing outside contractors for diagnostic services that they ensure appropriate quality control and integration of images and their interpretation with other diagnostic studies.
58c Motion by LOTHIAN DIVISION: That this Meeting regrets that departments of radiology are not funded to use resources to maximum capacity, while commercial companies profit by scanning NHS patients.
58d Motion by SCOTTISH COUNCIL: That this Meeting regrets the imposition of commercial imaging services by the departments of health in areas where lack of funding has limited provision of such services by the NHS.
The motions below are unlikely to be reached:
* 59 Motion by WEST MIDLANDS RCSC: That this Meeting notes with concern that the Freedom of Information Act applies to NHS organisations but not to Private and Independent Sector providers which will further disadvantage NHS providers in the developing health marketplace. We call on the government to legislate that the Freedom of Information Act apply to all care whether privately, independently or publicly provided.
59a Motion by CLEVELAND LMC: That this Meeting believes that, in the interest of fairness and equity, Schedule 1 of the Freedom of Information Act must be amended to place all providers of primary medical services under the same obligations.
59b Motion by SOUTH WEST RCSC: That this Meeting urges the BMA to use the freedom of information act to seek accurate, fully costed, comparison of comparable clinical activity carried out by private companies and NHS units.
60 Motion by BARNET AND FINCHLEY DIVISION: That in considering the cost of calling a patient in hospital, and in the spirit of a free market, all NHS trusts shall allow patients to use their personal mobile phones where safe and when not disturbing others.
61 Motion by WEST SUSSEX LMC: That this Meeting deplores the continuation of a prescription charging policy that is both unfair and inconsistent.
62 Motion by ENFIELD AND HARINGEY DIVISION: That ever increasing prescription charges in NHS is against the policy of “free at the point of delivery of care” and urges the government to abolish this charge.
63 Motion by ENFIELD LMC: That this Meeting considers that given the recommended increased use of drugs for long term conditions the government should abolish prescription charges for those being prescribed such medication.
64 Motion by BURY DIVISION: That this Meeting believes that the bureaucratic explosion in the NHS is harmful to patient health and needs to be urgently addressed.
65 Motion by DARTFORD, GRAVESEND AND MEDWAY DIVISION: That the BMA should urge the future governments to ring fence the funding for patient care and NHS administration so as to curb disproportionate expansion of NHS bureaucracy.
66 Motion by EAST DORSET DIVISION: That this Meeting is concerned that new money for the NHS is wasted on bureaucracy with outrageous profligacy.
67 Motion by BARKING, HAVERING AND BRENTWOOD DIVISION: That there is mounting evidence both anecdotal and otherwise of the NHS becoming a bureaucrat’s paradise. Clinicians at all levels, primary care included, have become a target for marginalisation thus undermining their professionalism. This Meeting calls for an end to this attitude so that patients and users can reap the benefits of the tax payers money.
68 Motion by OXFORD DIVISION: That Council should draw Government’s attention to the lack of transparency and accountability in:
(i) NHS management costs;
(ii) the costs of services contracted out.
This prevents the extra money in the NHS going directly into frontline and grass-roots services.
69 Motion by SOMERSET DIVISION: That this Meeting notes the recent demise of MG/Rover, and request that the persisting British Leyland style of managing British healthcare is replaced by something not only more modern and effective, but also less dictatorial and bureaucratic.
70 Motion by DUNBARTONSHIRE DIVISION: That this Meeting encourages the search for greater efficiency and value in healthcare, from genuinely evidence-based rationalisation of therapeutic modalities, via rationalisation of private and public sector hospital services, to the identification of a broader funding base for healthcare nationally than is possible purely via taxation.
71 Motion by BROMLEY DIVISION: That this Meeting believes that the centralisation of oncology services through the inflexible implementation of IOG (Improving Outcomes Guidance) wastes good clinical skills in district hospitals and is not of added value to patients.
72 Motion by EDGWARE AND HENDON DIVISION: That this Meeting requires an end to the requirement for NHS trusts to achieve financial balance on an annual basis, which encourages short term expedient behaviour, and instead demands a longer term financial approach that incentivises longer term investment strategies which can result in improved outcomes and cost efficiencies in future years.
73 Motion by DERBYSHIRE LMC: That this Meeting believes that that patient drug information leaflets should indicate the likelihood of an individual experiencing a drug’s side effects.
74 Motion by EALING DIVISION: That this Meeting opposes prescribing by pharmacists of POMs without having adequate training and safeguards.
75 Motion by LOTHIAN DIVISION: That the rules concerning the need to hand write certain classes of prescription need to be reviewed now that all scripts are uniquely numbered.
76 Motion by LIVERPOOL DIVISION: That this Meeting condemns the practice of the NHS trusts and its subcontractor companies, for imposing high phone charges on patients for phone calls to and from hospitals and to general practices and calls upon the BMA to investigate the extent of the practice and press for its replacement by fairer and lower cost systems.
77 Motion by CLEVELAND LMC: That this Meeting notes John Hutton’s defence on the provision of premium rate phones for hospital in-patients whilst prohibiting their use by general practitioners, and calls for him to provide a rational explanation for such double standard.
78 Motion by EDGWARE AND HENDON DIVISION: That this Meeting condemns the extortionate car parking fees charged by some NHS trusts, and demands an end to this unashamed income generation at the expense of patients, visitors and NHS staff.
79 Motion by BROMLEY DIVISION: That this Meeting believes that emergency treatment, as defined by the NHS Overseas Visitors Hospital Charging Regulations 2004, should be based on clinical condition and not on the location of the patient in the hospital.
80 Motion by BURNLEY, PENDLE AND ROSSENDALE DIVISION: That this Meeting recommends to introduce a “health card” with microchip storing information of the patient’s identity, medical conditions, drug history with the consent of the patient in the near future, thereby reducing paperwork and being environmentally friendly.
81 Motion by EDGWARE AND HENDON DIVISION: That this Meeting believes that NHS resources should only be used in the private sector where local NHS services lack capacity or are inadequate to meet the needs of their population.
82 Motion by EDGWARE AND HENDON DIVISION: That this Meeting requires that the government recognises and rewards the commitment, loyalty, and added value of NHS providers and staff who provide care to communities, as opposed to the shorter term and financial motives of private sector involvement.
83 Motion by JUNIOR MEMBERS FORUM: That this meeting believes that the naming and shaming of hospitals with poor star ratings has no positive effect on patient care and therefore demands that they are abolished.
84 Motion by CCSC A&E SUBCOMMITTEE: That this Meeting supports a single telephone number point of contact for all unscheduled care, supported by appropriately trained professionals, with a locally based response available if necessary.
85 Motion by BARKING, HAVERING AND BRENTWOOD DIVISION: That this Meeting urges the new Government to avoid making unnecessary changes to the provision of healthcare for the sake of “making a change” and to think of the long term health care needs of the population rather than putting their political agenda first.
86 Motion by WALTHAM FOREST DIVISION: That this Meeting believes there should be a halt to the issuing of further NHS initiatives until doctors have been able to properly assess and evaluate the many initiatives that have already been heaped onto the profession.
87 Motion by WEST SUSSEX DIVISION: That this Meeting believes that medicine in general and general practice in particular requires a period of tranquillity free from forced political agendas in order to consolidate their key functions and service to the nation.
88 Motion by BRISTOL DIVISION: That this Meeting demands that the Department of Health pilot studies are adequately analysed before national roll-outs.
89 Motion by BUCKINGHAMSHIRE DIVISION: That this Meeting deplores the plethora of DoH’s initiatives which prevents the successful implementation of many and the logical development of healthcare provision.
90 Motion by LINCOLN DIVISION: That this Meeting is concerned about the reduction in range of services offered by smaller hospitals in rural or remote areas, and believes in the principle of providing services for patients as close to their local area as possible.
91 Motion by JUNIOR MEMBERS FORUM: That this Meeting believes that remunerations for premier league footballers and “A” list celebrities is vastly out of proportion with their input and benefit to society and call on the government to implement a public service tax of 90% on all their net earnings over 1 million pounds to go directly into NHS healthcare provision.
92 Motion by WEST CUMBRIA DIVISION: That this Meeting believes that the Government should give extra financial support to rural NHS trusts to help them increase the ratio of medical staff to patients so that they can meet European Union Working Time Directive requirement, reduce the frequency of rotas for senior medical staff and encourage doctors to move out of large relatively well staffed units to relatively understaffed peripheral hospitals.
93 Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting opposes the wasting of money on private profit and demands that all clinical services and healthcare services should be publicly run agencies in order to avoid a funding crisis in the hospitals and PCTs.
94 Motion by BURY DIVISION: That this Meeting perceives that the way in which two or more district general hospitals are being managed under single trust arrangements has been disastrous.
95 Motion by SOMERSET DIVISION: That this Meeting intends to hold the Labour Government to its manifesto promise that NHS capacity (which we understand should include acute hospital beds) will be increased to accommodate the increased demand on hospital services that is occurring year on year.
96 Motion by EAST DORSET DIVISION: That this Meeting believes that the NHS is best run by doctors.
97 Motion by NORTH AND MID STAFFS DIVISION: That the field offices of the Health Protection Agency be brought back into the control of local NHS organisations.
98 Motion by SOMERSET DIVISION: That this Meeting is clear that the implementation of Connecting for Health will fail to deliver improvements in patient care without the appropriate involvement of clinicians, and insists that full and effective consultation with representatives of all health professional groups is undertaken forthwith.
99 Motion by MERSEY RCSC: That this Meeting insists that the NHS and the private sector must be regulated to the same standards and that the harmonisation process should be completed during 2005 so that the excessive regulation of the private sector ceases.
100 Motion by HEREFORDSHIRE DIVISION: That hospitals built under the terms of the Private Finance Initiative fail to provide enough beds for the needs of their communities.
101 Motion by SOMERSET DIVISION: That this Meeting notes that the BMJ has previously published studies demonstrating that the reduction of acute beds in English hospitals in the nineties was both too fast and too many. This meeting therefore, condemns the creation of further PFI hospitals (eg North Bristol) that are planned to result in a reduced number of acute beds compared to the unit(s) they are replacing. Furthermore we reject the foisting of this discredited policy onto our neighbouring devolved nations.
102 Motion by GLASGOW LMC: That this Meeting asks for secure paper recycling facilities to be available in all NHS facilities with the firm conviction that such paper may have a more useful role in any future reincarnation.
103 Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting opposes the running of NHS hospitals as commercial foundation trust enterprises learning from the experience of Bradford Foundation.
A 104 Motion by SHEFFIELD DIVISION: That this Meeting calls for the abolition of VAT on medicines and medical equipment.
A 105 Motion by ISLINGTON DIVISION: That this Meeting believes that the BMA should oppose the financial support provided by the Government to PFI schemes, as they divert funds from core NHS resources.
A 106 Motion by BURNLEY, PENDLE AND ROSSENDALE DIVISION: That the mortality/morbidity data of a surgeon of any trust must be robust, rigorous and risk adjusted before it is released into the public arena.
A 107 Motion by EDGWARE AND HENDON DIVISION: That this Meeting welcomes much of the Healthcare Commission’s revised proposals to measure performance of NHS trusts, but rejects the commitment to a single performance rating of trusts, which encourages erroneous league table comparisons between trusts, and detracts from recognising the heterogeneity of services within a trust.
A 108 Motion by ROTHERHAM DIVISION: That the NHS is far too important to be left in the hands of the politicians.
A 109 Motion by SOMERSET DIVISION: That this Meeting:
(i) recognises the overwhelming evidence that short-term political initiatives have caused significant damage to long-term patient care, and
(ii) believes that ministers should set policy and not directly or indirectly control NHS operational matters.
A 110 Motion by SOMERSET DIVISION: That this Meeting deplores the misrepresentation by the Government of staff numbers within the NHS by the counting of individuals rather than whole time equivalents.
A 111 Motion by SOUTH BEDFORDSHIRE DIVISION: That this Meeting reinforces the view that evidence-based medicine must be supported by evidence-based policy-making and management, and that the Association calls on government to provide this.
OPEN DEBATE - OVERSEAS RECRUITMENT MONDAY 12.15 – 12.45
Issues arising from the motions printed below will be discussed in this open debate. A motion taking account of the debate will be prepared at the direction of the Agenda Committee and submitted for consideration by the meeting, in the agenda section entitled “Motions arising from the ARM”.
112 Motion by LIVERPOOL DIVISION: That this Meeting views the recruitment of nurses and other health care workers from third world countries as a national disgrace, and is aware that it is still happening and calls on the BMA to continue to oppose this dubious practice.
113 Motion by WEST CUMBRIA DIVISION: That this Meeting believes that it is wrong for the NHS to actively induce trained doctors to leave developing nations which have themselves inadequate numbers of health personnel; but that instead the government should encourage the training of more people in this country to work in the NHS.
114 Motion by JUNIOR DOCTORS CONFERENCE: That this Meeting deplores the Department of Health for creating a climate where NHS trusts can abuse international medical graduates as cheap migrant workers.
115 Motion by SOUTH BEDFORDSHIRE DIVISION: That this Meeting demands that steps are taken to give teeth to the Ethical Recruitment Policy discouraging doctors from coming to this country to seek clinical work and training when this depletes developing countries of their medical staff.
116 Motion by JUNIOR MEMBERS FORUM: That this Meeting opposes the proposal to establish international medical schools linked to UK medical programmes, as another attempt to remove the skilled and professional workforce of emerging nations. The BMA must:
(i) oppose such proposals because the students in these countries are being charged excessive fees;
(ii) oppose such proposals because there is currently a shortage of clinical academics and resources in UK to support these proposed courses;
(iii) lobby the GMC and CHMS to abandon such unethical policies and encourage a more equitable system based on student merit.
TRAINING AND EDUCATION MONDAY 2.00 – 2.05
117 Receive: Report by the Chairman of the Board of Medical Education (Peter Dangerfield).
Undergraduate education MONDAY 2.05 – 2.15
118 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that expansion in student numbers in medical school has been mismanaged by the government, and medical schools that were already too large have got bigger. Expansion has had a detrimental effect on the delivery of education in some schools. We call for an urgent re-assessment of medical school numbers by an independent body, and a re-allocation where necessary.
The motions below are unlikely to be reached:
119 Motion by LIVERPOOL DIVISION: That this Meeting is concerned about the development of private and GMC non-recognised medical schools within the UK and calls for the Board of Medical Education to investigate and report on the issues.
120 Motion by JUNIOR MEMBERS FORUM: That this Meeting notes the variable practise concerning the ratio of examiners to students in OSCE stations, clinical examinations and vivas. It therefore demands that a minimum of two examiners must be present, per student, in each OSCE station, clinical examination or viva and it directs the medical student committee to lobby the Council of Heads of Medical Schools to agree such a ruling.
121 Motion by NORTHERN IRELAND COUNCIL: That this Meeting believes that, in the spirit of good communication:
(i) medical schools, when faced with inter-school transfer requests, should always attempt to assess and verify whether curriculum outcomes previously learned at other medical schools are sufficient to allow such a transfer to be possible;
(ii) CHMS should encourage medical schools to make their curricula suitably flexible to afford students the opportunities to study rotations and/or student selected components abroad or at other institutions.
122 Motion by LIVERPOOL DIVISION: That this Meeting is concerned with the constant request for inclusion of specialist subjects into undergraduate curricula and calls upon the BMA, through its Board of Medical Education, to investigate and report on the appropriate methods for incorporation of such subjects into medical curricula at both undergraduate and postgraduate levels.
123 Motion by NORTHERN IRELAND COUNCIL: That this Meetings believes that, in the spirit of good teamwork and co-operation:
(i) all healthcare profession students should be subject to equivalent consent seeking measures when interacting with patients with respect to equivalent procedures;
(ii) medical students should not have to compete with different healthcare profession students in order to complete their respective curricula’s practical objectives, and medical schools should have specific safeguards in place to prevent anxiety, anger and resentment among medical students and other healthcare profession students due to interdisciplinary competition.
124 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that consultants who absent themselves from protected medical teaching on more than one occasion with consequent cancellation of the session, should be reported to the appropriate authorities.
125 Motion by BRISTOL DIVISION: That this Meeting should ask the Board of Medical Education to investigate the effects of rising student numbers, and declining numbers of medical academic staff on the delivery of undergraduate medical education.
126 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that medical students should be trained in first aid to enable them to participate in the management of a major incident.
A 127 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that following MMC initiatives for earlier entry into specialist training and in light of selection possibly being commitment based, students should have evolving careers advice and guidance throughout medical school.
A 128 Motion by PLYMOUTH DIVISION: That a degree of flexibility be incorporated into undergraduate courses for students with special circumstances.
Undergraduate education - admissions MONDAY 2.15 – 2.30
129 Motion by SOUTH WEST RCSC: That this Meeting notes the success of the new postgraduate “fast-track” medical degrees and the increasing number of late entrants to conventional undergraduate degrees. We therefore recommend that consideration be given to establishing medicine as an entirely postgraduate degree course in the belief that this would:
(i) reduce the current overemphasis on A-levels as a selection tool;
(ii) reduce the current gender inequality in both the number of applicants and acceptances to medical school.
130 Motion by EAST YORKSHIRE LMC: That this Meeting believes that:
(i) it is in the best interest of patients that the gender balance of the medical workforce be approximately equal,
(ii) educational, social and biological factors reduce the performance of boys in their teens,
(iii) efforts to ensure equity of access to medical school need to make allowance for gender differences.
The motions below, in the shaded area, are unlikely to be reached.
131 Motion by EAST YORKSHIRE LMC: That this Meeting is concerned that, contrary to existing BMA policy, medical schools continue to favour students who have had medical work experience whilst at school. We believe this is discriminatory for students, unfair on doctors, and of negligible worth; and conference calls for medical schools to abandon this practice immediately.
* 132 Motion by CONFERENCE OF MEDICAL ACADEMIC REPRESENTATIVES: That this Meeting regrets that applicants from lower socio-economic groups appear to experience disadvantages during the application and selection processes, as identified in the BMA survey entitled ‘Demography of Medical Students’, and we believe there is a strong case for measures to counter the disadvantage.
132a Motion by WELSH COUNCIL: That this Meeting regrets that applicants from lower social-economic groups appear to experience disadvantages during the application and selection processes, as identified in the BMA survey entitled “Demography of Medical Schools”, and that this Meeting believes there is a strong case for measures to counter the disadvantage.
133 Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting urges BMA to look into the admission policies of medical schools currently in practice with a view to recommending a universal “one stop” selection process for the whole country.
Financing undergraduate education MONDAY 2.30 – 2.35
* 134 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that every medical school should publish the cost per student of each of its medical degree programmes.
134a Motion by JUNIOR MEMBERS FORUM: That this Meeting believes that every medical school should publish the cost per student of each of its medical degrees programmes given that top up fees were introduced to provide improved teaching and widening participation. The Board of Medical Education and MSC must campaign for this information and produce evidence on how this correlates to both teaching quality and widening participation schemes.
The motion below is unlikely to be reached:
135 Motion by LIVERPOOL DIVISION: That this Meeting requests that the BMA, through its Board of Medical Education, provides a summary report on the funding mechanisms employed in other countries for undergraduate medical education in order to inform debate on the fees issues in the UK.
A 136 Motion by CONFERENCE OF MEDICAL ACADEMIC REPRESENTATIVES: That this Meeting has deep concerns about "top-up" fees as they might be expected to deter students from wider social backgrounds from participating in medical education.
Modernising medical careers MONDAY 2.35 – 2.55
137 Motion by BUCKINGHAMSHIRE DIVISION: That this Meeting believes that the transitional arrangements for the introduction of Modernising Medical Careers (MMC) are inadequate to prevent the creation of a new “lost tribe” of existing SHOs.
* 138 Motion by JUNIOR MEMBERS FORUM: That this Meeting recognises the benefits of acute out of hours and daytime experience for PRHOs and foundation year 1 doctors. It directs the British Medical Association to demand that Postgraduate Deaneries and Medical Schools ensure that PRHOs and foundation year 1 doctors will not be removed from acute out of hours experience which forms a valuable part of training.
138a Motion by WORCESTERSHIRE DIVISION: That this Meeting believes that absence of Foundation Year 1 and Foundation Year 2 doctors-in-training from night-time working until they reach SHO status is detrimental to the training of fully qualified doctors.
* 139 Motion by GP REGISTRARS SUBCOMMITTEE: That this Meeting believes that the inclusion of a general practice placement for every postgraduate doctor in foundation year two should be compulsory in order to improve overall postgraduate medical education and also improve communication between primary and secondary care and calls upon the BMA to lobby the relevant body to ensure this occurs.
139a Motion by WALTHAM FOREST DIVISION: That this Meeting is dismayed at the confusion over whether all doctors in Foundation Year Two will have exposure to general practice, and instructs PMETB to ensure that this does occur.
139b Motion by JUNIOR MEMBERS FORUM: That this Meeting calls upon the BMA to ensure that any doctors wishing to become a GP can undertake a clinical attachment in primary care.
The motions below are unlikely to be reached:
140 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that in accordance with medical students’ freedom to pursue their chosen careers:
(i) a national framework should be implemented to support and facilitate inter-deanery transfer in F1 and F2 years;
(ii) students should be free to apply to as many different deaneries for foundation programme posts as they want, provided these are viable/acceptable postgraduate training posts, without restriction from their own deanery.
141 Motion by DUNBARTONSHIRE DIVISION: That this Meeting wishes to question the wisdom of the progressive shortening and narrowing of specialist training, and considers that this is not compatible with the sustainability of effective co-ordinated quality medical care in the long term.
142 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that every medical school should produce and distribute a comprehensive guide to the foundation programme to every medical student well before they apply and that this should comprise any information that may prove useful, for example:
(i) full details about the applications process;
(ii) details of how many students have applied per job for each placement;
(iii) a sample of a poor/average/well-written application form;
(iv) the foundation programme curriculum.
143 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that when a student is offered a place on a foundation programme through a Postgraduate Deanery run matching scheme that this does constitute a job offer. Furthermore, this Meeting believes that the terms and conditions of any job (including the pay banding) should be made available to students at the point of the matching scheme offer.
144 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting calls on the BMA to lobby Undergraduate and Postgraduate Deaneries and NHS Trusts to:
(i) exclude posts which do not meet GMC requirements for PRHO status from the matching scheme;
(ii) ensure that Trusts make their contracts transparent to students on application for jobs within their trusts;
(iii) commit to finding students new Foundation Posts if students are dissatisfied with the terms – not available upon application – but revealed after legal commitment to the job was made.
145 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that the intended outcomes of the Foundation Programmes may not be achieved until the needs for training are reconciled with the service commitments of the NHS and urges the BMA to bring this problem to the attention of the CMO.
A 146 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that the aims and structure of the Foundation Programmes for junior doctors will cause such radical changes that the BMA should demand that adequate quality assessment is in place to ensure success.
Postgraduate Medical Education and Training Board (PMETB) MONDAY 2.55 – 3.05
* 147 Motion by THE AGENDA COMMITTEE: That the BMA demands the representation of staff and associate specialist doctors on the main board of PMETB and on its Assessment and Training subcommittees.
The above Agenda Committee composite motion will be proposed by Sheffield Division.
147a Motion by SHEFFIELD DIVISION: That this Meeting believes that SAS doctors should be represented on the main board of PMETB.
147b Motion by JUNIOR MEMBERS FORUM: That the BMA demands the representation of staff and associate specialist doctors on the PMETB and its Assessment and Training Subcommittees.
148 Motion by WALTHAM FOREST DIVISION: That this Meeting is concerned that the new structures for training doctors in secondary care may lead to a reduction in hours of experience gained and calls on the PMETB to ensure that training experience pertinent to each discipline is preserved.
A 149 Motion by SOUTH BEDFORDSHIRE DIVISION: That this Meeting urges the BMA to continue to work to maintain the legitimate input of the profession into postgraduate medical education after handover to the Postgraduate Medical Education and Training Board.
Postgraduate training MONDAY 3.05 – 3.15
150 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting regrets the stated policy of the Royal College of Surgeons to use a ranking system based on the MRCS examination after the first specialist training year (STY1) to cull junior doctors and consign them to a service grade. We ask the BMA to review this matter with the Royal College of Surgeons.
151 Motion by GP REGISTRARS SUBCOMMITTEE: That this Meeting believes that quality assurance of doctors’ training should be paid for by government and therefore doctors should not have to pay certification fees. It calls upon the BMA to open negotiations with the Health Departments to ensure that this is funded by the appropriate body.
The motions below, in the shaded area, are unlikely to be reached.
152 Motion by LIVERPOOL DIVISION: That this Meeting is concerned about the many different methods of assessment of doctors at all levels of training from undergraduate to postgraduate and calls upon the Board of Medical Education to investigate whether these present best practice or are even appropriate for today’s doctors.
153 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that the absence of the role of medical academics and information on the delivery of education and training of students and doctors in the NHS Improvement Plan is of great concern. We call upon the BMA to ensure that the Department of Health sets out direction on how it perceives medical education will be provided in a privately delivered health service as set out under the NHS Improvement Plan.
154 Motion by JUNIOR MEMBERS FORUM: That this Meeting believes that all doctors in training who counsel patients should be adequately trained to do this. It therefore demands that:
(i) the Academy of Medical Royal Colleges ensure that this training forms part of every specialty training syllabus;
(ii) funding be made available to train all doctors in training in counselling skills;
(iii) multi-disciplinary counselling training is provided in every paediatric and maternity unit;
(iv) doctors in training be given the opportunity to counsel patients initially under direct supervision;
(v) 24 hour cover for patient counselling is provided in every maternity unit by members of staff with specific counselling skills.
155 Motion by REDBRIDGE AND STRATFORD DIVISION: That this Meeting demands that all potential front line healthcare workers be provided with adequate training and information to operate effectively in the event of terrorist, biochemical or nuclear incidents.
156 Motion by ENFIELD AND HARINGEY DIVISION: That this Meeting moves that BMA investigate the possibility of all examinations being conducted by one examination body/Board of medical examiners.
A 157 Motion by SOUTH BEDFORDSHIRE DIVISION: That this Meeting insists that effective systems to ensure the proper quality control of postgraduate medical education are essential and must include:
(i) adequate levels of visiting to trusts, practices and deaneries;
(ii) the ability to apply sanctions to improve standards where necessary.
MEDICAL STUDENTS MONDAY 3.15 – 3.25
158 Receive: Report by the Chairman of the Medical Students Committee (Leigh Bissett).
159 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting notes that discrimination is faced by both medical students with disabilities and those with disabilities applying to medical schools and:
(i) believes that disability should not necessarily be a barrier to medical school entry;
(ii) calls upon the BMA medical students committee to collect case studies of medical students with disabilities;
(iii) calls upon medical schools to provide adequate support for medical students with disabilities;
(iv) believes that assessment of medical students should be based positively upon competencies and not negatively upon conditions;
(v) calls upon the GMC to work with the BMA medical students committee and CHMS to issue specific guidelines regarding the assessment of fitness to practice with respect to disabilities including mental illness, physical impairment and specific learning disabilities.
The motions below are unlikely to be reached:
160 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting deplores the use of harassment and bullying in medical education and therefore resolves;
(i) medical schools should have clear anti-harassment/bullying policies similar to those in the NHS;
(ii) the MSC welfare subcommittee should produce and circulate a document to students detailing their rights with regard to harassment;
(iii) the way medical schools handle complaints must allow for both anonymous and mediated mechanisms that must report back and act upon findings accordingly;
(iv) the MSC, in conjunction with MASC and CCSC should develop a strategy plan considering mechanisms to tackle harassment and bullying of medical students which is to be presented to the ARM 2006;
(v) the practice of consultants “signing off” students can be subjective, open to abuse and prevent many students from complaining about incidents of harassments and bullying for fear of hindering progress through their course.
161 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting believes that medical students should be entitled to be exempt from parking fees at distant placements.
162 Motion by LEICESTERSHIRE AND RUTLAND DIVISION: That this Meeting regrets that entry to medical schools is likely to be determined less on academic and social ability and more on a student’s willingness to accept the prospect of a high level of debt by the time they qualify.
163 Motion by JUNIOR MEMBERS FORUM: That this Meeting believes that regular, unannounced visits by the GMC quality assurance visitors will provide a more realistic picture of the true circumstances at a medical school and it directs the medical students committee to negotiate with the GMC the introduction of surprise and unannounced visits for inspection purposes.
164 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting calls for the BMA and MSC to organise an annual away day for ISC Chairs to share best practice and enable problem solving and sharing.
A 165 Motion by MEDICAL STUDENTS CONFERENCE: That medical schools and teaching hospitals should provide for the needs of students of all faiths, particularly with regards to prayer room facilities and chaplaincy services.
Medical students' finances MONDAY 3.25 – 3.35
166 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that the current student loans system does not adequately reflect the needs of students on courses of professional study, and that:
(i) a higher value of student loan should be available to medical students that adequately reflects the number of weeks and hours of required study, preventing the option of taking a part-time job;
(ii) the amount of loan available to medical students should reflect the higher costs of participating in the course (materials, electives, travel costs, etc);
(iii) the amount of loan available in the final year should not be reduced on the grounds of employment being able to be sought following completion of exams, as house officer posts do not commence until August.
167 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting:
(i) notes that a notable proportion of medical students cease to receive financial support from their families before the age of 25;
(ii) notes that a number of families do not contribute to the maintenance and essential course expenses of their offspring.
(iii) believes many medical students are financially independent before the age of 25;
(iv) believes the current system which deems only those students who are 25 years or older as independent is a fallacy;
(v) resolves to mandate the MSC and BMA to campaign for a lowering of the age at which a student is deemed financially independent from 25 to a more appropriate age.
The motions below, in the shaded area, are unlikely to be reached.
168 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting believes that no ‘mature’ student should be penalised, in terms of total student loan assessment, as a result of being in a cohabiting relationship, but living financially independent lives.
169 Motion by MEDICAL STUDENTS CONFERENCE: That this Meeting calls upon the Health and Education Departments to:
(i) increase the basic grant and tuition fee subsidy for ALL students reading second courses in medicine regardless of the type of course;
(ii) ensure that there is parity between funding schemes for all second degree course types.
170 Motion by LIVERPOOL DIVISION: That this Meeting views with considerable disquiet the plans to charge non-Scottish medical students fees for their medical course and calls upon the BMA to fight this totally unjust imposition.
171 Motion by EALING DIVISION: That this Meeting recognises medical student debts are increasing and recommends that the BMA supports all efforts to reduce this through:
(i) opposing the imposition of tuition fees;
(ii) grants for poorer students lower the level of eligibility of parental income.
172 Motion by WREXHAM BOROUGH DIVISION: That this Meeting is concerned about the level of financial debt incurred by medical students during their training.
173 Motion by SCOTTISH COUNCIL: That this Meeting recognises the need to alter fee arrangements for non-Scottish domiciled students studying medicine in Scotland.
MEDICAL ACADEMIC STAFF MONDAY 3.35 – 3.50
174 Receive: Report by the Chairman of the Medical Academic Staff Committee (Michael Rees).
175 Motion by CONFERENCE OF MEDICAL ACADEMIC REPRESENTATIVES: That this Meeting supports a target of 40% of women in senior academic medical posts and Heads of Department in medical schools, as per the EU the Women in Science programme standards.
176 Motion by CONFERENCE OF MEDICAL ACADEMIC REPRESENTATIVES: That this Meeting believes that NHS medical staff will have an increasingly important role in delivering teaching and research activity in the future. The BMA should ensure that mechanisms are in place to ensure that NHS medical teaching and research staff are properly represented, either through a change in the remit of the MASC, or by greater priority being given to these issues by the NHS crafts.
The motions below are unlikely to be reached:
177 Motion by BRISTOL DIVISION: That the BMA should ensure that doctors employed in universities receive the same standards of employment process and support from their academic employers as their counterparts in the NHS. In particular all doctors are entitled to proper job planning, appraisal, disciplinary processes, and clear lines of clinical and managerial accountability.
178 Motion by EALING DIVISION: That this Meeting is concerned at the disincentives to a clinical academic career presented by the unstable position with regards to inter grant funding particularly of academics in training.
CONSULTANTS MONDAY 3.50– 4.10
179 Receive: Report by the Chairman of the Central Consultants and Specialists Committee (Paul Miller).
180 Motion by CCSC CLINICAL MEDICAL DIRECTORS SUBCOMMITTEE: That this Meeting notes:
(i) the increasing role of medical managers in primary care;
(ii) that the CCSC Clinical and Medical Directors Subcommittee has responded to this development by enabling primary care medical managers to be represented on the subcommittee;
(iii) that the articles and byelaws of the association state that Council may “authorise the formation of … special groups of members having distinctive professional interests and being by reason either of their paucity of numbers or their local distribution unable to obtain adequate representation of those interests through the divisions and branches”;
(iv) the decision by the seniors conference in 2004 to support the Clinical and Medical Directors Subcommittee call to establish a medical managers group within the BMA.
This Meeting, therefore, calls on the Organisation Committee to work with the CCSC and the GPC on the establishment of a Medical Managers Group of the BMA to take on the work of the CCSC Clinical and Medical Directors Subcommittee and to reach out to and represent medical managers in primary care.
181 Motion by WEST MIDLANDS RCSC: That the BMA welcomes the agreement on “Maintaining High Professional Standards in the NHS” and calls for a review of all suspensions under the old rules with a view to applying the principles in the new agreements to the resolution of seemingly intractable problems.
JUNIOR HOSPITAL DOCTORS MONDAY 4.10 – 4.25
182 Receive: Report by the Chairman of the Junior Doctors Committee (Simon Eccles).
183 Motion by JUNIOR DOCTORS CONFERENCE: That this Meeting believes that junior doctors should not be coerced into changing hours monitoring information in order to achieve New Deal compliance or face disciplinary action if they breach New Deal regulations due to clinical needs and calls on the BMA to continue to inform junior doctors about their rights and calls on the NHS Counter Fraud Agency (CFSMA) to investigate and act upon any instances brought to their attention.
184 Motion by JUNIOR DOCTORS CONFERENCE: That this Meeting believes that opportunities for taking study leave should not be limited by commitments to service delivery and it therefore directs the BMA to negotiate with appropriate bodies:
(i) to ensure that rota design does not limit ability to take study leave;
(ii) to ensure that locum cover is provided by employers as appropriate to cover study leave;
(iii) to ensure that service delivery is cancelled, when appropriate, to facilitate study leave for junior doctors;
(iv) to ensure that employers are responsible for finding cover for study leave, rather than junior doctors.
The motion below, in the shaded area, is unlikely to be reached.
| 185 Motion by BIRMINGHAM DIVISION: That the BMA should regard doctors currently in basic specialist training as a priority group. |
STAFF AND ASSOCIATE SPECIALIST DOCTORS MONDAY 4.25 – 4.45
186 Receive: Report by the Chairman of the Staff and Associate Specialist Doctors Committee (Mohib Khan).
* 187 Motion by THE AGENDA COMMITTEE: That this Meeting requests the Staff and Associate Specialists’ Committee Negotiating Team to press for a new contract for SAS doctors which:
(i) subsumes non standard grades throughout the United Kingdom;
(ii) encourages personal development;
(iii) allows autonomous practice where appropriate.
The above Agenda Committee composite motion will be proposed by Lincoln Division.
187a Motion by LINCOLN DIVISION: That this Meeting mandates the Staff and Associate Specialists’ Committee Negotiating Team to press for a new contract for SAS doctors which:
(i) unifies non-standard contracts throughout the United Kingdom;
(ii) encourages personal development;
(iii) allows autonomous practice where appropriate.
187b Motion by BURNLEY, PENDLE AND ROSSENDALE DIVISION: That we would like the BMA to warn, name and shame the employers who refuse to re-grade doctors to save cash.
187c Motion by CARDIFF AND VALE OF GLAMORGAN DIVISION: That this Meeting calls upon the BMA to address urgently the needs of colleagues in non-standard “trust” grade posts.
187d Motion by THE CONFERENCE OF HONORARY SECRETARIES OF BMA DIVISIONS: That this Meeting calls upon the BMA to address urgently the needs of colleagues in non-standard “trust” grade posts.
187e Motion by DARTFORD, GRAVESEND AND MEDWAY DIVISION: That this Meeting deplores the governments apathy towards trust doctors and is concerned that the trust doctors are being excluded from the current national negotiations between Government and SAS representatives about pay structure and career progression.
187f Motion by DARTFORD, GRAVESEND AND MEDWAY DIVISION: That this Meeting urges the BMA to explore ways for the SAS doctors to have a clear, fair and transparent pathway to career progression.
187g Motion by BURNLEY, PENDLE AND ROSSENDALE DIVISION: That we want to see a formal route towards autonomous practice built into any new contract framework for SAS doctors with higher skill and long years of experience.
187h Motion by NORTH THAMES RSASC: That this Meeting believes that the SASC Negotiating Team should include the interests of the Trust Grade and non standard grade doctors in the Negotiations for SAS Grades and thereby prevent the continued creation of another exploited group of doctors.
188 Motion by SOUTH WESTERN STAFF AND ASSOCIATE SPECIALISTS COMMITTEE: That this Meeting recommends that the BMA implements a concentrated media campaign aimed at informing the public of the significant contribution SAS doctors make to the successful treatment of patients in the NHS, and to the inequities of a system which encourages the NHS to spend valuable resources on importing specialists from abroad when it has a valuable pool of highly trained and experienced doctors who are not adequately recognised and rewarded for their work, and without whom the NHS would fall apart.
The motions below are unlikely to be reached:
189 Motion by HOLLAND DIVISION: That this Meeting commends the BMA on assembling a good support team for the SAS contract negotiations.
190 Motion by CARDIFF AND VALE OF GLAMORGAN DIVISION: That this Meeting calls upon the BMA to continue to seek full recognition and reward for SAS doctors whose work forms a significant (and significantly under-recognised) contribution to the NHS.
A 191 Motion by JUNIOR MEMBERS FORUM: That the BMA supports the Staff and Associate Specialists Committee in its recognition and reward campaign and single spine proposals to promote career progression within the grade.
A 192 Motion by PRESTON, CHORLEY AND SOUTH RIBBLE DIVISION: That all trusts establish Staff and Associate Specialist charters to ensure minimum working conditions.
PUBLIC HEALTH MEDICINE AND COMMUNITY HEALTH MONDAY 4.45 – 4.55
193 Receive: Report by the Chairman of Committee for Public Health Medicine and Community Health (Peter Tiplady).
194 Motion by SOUTH EASTERN RCPHMCH: That this Meeting is concerned that practice based commissioning will have a negative effect on clinical and public health priorities and insists that further implementation by the Department of Health must be based on appropriate evaluation, and informed by appropriate clinical and public health advice.
The motion below is unlikely to be reached:
195 Motion by NORTHERN RCPHMCH: That this Meeting believes that the greatest care is needed before non-medical public health specialists are given clinical responsibility equivalent to medically qualified consultants and calls upon the BMA to investigate this practice and reports back to this Craft Conference in 2006.
GENERAL PRACTICE MONDAY 4.55 – 5.15
196 Receive: Report by the Chairman of the General Practitioners Committee (Hamish Meldrum).
197 Motion by CONFERENCE OF LMCs AGENDA COMMITTEE: That this Meeting asserts in the strongest possible terms the commitment of British GPs to holistic, list-based, patient-orientated general practice and believes that:
(i) patients of this country will never forgive any government which destroys the cherished GP registered list system;
(ii) primary care needs of patients who work away from home can be provided for without the need to move away from registered lists;
(iii) continuity of care is under a steady and growing threat and that every new policy initiative needs to be publicly measured against its benefit or threat to continuity;
(iv) the overwhelming priority of the GPC should be to resist the destruction of independent contractor general practice.
198 Motion by CONFERENCE OF LMCs AGENDA COMMITTEE: That this Meeting:
(i) believes that the government is totally misguided on the value of large primary care “super-surgeries”, and believes this is not what the UK public want;
(ii) believes that super-surgeries will not improve quality, care or outcomes;
(iii) strongly opposes any policy which gives financial or other advantages to super-surgeries over the traditional models of service;
(iv) rejects the modernisation agency’s plan for a reduction in the number of GP practices and the construction of a three tier primary care service;
(v) directs the GPC to enter into urgent talks with the Health Departments to demand a balance between the widely trailed idea of very large GP “super-surgeries” by producing a complimentary, effective and costed policy for the support of smaller and single-handed practices.
The motion below is unlikely to be reached:
199 Motion by CONFERENCE OF LMCs AGENDA COMMITTEE: That this Meeting re-affirms its support for the multidisciplinary primary health care team and:
(i) believes that the establishment of community matrons must be an integral part of pre-existing primary health care teams;
(ii) deplores the move towards the separation both physically and managerially of nursing and other teams from general practice;
(iii) demands that health visitors and district nurses should always be attached to practices;
(iv) requires clarification as to where clinical accountability rests.
QUESTIONS TO THE CHAIRMAN OF COUNCIL MONDAY 5.25 – 5.45