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Junior Doctors Conference agenda

28 April 2007

This is the agenda for the junior doctors conference 2007, held on the 28 April 2007 at the Marriott Hotel, Regents Park, London

Part I — Procedural and formal matters
10:00
Return of representatives

Motion by THE CHAIRMAN:
That the return of representatives to the Junior Doctors Conference 2006 (Guide for representatives – JDC(C)2, 2007) be received.

Late return of representatives
Motion by THE CHAIRMAN:
That the late return of representatives (JDC(C)2A, 2007 – document) be received, taken as read, and entered in the minutes.

Apologies
Motion by THE CHAIRMAN:
That apologies for absence from members of conference be received, taken as read, and entered in the minutes.

Junior Doctors Conference, May 2006: minutes
Motion by THE CHAIRMAN:
That the minutes of the Junior Doctors Conference held on 6 May 2006 (JDC(C)10, 2006 – document) be confirmed.

Standing orders
Motion by CONFERENCE AGENDA COMMITTEE:
That the standing orders of conference (JDC(C)3, 2007 – guide) be adopted for the 2007 Junior Doctors Conference.

Motion by CONFERENCE AGENDA COMMITTEE: That the standing orders of conference be amended for the 2008 Junior Doctors Conference as shown in tracked changes (JDC(C) 12, 2007 – guide) and recommends that the standing orders of the Junior Doctors Committee shall be amended accordingly.

Disturbances during conference
Motion by CONFERENCE AGENDA COMMITTEE:
That this conference directs that all attendees who disturb the proceedings of the conference shall be invited to pay a voluntary fine to a charity nominated by the conference. Such disturbances may, at the discretion of the chairman, include but not be limited to:

i. mobile telephones or paging devices (even if switched to a ‘silent’ mode)
ii. audible alarms from other electronic equipment
iii. excessive/inappropriate use or abuse of standing orders
iv. late return from lunch!

This policy shall stand for the duration of each conference only and be subject to annual re-adoption (Policy first made in 2001).

Report of the Conference Agenda Committee
Membership
Receive: membership of the Conference Agenda Committee for 2006-07:

Dr Simon Minkoff (Chairman)
Dr Michael Daley
Dr Remy McConvey (Deputy Chairman
Mr Ram Moorthy
Dr Jo Hilborne (Chairman of JDC)
Dr Kitty Mohan
Dr Eleanor Draeger

The members of the Conference Agenda Committee have met as recommended and have, in the light of the motions received drawn up an agenda which has been arranged in sections to cover important topics.

Grouping of motions and amendments
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 an asterisk) on which it proposes that discussions should take place (standing order 18(c)(i)).

Motions and amendments prefixed ‘A’ are either non-controversial or already policy of the Junior Doctors Conference, and therefore will be voted on without debate (standing order 18(c)(ii)).

Priority motions for JDC action
Near the end of the conference a list of motions carried will be available with a form allowing members of conference to choose the five areas/motions which they think should be given priority for action by the JDC during the 2007-08 session.

Lapsing and retention of policy
Motion by THE CHAIRMAN: That, in accordance with standing order 10, policy made or re-adopted at the 2002 conference be allowed to lapse or be retained as set out in (JDC(C)11, 2007 – guide).

NOTE: WOULD ANY MEMBERS OF THE CONFERENCE WISHING TO RETAIN POLICY WHICH IT HAS BEEN SUGGESTED SHOULD LAPSE SHOULD NOTIFY THE SECRETARIAT IN WRITING, BY TUESDAY 24 APRIL 2007.

'A' motions
Motion by THE CHAIRMAN:
That all ‘A’ motions in the conference agenda be carried.

Order of business
The committee RECOMMENDS:
i. That the business be taken in the order and at the time indicated below:

09:00 Registration and coffee

Morning session
10:00 Procedural and formal matters
– Lapsing and retention of Conference Policy from 2002
– Consider changes to conference standing orders

10:10 Grass roots event motion

Our Training, our future, our say
Presentations
Dr Kevin Haire, Co-director Medical Simulation,
10:15 Chelsea and Westminster Hospital

Mr Conor Marron,
10:30 Immediate past president of the Association of Surgeons in Training.

Dr Charlotta Sävblom,
10.45 President of the Swedish Junior Doctors Association

Professor Janet Grant
11.00 Director of the centre for Education in Medicine, The Open University

11:15 Question and answer session

Report of the Junior Doctors Committee
11.25 — Speech from the Chairman of JDC
11.30 — Questions to the Chairman and Deputy Chairmen of JDC

11:45 Open debate (Modernising Medical Careers)
12:15 Medical education and training (Part I)
12:25 Allied Health Professionals
12:30 Independent Sector Treatment Centres
12:40 Science and the the public health

12:45 Election of Chairman of and Deputy Chairman of Conference for 2007
12:50 BLT
12:55 Lunch

Afternoon session
14:00 Grass roots event motions
14:15 Modernising Medical Careers
14.30 The British Medical Association
14:45 External organisations

14:50 Open debate on a topic chosen at the grass roots event
15:20 Coffee

15:50 Election of members of the Conference Agenda Committee 2007-08
15:55 Supplementary agenda
16:05 Chosen motions
16:20 Feedback from morning and afternoon open debate sessions
16:35 Regulation and registration
16:45 Facilities and benefits
16:50 The NHS
17:10 Medical education and training

17:20 Results of the elections to the Conference Agenda Committee, 2007-08
17:25 LSD
17:30 Summary of the day
17:45 Close

1. That a ballot (form JDC(C)9, 2007 – document) be held before 12:25 to determine which motions from any part of the agenda shall be debated at 16:05.
2. That, in the event of any section being completed before the allotted time, other items be considered and taken in order.

Motion by the Chairman:
That the report of the Conference Agenda Committee (Items 7-15) be approved.

Elections
Elect: Conference Chairman, Deputy Chairman, Agenda Committee and conference representatives to ARM.

Note:
Nomination forms should be handed in at the following times:

11.15 Nomination of the Chairman of the Conference (JDC(C)5, 2007 – nominations pack)
11.25 Nomination of the Deputy Chairman of the Conference (JDC(C)6 2007 – nominations pack)
14.00 Nomination of four members of the Conference Agenda Committee (JDC(C)7, 2007 – nominations pack).
14.00 Nomination of 20 Junior Doctors Conference representatives to the BMA Annual Representatives Meeting (JDC(C)14, 2007 – nominations pack).

Part II — Motions and debate
10:10 Grass roots event motion
Please see supplementary agenda (JDC(C)1B 2007) tabled on the day.

10:15 Our Training, our future, our say
Presentations
10:15 Dr Kevin Haire, Co-director Medical Simulation, Chelsea and Westminster Hospital
10:30 Mr Conor Marron, immediate past president of the Association of Surgeons in Training.
10:45 Dr Charlotta Sävblom, President of the Swedish Junior Doctors Association
11:00 Professor Janet Grant, Director of the entre for Education in Medicine at The Open University

11:15 Panel discussion – question and answer session

11:25 Report of the Junior Doctors Committee
1 Motion by THE CHAIRMAN That the 2007 annual report of the Junior Doctors Committee be received.
2 Motion by THE CHAIRMAN OF THE JDC Receive: Oral report from the chairman of the JDC, Jo Hilborne, on the committee’s activities during the 2006-07 session.

This will be followed by a question and answer session to the chairman and deputy Chairmen of the JDC regarding the committee’s work over the 2005-06 session.

11:30 NOTE: WOULD ANY MEMBERS OF THE CONFERENCE WISHING TO ASK QUESTIONS PLEASE SUBMIT THESE TO THE SECRETARIAT BY TUESDAY 2 4 April 2007 AT NOON. Questions will also be taken from the floor, time permitting.

11:45 Open debate (Modernising Medical Careers)

12:15 MEDICAL EDUCATION AND TRAINING (PART I)
Funding
3 Motion by NORTH THAMES RJDC That this conference believes that funding of training posts and study leave is essential to allow doctors in training to gain a full range of experience. We call on the DH

i) to restore MPET and specifically MADEL funding to at least the original 2006-7 funding levels
ii) to ringfence MPET and specifically MADEL funding within the SHA budget
iii) to commit to a three year funding plan for MADEL to facilitate workforce planning and allow programme design to be planned in advance.
iv) to standardise study leave allowances across the UK

4 Motion by NORTHERN RJDC That this conference believes that JDC should lobby for MPET funding to;

i) become ring-fenced,
ii) be increased in order to support improvement of training and the implementation of MMC.

A 5 Motion by WESSEX RJDC That this conference calls for ringfencing be restored to the Multi-Professional Education & Training (MPET) levy set by central government so that these funds can be guaranteed to be used for the educational and training purposes intended.

Flexible training
6 Motion by NORTHERN RJDC That this conference believes that the JDC campaign to make the provision of flexible training an immediate priority for the Department of Health.

A 7 Motion by WESSEX RJDC That this conference recognises the recent decline of those undertaking flexible training (according to COPMEDs biannual survey), and calls for an urgent enquiry into the reasons for this. Where this is due to insufficient funding, this conference calls for adequate financial resources, which must be protected, to be dedicated to flexible training, so that the disappointing trend can be reversed, in order for the Department of Health target of 20% of the workforce training flexibly to be a realistic goal.

A 8 Motion by SOUTH THAMES RJDC That this conference notes with alarm that the number of flexible trainees across the country has fallen, despite promises from NHS employers that the new contract for flexible trainees would widen access. In addition, one of the Improving Working Lives standards from the NHS plan 2000 was for “flexible working”. This conference calls upon NHS employers to assure us that flexible training will continue to be funded, and that they will take steps to ensure that the numbers of flexible trainees increases in line with demand.

12:20 Competency based training
9 Motion by NORTHERN RJDC That this conference believes that progression through Specialist Training (ST) years should become truly competency-based – and therefore become phases, whereby completion of competencies (rather than time in post) are required for progression to the next ST phase.

10 Motion by SCOTTISH JDC That this conference notes the reduction in hours worked and changes in post graduate training could result in junior doctors gaining less experience than previously. It therefore calls on the JDC to lobby PMETB to monitor the experience of junior doctors, and should this experience be less than what is currently expected at the stage of issuing a Certificate of Completion of Training will lobby for an extension of ST programs to make up this deficit.

11 Motion by SCOTTISH JDC That this conference calls on COPMED and the other authors of the Foundation Programme Guide to:

(i) produce a clear, concise formal appeals process for those deemed as not progressing through the foundation programme;
(ii) produce clear guidance on the length of time appropriate for measuring progression in those not reaching competencies in Foundation Year1.

A 12 Motion by NORTHERN RJDC That this conference calls for the standards for the consultants of the future to be at least as high as they are currently.

A 13 Motion by SCOTTISH JDC That this conference:

(i) notes that ALS training is part of the Foundation Programme curriculum;
(ii) notes that not all FHO2 doctors are currently being given access to Resuscitation Council Accredited ALS training;
(iii) is concerned that not all FHO2 doctors will receive any ALS training.

It therefore calls on the JDC to lobby for:
(i) ALS training to remain part of the Foundation Programme curriculum;
(ii) all FHOs to be given access to Resuscitation Council Accredited ALS training as early as possible in their curriculum.

12:25 ALLIED HEALTH PROFESSIONALS
14 Motion by SOUTH THAMES RJDC That this conference believes that an urgent, independent and public review is needed to evaluate the role (if any) of non-medically qualified practitioners and that robust quality and outcomes including cost effectiveness, error and incorrect diagnosis/management rates must be recorded for these practitioners and made available in the public domain.

* 15 Motion by NORTH WESTERN RJDC That this conference recognises the tension that can arise where training opportunities need to be offered to both junior doctors and nurse practitioners, and calls upon the CCSC to ensure that consultants are reminded of their professional and ethical responsibilities to provide training for juniors of adequate duration and quality, and where necessary, to prioritise juniors.

16 Motion by NORTH WESTERN RJDC That this conference is gravely concerned about the training of advanced nurse practitioners, and calls upon

i)consultants to prioritise junior doctor training over the training of nurses
ii)consultants to train nursing staff in skills specific to their own specialty only
iii) junior doctors not to undertake training of nurses that they are not qualified to give.

17 Motion by SOUTH THAMES RJDC That this conference believes that non-medically qualified practitioners must not be allowed to perform surgical or other invasive procedures on patients, even if supervised. The role and duties of the doctor must be protected and these practitioners must not be used to replace or supersede doctors.

12:30 INDEPENDENT SECTOR TREATMENT CENTRES
18 Motion by NORTH THAMES RJDC That this conference believes that CATS and similar independent sector centres

i) destabilise local health economies,
ii) inappropriately draw money and patients from the NHS,
iii) present indefensible conflicts of interest by combining referral and receiving centres with an additional financial incentive for internal self-referral

This conference calls for the BMA to vigorously campaign for CATS and similar schemes to be stopped and reversed.

19 Motion by SOUTH THAMES RJDC That this conference believes that Independent Sector Treatment Centres and ICATS have no value or benefit in a properly run NHS. They are also a major threat to medical training and education. It calls for them to be halted immediately and their contracts to not be renewed.

20 Motion by WEST MIDLANDS RJDC That this conference believes all doctors working in Independent Sector Treatment Centres/ Integrated Clinical Assessment and Treatment Services centres should be registered, regulated and subject to the same process of revalidation/ recertification and training as doctors working in the NHS.

21 Motion by WEST MIDLANDS RJDC That this conference believes there should be no distinction between the quality of care offered by doctors in Independent Sector Treatment Centres/ Integrated Clinical Assessment and Treatment Services compared to the NHS.

22 Motion by WEST MIDLANDS RJDC That this conference recommends that elective surgery carried out in Independent Sector Treatment Centres/ Integrated Clinical Assessment and Treatment Services centres should be used for training.

A 23 Motion by SOUTH THAMES RJDC That this conference notes that an increasing number of doctors in training are being employed to work in Foundation Trusts and Independent Sector Treatment Centres. It calls upon the government to make an assurance that all doctors in training will remain on the national terms and conditions, regardless of the workplace they are in.

12:40 SCIENCE AND THE PUBLIC HEALTH
24 Motion by NORTH THAMES RJDC That this conference calls for the forfeiting of a single scale point of salary from NHS staff who smoke at work.

25 Motion by NORTH THAMES RJDC That this conference deplores the government’s decision to sanction the advertising of gambling and calls upon the government and media alike to recognise the power of advertising, and thus the detrimental effect that this legislation will have on both addicts and their dependents.

26 Motion by NORTH THAMES RJDC That this conference calls on the government to ban the sale of tobacco products in vending machines as an essential measure to prevent the sale of tobacco to children, and as a natural measure to fall in line with anti-tobacco legislation commencing on 1 July 2007.

27 Motion by WEST MIDLANDS RJDC That this conference recommends that all junior doctors should wear scrubs cleaned by the hospital laundry to improve infection control. Green scrubs for surgical juniors and blue scrubs for medical juniors.

A 28 Motion by NORTH THAMES RJDC That this conference requests that the Faculty of Public Health work with BASHH and the Royal College of Obstetricians & Gynaecologists to clarify the need for a family planning specialty in order that all women have access to appropriate reproductive health support in the community.

A 29 Motion by SCOTTISH JDC That this conference believes that at least 40% of patients in UK hospitals are malnourished, which is 10% above the EU average for hospital malnutrition. This conference demands the highest level of commitment from government, towards Council of Europe Alliance (UK) and BMA initiatives, preventing patients from starving in our care.

12:45 Election of Chairman of Conference and Deputy Chairman of Conference 2007-08

12:50 BLT
30 Motion by NORTH THAMES RJDC That this conference calls on the Secretary of State for Health to resign, and then have the opportunity to re-apply for her old position under the following revised terms and conditions:

a) To apply, you must fill out a succinct 600-page application form by 10pm today. You may not be able to access this system before: 10pm today due to high demand for the service.
b) This will be scored by a minimum of two people, one of whom will be your cleaner, the other Andrew Lansley. Both will have received telephone training lasting at least 46 seconds on this. Maybe.
c) Your answers will be scored on an arbitrary system which we might have released accidentally to some of your competitors.
d) None of your previous experience will count towards the current appointment.
e) The job specifications can be found on our website which is currently experiencing technical difficulties but which will hopefully be remedied the day after applications close.
f) You may apply for more than one ministerial post, and in more than one political party. You MUST accept any job you are offered under this scheme, even if it involves becoming a Tory. Do not worry - if you are unsuccessful in this round, there may well be some exciting and fulfilling jobs such as the Monster Raving Loony Party Spokesman on medieval literature and the Veritas spokesperson on fake tanning.
g) The Secretary of State for Health post may, in the course of this application, be re-defined. You will experience a 30% pay cut as the out-of-hours component of this job is cut and you may be expected to cover the Ministry of Defence out of hours. A more detailed job description will be available towards the end of your post.
h) If you are lucky enough to be shortlisted for this job, you will be expected to attend interview tomorrow morning with: 15 copies of your 1983 tax return, 5 copies of your original proof of TB immunity, 2 copies of your first undergraduate essay, 3 copies of your passport, your ORIGINAL first attempt at writing your name and a Blue Peter badge. Failure to bring these EXACT documents will result in your disqualification from the round.

Reminder that the interviews for this posts will be held: week commencing May 29th. You will be notified whether or not to attend tomorrow’s interview by: May 29th.

Best of luck in your application,

Regards

Junior Doctors Conference 2007

12:55 Lunch

14:00 Three motions from the grass roots event
Please see supplementary agenda JDC(C) 1B tabled on the day.

14:15 MODERNISING MEDICAL CAREERS
* 31 Motion by NORTH THAMES RJDC That this conference believes the current Modernising Medical Careers reforms have been implemented in shambolic and deeply destructive manner. The public and the medical profession have had enough of the political games that are being played with training of the future medical workforce.

This meeting demands:

1. An independent public enquiry into implementation of Modernising Medical Careers
2. A review by the National Audit office regarding the wasting of public money as a result of MMC
3. The immediate resignation of Lord Philip Hunt of Kings Heath OBE, Minister of State for Quality at the Department of Health
4. The immediate resignation of Patricia Hewitt, Secretary of State for Health

32 Motion by NORTH THAMES RJDC That this conference calls for the resignation of the Secretary of State for Health over the disastrous implementation and administration of the MMC process.

33 Motion by SOUTH THAMES RJDC That this conference feels that in view of the shambolic way in which MTAS and MMC have been implemented, we call upon Liam Donaldson to resign as he was the author of “Unfinished Business”, which was the platform for the MMC reforms.

34 Motion by SOUTH THAMES RJDC That this conference has no confidence that a single point of entry into specialty training as planned under MMC can effectively select the best candidates. We therefore call on the Department of Health to suspend run-through training and return to a system of separate basic and higher specialty training.

35 Motion by SCOTTISH JDC That this conference notes that the Scottish Executive Health Department has stated that it will allow entry above ST1 between 2008-10 in Scotland and asks the JDC to lobby the other three departments of health to adopt similar measures, in order to ensure that FTSTAs are not dead end posts.

36 Motion by NORTHERN RJDC That this conference believes that there should be a phased transition to the MMC model.

37 Motion by NORTHERN RJDC That this conference believes that MMC implementation, as it currently stands, will create a “lost tribe” of doctors.

38 Motion by NORTHERN RJDC That this conference recognises the current MMC implementation has a cynical view of using doctors as a resource without consideration to them as individuals, humans, or to their work/life balance.

14:20 MTAS
* 39 Motion by NORTHERN RJDC That this conference recognises the failure of MTAS and has no confidence in those individuals leading the MMC initiative.

40 Motion by MERSEY RJDC That this conference proposes a vote of no confidence in the MMC team, and calls for a review of its members and their suitability for their roles to ensure better representation from the medical profession in future.

41 Motion by WEST MIDLANDS RJDC That this conference calls for the abolishment of MTAS and the introduction of a fair and discriminative selection process, which is speciality specific and has been discussed with royal colleges. As the GP VTS scheme had an examination as part of the selection procedure, Medical and surgical applicants should have a similar related OSCE, EMQ interview type selection process.

42 Motion by NORTHERN RJDC That this conference calls for an application system in which trainees can apply for a training post in the area they wish and in the speciality they wish.

43 Motion by NORTHERN RJDC That this conference believes that the MTAS system was too rigid and compartmentalised and calls for a return to a more holistic approach to assessing the applicant’s excellence.

44 Motion by NORTHERN RJDC That this conference for any subsequent selection system for training posts to have a demonstrable evidence base for it’s use.

14:25 Misc.
45 Motion by NORTH THAMES RJDC That this conference believes that the selection methodology for MMC Specialty Training programmes is deeply flawed and poorly evidenced. We call on the Colleges, BMA, MMC and DH to work together to improve the methodology to adequately reflect the experience of people entering above ST1, whilst identifying the most suitable candidates to enter a specialty at ST1.

* 46 Motion by NORTHERN RJDC That this conference calls for a “swap shop” (facilitated inter-deanery transfer) for trainees between deaneries.

47 Motion by SOUTH THAMES RJDC That this conference believes that should the current round of applications go ahead, there may be many junior doctors who are offered jobs in areas far from their home and their family. This conference therefore calls upon the deaneries to allow inter-deanery transfers prior to the start of August 2007, so that candidates can swap jobs with colleagues at the same level as them.

48 Motion by NORTHERN RJDC That this conference believes that the Department of Health be held to account over their recurrent failure to provide careers advice to doctors.

49 Motion by SCOTTISH JDC That this conference notes that the decision by PMETB to remove the ability of trainees in post before the introduction of MMC to apply for retrospective recognition for their training was made without prior consultation. It therefore calls upon the JDC to lobby PMETB to allow trainees in post prior to the introduction of MMC to apply for retrospective recognition of training.

50 Motion by NORTHERN RJDC That this conference calls on the BMA to send every member through the BMJ a postcard that enables them to protest against the MMC and MTAS process.

51 Motion by NORTHERN RJDC That this conference believes that the BMA’s Board of Medical Education should review the strengths and weaknesses of the Modernising Medical Careers initiative.

52 Motion by NORTHERN RJDC That this conference believes that the current model of MMC implementation will impair patient safety and the quality of future consultants and GPs.

53 Motion by NORTH THAMES RJDC That this conference calls on the BMA’s head of legal affairs to sanction a fully independent legal review of the implementation, administration and conduct of MMC and MTAS.

A 54 Motion by WESSEX RJDC That this conference calls for the essential provision of deanery based careers advisors to support specialty trainees who are experiencing difficulties within their chosen specialty.

A 55 Motion by SOUTH THAMES RJDC That this conference calls for trusts to honour junior doctors’ contracts that extend past August 2007 irrespective of the implementation of MMC. In addition, all doctors in currently recognised training posts should have this counted for recognised training under MMC.

A 56 Motion by NORTH THAMES RJDC That this conference believes that the flexibility which was supposed to be one of the seven pillars of MMC has been lacking so far, and:

i) calls on PMETB and others to amend curricula and structures to facilitate transfer of trainees between specialties (including general practice) with minimal wasted time or training
ii) calls on the Royal Colleges to urgently collaborate to agree transferable competencies
iii) calls on the BMA to lobby for improved careers guidance for junior doctors
iv) recognises the good work done by the BMA in setting up careers guidance sessions for juniors and calls for this to be expanded as a membership benefit

A 57 Motion by SOUTH THAMES RJDC That this conference calls upon trusts and deaneries to honour all reasonable travel and relocation expenses incurred by junior doctors as a result of the MTAS process.

14:30 THE BRITISH MEDICAL ASSOCIATION
* 58 Motion by NORTH WESTERN RJDC That this conference continues to be appalled at the poor design, organization, usability and utility of the BMA website and calls upon BMA Council to commission a proper and open review of the website, with a detailed timetable for implementing necessary changes.

59 Motion by NORTHERN RJDC That this conference believes that the BMA web strategy be reviewed and

i) the web site made more fit for purpose
ii) email become the dominant mode of communication with members.

60 Motion by SOUTH THAMES RJDC That this conference calls upon the BMA to improve their communication strategy, including a redesign of the website, with immediate effect, to make it more user-friendly. It also calls upon JDC to ensure that the committee fully supports and implements any recommendations of this conference that could positively improve communications.

61 Motion by SOUTH THAMES RJDC That this conference notes the overwhelming evidence that human behaviour is contributing to global warming. It calls upon the BMA to:

i) investigate what a realistic timescale for reducing its carbon footprint to zero would be
ii) commit to meeting this target within the timescale specified.

62 Motion by NORTH WESTERN RJDC That this conference believes that the provision of bottled water at meetings in BMA House incurs a significant environmental penalty, and calls upon the Association to install mains water water chillers in meetings suites and cease purchasing bottled water.

63 Motion by WEST MIDLANDS RJDC That this conference believes junior doctors who are BMA members should have more support for bullying and harassment by other health professionals. This support should be in the form of a ‘bullying & harassment phone-line’ that results in immediate action from BMA personnel with the persons involved.

Junior Doctors Committee
* 64 Motion by NORTHERN RJDC That this conference believes that;

i) there should be an internal review of the structure and function of the JDC with possible restructuring to improve effectiveness
ii) there should be a review of the efficacy of JDC communication with members.

65 Motion by SCOTTISH JDC That this conference:

i) notes the difficulties that local BMA representatives have in communicating with those they represent;
ii) believes that contact details from Association membership records should be made available to representatives;
iii) asks JDC, regional services and membership to work together to improve communication with members in this way.

66 Motion by NORTH WESTERN RJDC That this conference recognizes that JDC must improve its communication with members and calls upon the BMA, within the next twelve months, to:

i) provide listservers for all RJDCs
ii) support the preparation of quarterly RJDC newsletters centrally
iii) introduce a paperless site for RJDCs.

67 Motion by WEST MIDLANDS RJDC That this conference believes upon joining the BMA and at each membership renewal each junior doctor should receive a list of the JDC members and contact details of local regional chair and information about function of Local Negotiating Committees and how to contact representatives.

68 Motion by SOUTH THAMES RJDC That this conference believes that a back-dated vote of no confidence be passed against Dr Simon Eccles in light of the increasing evidence of his conflict of interests dating back to his time as Chair of the JDC.

69 Motion by SOUTH THAMES RJDC That this conference strongly believes that the Simon Eccles does not represent the views of the JDC nor junior doctors as a whole. It calls for this to be recognised by all seeking an opinion from the junior body – including the media and the Government.

70 Motion by NORTHERN RJDC That this conference believes that all JDC members should, when first joining JDC, undergo training around the junior doctor contract in order to enhance their role.

71 Motion by NORTH WESTERN RJDC That this conference believes that grassroots members need to be more closely involved in national JDC policy making, and, to this end, calls upon JDC to ensure that RJDC meetings are held shortly before UK JDC meetings and that the agendas for national meetings are made available for discussion at these meetings.

14:45 EXTERNAL ORGANISATIONS
* 72 Motion by SOUTH THAMES RJDC That this conference believes that the AoMRC is an undemocratic organisation which does not represent all junior doctors in training, and we therefore call for a vote of no confidence in them as a representative body. Until and unless the AoMRC does become more representative, it should not be allowed to claim it represents the interests of junior doctors in training.

73 Motion by NORTHERN RJDC That this conference believes that;

i) the Royal College Trainees’ groups cannot claim to be representative for junior doctors,
ii) demands that should they wish to represent junior doctors they must create or have local or regional representative structures.

74 Motion by SOUTH THAMES RJDC That this conference notes with concern that the DDRB has failed yet again to recommend a fair pay award for doctors in training. We therefore call upon the BMA to formally withdraw from the DDRB process.

75 Motion by NORTHERN RJDC That this conference believes that the BMA should discuss industrial action in response to serial derisory DDRB awards.

76 Motion by NORTH THAMES RJDC That this conference:

i) considers the spring 2007 DDRB award to be derisory, and to not recognise or reward the work of doctors of any grade
ii) calls on the BMA to campaign for the 2007-8 DDRB award not to be staged anywhere in the United Kingdom
iii) calls on the DH to ensure that pay awards are universally applied across the United Kingdom

77 Motion by SOUTH THAMES RJDC That this conference believes that the creation of the PMETB has added an unnecessary extra layer of bureaucracy which has no demonstrable benefit to the medical profession, or to NHS patients. It therefore calls for the PMETB to be disbanded.

78 Motion by NORTH THAMES RJDC That this conference:

i) believes that the PMETB fees structure does not reflect the principle of “beneficiary pays”
ii) insists that the principle of political independence does not require financial independence
iii) calls on PMETB to substantially reduce fees to doctors for CCT and Article 14 and recoup the remaining costs from the Department of Health

79 Motion by NORTHERN RJDC That this conference believes that JDC should lobby the Conference of Postgraduate Medical Deans (COPMeD) to include Regional JDC (RJDC) members in local or regional educational deanery committees.

14:50 Open debate on a topic to be chosen by grass roots attendees

15:20 Coffee

15:50 Elections of members of the Conference Agenda Committee 2007-08

15:55 Supplementary agenda
Please see supplementary agenda JDC(C) 1A tabled on the day.
16:05 Chosen motions

16:20 Feedback from morning and afternoon open debate sessions

16:35 EMPLOYMENT
Professional registration and regulation
* 80 Motion by SCOTTISH JDC That this conference notes the recent Government White Paper, “Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century” and:

(i) believes that self-regulation is essential to being a profession;
ii) re-affirms that junior doctors believe strongly in the principle of self-regulation of the medical profession by the GMC;
iii) believes that the GMC should continue to be constituted with a majority of elected medical members;
iv) resolves that the JDC lobby within and outside the BMA on this matter.

81 Motion by NORTH THAMES RJDC That this conference believes that the Donaldson review of medical regulation and the subsequent White Paper:

i) threaten the future of the medical profession and spell the end of self-regulation;
ii) pose an unjustified threat to doctors’ careers through an inappropriately lowered threshold for decisions in fitness to practise proceedings;
iii) are not fit for purpose in their current form.
This conference calls on the BMA to strongly campaign against the deleterious changes proposed in the White Paper.

82 Motion by NORTH THAMES RJDC That this conference

i) notes the introduction of tests of prescribing competence in some hospitals
ii) notes that the GMC is commissioning research into such tests, their utility and validity, and means of improving competence in prescribing
iii) calls for Trusts not to introduce piecemeal, unvalidated, local tests of prescribing competence, and not to prevent junior doctors from prescribing on the basis of the outcome of these tests.

83 Motion by SOUTH THAMES RJDC That this conference calls for the government to guarantee that a subconsultant grade will not be introduced and that all CCST/CCT holders who are on the specialist register should be employed in Consultant Grade Posts only.

84 Motion by SOUTH THAMES RJDC That this conference believes that the NHS should continue to provide consultant-led care, and calls upon the government to assure the medical profession that there are no plans for a sub-consultant grade.

85 Motion by SOUTH THAMES RJDC That this conference calls upon Government to ensure that all appropriately qualified doctors who may be employed outside the NHS in private sector facilities, should be employed as Consultants, not at sub-Consultant level.

86 Motion by SOUTH THAMES RJDC That this conference calls for the return of responsibility of regulation and administration of post-graduate medical education to the Royal Colleges and Speciality Bodies.

Industrial relations
87 Motion by NORTH THAMES RJDC That this conference abhors the bullying of juniors into using clinical time for non-clinical administration to benefit the trust financially.

A 88 Motion by NORTH THAMES RJDC That this conference believes juniors should not be bullied into altering the hours they have worked to ensure rota compliance during rota monitoring audits.

International Medical Graduates
89 Motion by MEDICAL STUDENTS CONFERENCE That this conference deplores the recent changes in Home Office Immigration Laws and:

(i) believes that they are unfair to students currently studying medicine in the UK, particularly given the sudden introduction of the legislation
(ii) believes that they will not allow the NHS to make optimum use of the pool of UK medical school graduates
(iii) believes that they will have a detrimental effect on recruitment of international students to UK medical schools
(iv) calls on the BMA and MSC to continue to lobby the government to exempt graduates of UK medical schools from this legislation
(v) calls on the DoH, GMC, CHMS and Medical Schools to make potential international students fully aware of these changes and the implications for their future career path..

90 Motion by WEST MIDLANDS RJDC That this conference believes that universities and the British Council should make overseas applicants to medical schools very aware that there has been a recent change in the immigration rules which means that foreign medical students will no longer be able to complete their postgraduate training in the UK.

91 Motion by SOUTH THAMES RJDC That this conference believes that all non-UK graduates should have to take the PLAB exam, as well as a universal English language proficiency test, before being approved to work in the UK.

16:45 Facilities and benefits
92 Motion by WEST MIDLANDS RJDC That this conference believes a water machine should be provided in all departments for staff use, so to ensure good hydration and optimum work output.

93 Motion by NORTH THAMES RJDC That this conference calls on the JDC to:

i) urge the DDRB to recommend an increase in the basic pay for Foundation House Officer 1s (Pre-Registration Doctors) in lieu of any loss of free accommodation and
ii) demand that the Department of Health upholds any such recommedation from the DDRB.

94 Motion by NORTH THAMES RJDC That this conference calls for the JDC to actively campaign for Trusts to facilitate the safety of their junior medical employees in returning home after completing shifts that finish between 21:00 and 06:00 hours through the use of on-call rooms; free transport or secure car parking facilities.

Terms and Conditions of Service/Job Contracts
95 Motion by NORTH THAMES RJDC That this conference reaffirms its commitment to renegotiate the juniors contract and calls on the BMA to lobby the DH to begin this process quickly in order to be ready for 2009 and EWTD.

96 Motion by NORTHERN RJDC That this conference believes that negotiations towards a new junior doctor contract be postponed until a more favourable period.

97 Motion by WESSEX RJDC That this conference calls for study leave budgets to be restored in full and that doctors courses be afforded tax relief.

98 Motion by SCOTTISH JDC That this conference believes that FHO1 doctors should be able to ‘borrow’ 5 days study leave from their FHO2 allocation of 30 days in order to undertake a 5 day “taster” period.

99 Motion by NORTHERN RJDC That this conference calls for study leave to be recognised as, and handled separately to in-house or deanery-led teaching.

100 Motion by NORTH THAMES RJDC That this conference calls upon JDC to support the creation of an individual study leave funding budget; i.e. £800 pa to be ring-fenced for each trainee, and to be spent by the trainee according to their personal educational requirements; and calls upon JDC to actively campaign for this to be implemented.

101 Motion by WEST MIDLANDS RJDC That this conference insists terms & conditions of junior doctors working conditions should be of similar standards as other professionals such as lawyers and dentists.

102 Motion by NORTHERN RJDC That this conference calls for any new junior doctor contract to be based around;

i) working time and
ii) intensity
iii) proportion of time spent in “work” as opposed to time spent in “training”.

103 Motion by MERSEY RJDC That this conference believes that junior doctors should not be expected to cover colleagues' sick leave for more than a week, and that this should be clearly stated in their contract. Furthermore, they should be compensated accordingly at trust locum rates for any cover provided beyond this period.

A 104 Motion by NORTH THAMES RJDC That this conference deplores the universal unbanding of the entire F1 year in certain hospital trusts from both an educational and professional point of view, and calls upon JDC to lobby COPMeD to halt this disastrous turn of events.

Work - Life Balance
105 Motion by WEST MIDLANDS RJDC That this conference recommends foundation year 2 doctors should be provided with hospital accommodation due to the short period of the post, university debt and difficulty in arranging short term accommodation.

106 Motion by WEST MIDLANDS RJDC That this conference believes a single junior doctor should not have to cover to a colleague’s leave/absence. Patient care should be split equally and appropriately amongst the juniors working that day according to maximum number of patients allowed to be responsible for.

107 Motion by NORTH WESTERN RJDC That this conference recognises the difficulties faced by junior doctors in completing compulsory audits and calls upon the JDC to campaign for protected time for audit where it is compulsory.

108 Motion by NORTHERN RJDC That this conference believes that harassment and bullying of junior doctors could be further reduced in the NHS and the Department of Health and the Royal Colleges enact plans to further reduce this.

109 Motion by NORTHERN RJDC That this conference believes that all junior doctors should receive information at induction about sick leave and study leave at their local induction and that this should be consistent with national good practice and the terms and conditions of service.

110 Motion by NORTHERN RJDC That this conference believes that there should be an independent analysis of the impact of and cost of mechanisms for appointment to training posts within the NHS.

A 111 Motion by WESSEX RJDC That this conference applauds those NHS Trusts which continue to provide on-call rooms for trainees to recover from night-shifts prior to journeying home and calls for NHS Employers and deaneries to establish this as normal practice.

A 112 Motion by NORTHERN RJDC That this conference believes that the JDC should campaign for Foundation year 1 doctors to receive free hospital accommodation.

A 113 Motion by SOUTH THAMES RJDC That this conference believes that the BMA should recognise the contribution of all doctors to the medical workforce, regardless of race, gender, disability, sexual orientation, age or religion. It calls upon the BMA to affirm its commitment to protecting them from discrimination.

16:50 THE NATIONAL HEALTH SERVICE
114 Motion by SOUTH THAMES RJDC That this conference notes that the Treasury has now declared that the NHS is no longer in deficit. We believe that it this is misleading, as it does not take into account the future debts to PFI companies which NHS trust will have to make over the next 30 years. We therefore call for the treasury to include future debts to PFI companies when calculating the NHS deficit.

115 Motion by SOUTH THAMES RJDC That this conference feels that the target culture, mismanagement of funds and basic disdain for the welfare of our patients by the present government has now reached shameful proportions. We therefore call for:

i) a vote of no confidence in the Secretary for state for Health – Patricia Hewitt MP
ii) radical revisions to the nature of the relationship between politicians and the management of the health service in this country.

116 Motion by WEST MIDLANDS RJDC That this conference calls for trusts and doctors to be made aware that doctors who see victims of Road Traffic Accidents are entitled to fees as per the Road Traffic Act. A standard form should be available so the current fee of £21.50 per patient can be claimed from the driver of the vehicle involved.

117 Motion by WEST MIDLANDS RJDC That this conference believes patients who abuse the casualty department with regular attendances instead of seeking services of a general practitioner should receive a penalty.

118 Motion by WEST MIDLANDS RJDC That this conference believes general practices should receive a penalty for patients on their list who abuse the casualty department with regular attendances suitable of services provided by a general practitioner.

17:00 Workforce planning
119 Motion by NORTH WESTERN RJDC That this conference is disgusted with the total inability of the government to manage workforce planning for doctors and calls upon the BMA to open discussions with the Department of Health on setting up robust, independent mechanisms for workforce planning, including proper involvement of medical professionals.

120 Motion by NORTH THAMES RJDC That this conference calls upon the DoE to restrict the number of medical graduates from entry in 2008 to reduce future predicted unemployment levels amongst the profession, thereby saving taxpayer’s money and implementing appropriate workforce planning.

Patient Safety
121 Motion by WEST MIDLANDS RJDC That this conference believes there should be a maximum quota of patients a junior doctor should have responsibility of during normal working hours.

122 Motion by WEST MIDLANDS RJDC That this conference recommends that upon graduation all junior doctors should be supplied with a self-inking stamp with GMC number and name. This should be used when signing all documentation. The initial stamp should be funded and provided by the first post but thereafter it should be the doctor’s own responsibility to maintain.

123 Motion by WEST MIDLANDS RJDC That this conference calls for the revision of the casualty department ‘four hour wait rule’ as it has become an obsessive rule compromising patient care. It often forces rash clinical decisions and allows limited time to stabilise the patient before admission. A suggestion is to have a 2/3-hour wait from time of seeing a casualty officer to admission or discharge.

A 124 Motion by NORTHERN RJDC That this conference believes that the BMA should set up a working party with the Department of Health and NPSA and any other interested parties to improve clinical handover, in particular looking at training and IT solutions.

17:10 MEDICAL EDUCATION AND TRAINING (PART II)
125 Motion by NORTH THAMES RJDC That this conference deplores the implementation of an entirely Consultant delivered Paediatric service at the Royal Free Hospital and calls upon JDC to lobby RFUCMS and the Trust concerned through the appropriate channels to re-instate a Paediatric training programme, as should be expected from a ‘teaching hospital’.

* 126 Motion by SOUTH THAMES RJDC That this conference calls upon the deaneries to continue to allow junior doctors to go abroad for a year at some point in their training and to be able to return to their training number on their return.

127 Motion by NORTHERN RJDC That this conference believes that JDC should lobby the MMC team to re-introduce out of programme experience in order to protect valuable areas such as overseas work and experience and higher degrees.

128 Motion by SOUTH THAMES RJDC That this conference believes that only NHS employed consultants or their academic equivalents should be used to supervise and train junior doctors and medical students. Other grades of junior doctor or academic should be involved with this training only as part of the consultant or equivalent academics team.

129 Motion by NORTH THAMES RJDC That this conference supports the abolishment of the distinction between training and trust posts in equivalent posts (within PMETB); and calls upon JDC to actively campaign for this through the appropriate channels.

130 Motion by NORTH THAMES RJDC That this conference calls upon JDC to lobby COPMeD to inform all trainees of their proposed placements within their ST programmes at the time of their initial appointment to the training programme, given that Trusts now have no fear of potential financial recriminations.

131 Motion by NORTH THAMES RJDC That this conference notes the addition of the academic foundation programme and calls for additional academic curricula to be implemented alongside the core clinical competencies in those academic programmes, in order to maximise academic training at the earliest opportunity.

132 Motion by NORTH THAMES RJDC That this conference endorses the efforts of the BMA cross crafts committee to investigate the effects of EWTD on procedural specialties and calls upon the committee to work closely with the colleges and PMETB to maximise training opportunities within this restriction.

133 Motion by WEST MIDLANDS RJDC That this conference insists that to improve teaching and training educational supervisors and foundation year doctors should have a set time each week for teaching that is monitored and agreed with the trust.

134 Motion by NORTH THAMES RJDC That this conference calls upon the DH to provide universal training to all medical professionals with regards to the implementation of the new Mental Capacity Act.

135 Motion by NORTHERN RJDC That this conference believes that JDC lobby the Department of Health to;

i) create a single body with responsibility for the delivery of junior doctor training,
ii) to include representation from the Department of Health, NHS Employers, the Royal Colleges, the Postgraduate Medical Education and Training Board (PMETB), Conference of Postgraduate Medical Deans (COPMeD) and the BMA.

136 Motion by NORTHERN RJDC That this conference believes that leadership roles in local NHS structures for junior doctors be created and enhanced, in order to improve patient care and to train junior doctors further.

17:20 Results of the elections to the Conference Agenda Committee 2007-08

17:25 LSD
137 Motion by SOUTH THAMES RJDC That this conference calls for the title Consultant to be restricted to medically qualified specialists.

138 Motion by NORTH THAMES RJDC That this conference notes that junior doctor training has been adversely affected by the current financial difficulties in the NHS. In line with Trusts’ attempts to generate income by charging patients and visitors for services such as bedside telephone calls and car parking, we have some suggestions for other opportunities to extort money from critically ill patients and their relatives. We propose that Trusts could charge patients and their relatives for the following ‘optional extra’ services:

a) Patients should have the opportunity to upgrade their room with extra fees for a bed with a view, single occupancy rooms, and larger beds
b) Patients should have to pay laundry fees and we suggest introducing extra charges for those who wish to upgrade to Egyptian cotton or silk bed linen
c) Patients should be asked to pay for a trolley service for meals and snacks, similar to those offered by airlines. Patients could choose basic sandwiches for little cost or could opt to spend more on luxury food items such as caviar or smoked salmon
d) Patients could also be asked to pay fees for a ‘room service’ provision of snacks and drinks if they were peckish between meals or in the middle of the night. For this to generate sufficient revenue here would need to be a ban on food items not purchased from the Trust, ‘smuggled’ onto wards by patients or visitors
e) Patients could choose to pay a fee to upgrade their medication. For example a patient might choose to upgrade codeine to morphine, or swap their saline drip for Hartman’s solution
f) Similarly patients might wish to pay extra to have organic sparkling mineral water instead of saline in their drip
g) Visitors will have to pay an entrance fee to see their relative or friend in hospital. This would be similar the entrance fee paid in nightclubs
h) Doctors should charge a fee (per minute) to relatives if they want to see the doctor for a discussion. Alternatively, relatives could call a premium rate telephone line to the doctor if a face to face visit was too expensive
i) Grooming products such as toothpaste, shampoo, face creams etc could be sold to patients with basic brands available and more expensive luxury brands for those who want to spend more. This could work well for lavatory paper, with extra cost for those who prefer recycled, quilted, moist and aloe vera enriched brands
j) Patients could upgrade their bedside alcohol-based hand wipe solution (available for hand washing). More expensive ‘vintage’ versions could be purchased, for example solution fermented in oak barrels, or single malt products
k) Patients could pay to choose the music played in operating theatres during surgery. Patients might choose to pay extra for top ten hits, classical music or ambient noise such as whale song
l) Finally patients might wish to pay extra to have a personal, private bed bath given by the nurse or care assistant of their choice

We see this as the fairest way to charge more to those who can afford it and who want luxuries, thus the richest would spend more while poorer patients have little additional financial burden.

17:30 Summary of the day

17:45 Close