Doctors at the British Medical Association (BMA) Annual Representative Meeting (ARM) in Cardiff expressed their serious concerns at the impact of cuts on healthcare.
They voted almost unanimously, with just one or two abstentions, for Motion 132 from the ARM Agenda Committee, deploring ‘that current financial constraints and efficiency savings result in both vacancy control measures and staffing cuts which destabilise services and reduce patient safety.’
The motion added: ‘This meeting demands that the governments come clean on the effect on front-line staff and the effect on clinical services to patients.’
Mover Dr Philip Banfield told representatives: ‘In my area, a shortage of midwives and nurses led to closing down services.
‘When you ask why can’t we get more midwives, we’re told there’s not enough trained, and that’s because of vacancy controls.
‘Posts are being disestablished, there are less trained staff.’
He warned: ‘The service becomes unsafe as it’s being run down to be that way.’
He called for the BMA to take action ‘before we have no NHS left’.
Dr David Summers said: ‘We have two or three doctors when we should have eight.’
He asked: ‘What price can you put on a patient’s life?’
He added that ‘patients are dying, support the motion before the NHS dies and our patients die.’
Doctors also voted overwhelmingly for Motion 133: ‘That this meeting deplores that widespread government spending cuts across all government areas, particularly health and social care and government services, will be harmful for the nation’s health and well-being, and believes that the scale and speed of these cuts are not economically justifiable.
‘This meeting calls on the government to radically revise the scale and speed of these cuts and to ensure that the most vulnerable are protected from them.’
Mover Dr Lucy-Jane Davis said: ‘There are 490,000 public sector jobs to be cut. Funding for carers is being cut.
‘Already, we are hearing there are cuts to health and social care and people having to work across partnerships.
‘Cuts in social care are having a devastating impact.’
She warned: ‘The current cuts will echo into decades to come. The scale and speed of cuts threaten the most vulnerable in society.’
Opposing the motion, Dr Keith Brent said that the wording says ‘cuts across all areas’. Citing defence cuts, he asked: ‘Do we really think “cuts across all areas’’ is bad for the nation’s health?’
Speaking in support of the motion, Dr Robin Arnold insisted: ‘The motion implies those cuts that will affect patients.’
He added: ‘The cuts are really hurting. A lot are being implemented already.’
BMA Council Chairman Hamish Meldrum recommended support for the motion, but said: ‘I leave it to you.’
In her right of reply, Dr Davis said: ‘The issue here is cuts in health and social care. And cuts in local government is a health issue.’
The conference went on to vote overwhelmingly for the Agenda Committee’s Motion 134: ‘That this Meeting believes that the decision to refer for further care is made between a GP and patient, following a clinical assessment, and rejects the use of referral centres and other crude methods to reduce referrals for financial reasons rather than for the benefit of patients.’
Mover Dr Gillian Beck told the ARM: ‘This week I’ve had my referral quota of four patients because of financial restraints.’
After giving examples of how this delayed and rationed patient care, she continued: ‘Why should another person direct my patients without my agreement. This is something worth fighting for.’
Dr Michael Ingram slammed delaying or refusing treamtment for smokers unles they went on a course first.
He said: ‘This is about preventing needed procedures to save money.’
BMA Council Chairman Dr Meldrum advised the meeting: ‘You can support.’
In her right of reply, Dr Beck said: ‘This motion is about opposing masquerading beneath triage and referral to manage budgets.’
The meeting was divided on a call to ‘consider all action, up to and including indstrial action’ to combat NHS cuts.
Motion 135 from the Northern Ireland Council had not been expected to be heard.
Mover Dr Paul Darragh said: ‘We are facing £5bn cuts in Northern Ireland. There are attacks on funding and attacks on conditions of service.
‘In the face of such assaults we should consider all forms of action, including industrial action.
‘And we should continue to publicise the issues against the propaganda used by the government.’
As nobody had expected the motion to be heard, and there were no more speakers listed, the ARM chairman took a vote on a move to next business, and was forced to go to electronic vote.
This failed to reach a required two-thirds majority, with 47 per cent voting ‘Yes’, 48 per cent voting ‘No’ and 5 per cent abstaining.
BMA Council Chairman Meldrum advised the ARM that under the anti-union laws, industrial action can only be taken in furtherance of a trade dispute.
It was pointed out that the motion said ‘consider’ industrial action.
So the motion was put to a vote and was lost on a show of hands by appoximately 45 per cent for and 55 per cent against.
Representatives went on to vote overwhelmingly for Motion 158 from the Agenda Committee, which states: ‘That this meeting believes that the requirement for year-end financial balance in NHS organisations:
‘i) can endanger quality and safety of service delivery;
‘ii) should not be achieved by deferring the treatment of patients;
‘iii) should not be achieved by pressure on doctors to compromise in their duty to make the care of their patient their first concern;
‘iv) should be managed even-handedly across all sectors by commissioners;
‘v) must not be achieved by withholding funding from NHS staff;
‘vi) should be underpinned by a contingency fund to reduce the risks from financial pressures.’
Mover Marie-Louise Irvine said that hospitals ‘have to reach a balanced budget to reach foundation trust status.
‘This has led to severe problems,’ she added.
She cited the Mid-Staffs disaster when patients died unnecessarily.
She insisted: ‘There should be enough resources for patient care.’
Dr Chaand Nagpaul said that trusts having to achieve their balance annually ‘is perverse and damaging patient care’.
Dr Nagpaul said: ‘Operations are delayed to remove cost to the next financial year.
‘This puts pressure on doctors to renege on their duty of care to patients.’
