Delegates at the British Medical Association (BMA) Annual Representative Meeting (ARM) in Liverpool on Tuesday voted overwhelmingly for Motion 247 on ‘humanitarian crises in conflict areas’.
The motion deplored the deliberate targeting of civilians and healthcare professionals, and the use of white phosphorus as a weapon in urban environments.
obby the relevant bodies to ensure that each party in a conflict allows for the free passage of medical supplies to the victims’ and ‘to lobby the relevant bodies to hold to account those who prevent access to healthcare’.
The motion also called on the BMA ‘to consider suspending contact with any national medical association which does not oppose the targeting of healthcare personnel or the denial of medical supplies.’
Mover Dr Nazir Rashid said: ‘The UN calls for the right to water, food and medical supplies and is against collective punishment.
‘1.5 million people live in Gaza.
‘There is 80 per cent unemployment. Hospitals are short of medicines and in crisis, exacerbated by the lack of water and electricity.
‘Banned weapons are used against civilians.’
She concluded: ‘We are not here to judge, we are here to help people of all races and religions.’
Dr John O’Driscoll opposed a clause in the motion on grounds: ‘I don’t think we should even consider suspending contact with any national association.
‘Many live under repressive regimes and can’t speak out. We need to keep contact with these people.’
Supporting the motion, Dr Ahmed Sewehli said: ‘This is about helping our fellow medics.
‘In Gaza, paramedics have been killed. In Sri Lanka, the national medical association said nothing about the imprisonment of their colleagues.
‘Speaking up is an act of conscience.’
Advising delegates, BMA Council Chairman Dr Hamish Meldrum pointed out that ‘the motion says consider suspending contact, it’s not something we would rush to do’.
Later delegates voted for Motion 328 which stated: ‘That this meeting
(i) expresses concern about the Metropolitan Police Service’s current management of “reforms” to its forensic medical services;
(ii) believes that police forces are not competent to deliver the clinical governance required for the safe healthcare of detainees;
(iii) requests the BMA to press for the transfer of people in police custody to the National Health Service.’
Mover Dr Michael Wilks said: ‘Since January 12th, the Metropolitan Police Service’s (MPS) new contract with new conditions of service has given up clinical guidance and is using unqualified doctors in that field.
‘The new contract was flawed, and many refused to sign it.
‘Since January 12th it’s been chaos. Fifteen London boroughs had no cover at all and brought in doctors from local areas.
‘The MPS had to spread doctors too thinly. On January 21st, there was a death in custody in Chelsea Police Station.
‘The man was seen by an agency doctor who certified he was fit to stay in the police station. He subsequently died and the matter is under investigation.’
The ARM also voted for Motion 329 which opposed the ‘trend to outsource police forensic medical services to private companies’.
Mover Dr Rachel Pickering from Yorkshire Regional Council, said: ‘In police stations across the country, there is a growing trend to outsource forensic services to private for profit companies.
‘There are significant concerns over standards. Medicine is not a simple commodity like cleaning or catering.’
She concluded: ‘If you care about what happens to detainees, please support.’
In his report to the ARM Dr Brian Patterson, Chairman of the BMA’s Northern Ireland Council warned that the health service financial belt will have to be tightened even further.
In his speech, Dr Patterson said: ‘We are looking forward to the new streamlined structures delivering the promised quality health service.
‘However, as we had feared, the Review of Public Administration did not release, in real terms, the promised tranche of money to reinvest in expansion of frontline services.
‘The likelihood is that some services will disappear.
‘The BMA in Northern Ireland is keen to work with our Health Department to make sure that as many services as possible remain and that quality is maintained.
‘For example, huge sums are wasted on agency nurses and doctors, and we would get much better value by expanding the normal workforce.
‘This would result in less cost and more continuity of care for patients.’
Dr Patterson added: ‘The reliance on the private sector both inside and outside Northern Ireland is hugely expensive and we must find ways of delivering timely care without these luxuries which we can’t afford.’
He also outlined the huge challenge that is the change required to comply with the new European Working Time Directive, saying: ‘We have experienced great difficulty getting accurate figures on likely compliance from the Northern Ireland Trusts, and have grave concerns because of the gaps in local junior doctor rotas.
‘We will insist on real compliance by employers.’
Dr Patterson finished his speech by warning of the ‘growing tendency to be cavalier with confidential patient information and the increasing number of blatant attempts to get non-anonymous information without recourse to the patient.
‘Clinicians, as data controllers, must be vigilant and prepared to insist on adherence to proper data protection principles.
‘We are all patients and we have a right to say who accesses our personal information and for what purpose.’
At close of session on Tuesday doctors took part in a mass photo opportunity to publicise the BMA’s Look After Our NHS campaign.
Earlier, consultant surgeon Anna Athow warned the BMA Annual Representative Meeting that the government is setting up hospitals to fail and is planning a mass hospital closure programme.
She was moving Motion 268 on NHS Funding and Finance, which states: ‘That this meeting notes that the health bill legislates that the Secretary of State for Health can close down, or franchise out to the private sector, any NHS acute hospital or provider in England within 120 days, if deemed financially or clinically “unsustainable’’.
‘This meeting calls on the BMA to campaign for proper funding of NHS hospitals and units, in the first instance, so that they can perform to high standard, and to oppose their closure or takeover by the private sector.’
In her speech, Athow said: ‘There never used to be a requirement for NHS hospitals to be run as a “sustainable’’ business.
‘Now there is, and every Trust had to become a Foundation Trust business by December 2008.
‘These have to break even or make a surplus.
‘They cut £10 million at Stafford in order to become a Foundation Trust.
‘As a non-executive director said: “We had to take radical action. It was proposed to reduce staff, because, in a hospital, that is the only way you can make savings.
‘ “There was also the imperative to become a Foundation Trust.
‘ “If we did not, we would be closed down or taken over.” ’
Athow continued: ‘And the Darzi Next Stage review reinforces this position.
‘If Trusts fail on their quality accounts, they are penalised with lower tariffs and fines.’
She stressed: ‘Trusts are being set up to fail.
‘If they don’t cut spending, they financially fail.
‘If they do, they can’t provide high-quality care.
‘And what is the plan for these “unsustainable’’ providers and trusts, which may never make it to Foundation Trust status, and so far 60 haven’t.
‘The Department of Health proposes – merger, acquisition, break-up, franchising to public or private management, closure or sell-off to the private sector.
‘It’s been estimated that one Trust could be culled every two months.
‘The recent statements of the NHS Confederation and Healthcare for London signal pressing on with a mass hospital closure programme.
‘There should be no threat to close down or farm out NHS units to the private sector on the back of inadequate fundings.’
She concluded: ‘The BMA must insist that NHS acute units are properly funded in the first instance, so that sufficient trained staff are employed to provide high-quality care, and services are maintained where patients need them.’
Speaking in opposition, Dr Michelle Drage said: ‘The spirit of the motion is good.
‘But how can you put your hand over your heart and say you would never support a hospital closure.’
Dr Bill Beeby added: ‘How can we oppose the closure of units which are clinically unsustainable.’
The motion was lost, although a sizeable minority (about 40 per cent of delegates) voted for it.
