BMA chair Dr Mark Porter told the union’s Special Representative Meeting yesterday that ‘Twenty-four years ago, it was the first reforms that established an internal market.
‘We still live in the shadow of those decisions. The care we can offer our patients is restricted by them. The mess we are in today owes so much to them. Then, and now, we see what happens: When ideology is put ahead of evidence. When an unshakeable self-belief means pressing on regardless.
‘When for every complex question, there is a rushed and simplistic answer. We are here today to discuss and define the crisis we face, to address the corrosive pressures on our morale and workload and – I stress – to find and define new solutions. Going beyond our existing policy.’
He said of the NHS: ‘The chancellor speaks of a “fully-funded” NHS but has come up with less than a third of the extra £30 billion in England alone that he admits it needs. Stop and reflect on that for a moment. A government claiming to increase resources while the mathematically competent can see that it’s all cuts and efficiencies. His claims are fantasy, but so too are his solutions.
‘He says we just need to be more efficient. So much more efficient that £22 billion worth of work that we do apparently won’t exist, or won’t cost anything, in four years’ time.
‘That sounds like a lot of patients who will no longer need treating. Is the chancellor hoping they’ll all move to Australia with the junior doctors? He was warned that such a scale of efficiencies simply couldn’t be found. We have looked, my word, we have looked. And we haven’t found anything remotely matching that.
‘Instead, they’ve put the squeeze on hospitals. They receive less for every patient they treat. And every year, their deficits grow. So the health service uses new money to pay off old debts.
‘They’ve put the squeeze on general practice, which they thought could make do with less and less of the share of healthcare resources and do more and more. We can only hope that situation will now improve.
‘They’ve put the squeeze on doctors. Every year we are expected to do more. Every year, in real terms, we are paid less. Worse, even worse than that, they’ve scuppered the lifeboats. They’ve put the squeeze on the rescue plans and made them more likely to fail.’
He said of the junior doctors dispute: ‘From outer space, the government sees a contract that is all but agreed. Here on earth, we see a contract that fuels the recruitment crisis in the most intense specialties, that cannot ensure safe hours, and by the government’s own admission has an adverse effect on women. It is a contract that breaks relationships and cannot build them.
‘Here’s a solution. We’ll both back away from the cliff edge, restart talks and start the work of rebuilding junior doctors’ confidence. They just want to serve their patients in a health service that supports them.
‘The government must drop its cynical and corrosive tactic of trying to undermine trust in doctors. Making laughable accusations – that doctors don’t work weekends or that GPs don’t do out of hours – doesn’t soften us up in negotiations. And it doesn’t fool the public either. It just squanders the morale of decent people.
‘The government has forgotten what negotiation even means. Have you seen what it’s trying on with the junior doctors? It’s not just a contract imposed by a government that refuses to talk, but it’s a contract that will get rid of the need to ever talk again.
‘It says – and they expect junior doctors to be happy with this – it says, “we reserve the right . . . in our absolute discretion to review, revise, amend or replace any term or condition of this contract”!’
Anna Athow won applause yesterday when she called on the BMA to officially approach the TUC to organise a national demonstration and a day of strike action to support the junior doctors.
Athow said: ‘The driver for the junior doctors conflict is the government imposing a dangerous contract on them – and not just them but also on the consultants and all NHS staff.
‘Why must NHS staff become cheap flexible labour with increased productivity, a reduced skill mix, worse terms and conditions and seven day elective working? This is to facilitate “service re-design” as described in the Five Year Forward View.
‘Why has there to be “service re-design” with US-style models of care, hospital chains, huge out-of-hospital Accountable Care Organisations, 44 STP patches by September – closing down our DGHs and GP surgeries which patients so desperately need?
‘STP stands for “Sustainability and Transformation Plans” – that is cuts and privatisation in plain English. All of this is because the Tories are driving to get the whole of clinical medicine privatised, in a gigantic top-down re-organisation, to end the NHS as a publicly provided service, by 2020.
‘It was not proclaimed in any election manifesto, nor voted on, but covered up with a barrage of spin about weekend working. What is driving the Tory government? It is big business, desperately seeking profits in the global economic crisis. Health Corporation America wants a big slice of the £115bn NHS budget.
‘The EU helps it along by negotiating TTIP. In fighting for a safe and fair contract the junior doctors are fighting to defend the NHS itself. The civil servants and the fire brigades unions have officially called on the TUC to organise a national demonstration with strike action to support the junior doctors and the NHS,’ she said to applause.
She concluded to further applause: ‘Representative Body, we must call on the the BMA to officially approach the TUC for a national demonstration and a national day of action and support the junior doctors. The junior doctors cannot win on their own. They need the support of the whole working class.’
Despite great support from the floor, the platform would not allow a resolution on the issue saying that the matter would be discussed at the Junior Doctors Committee when it meets on May 7th.
