Appeasement is rife

The President of the Royal College of Physicians, Prof Ian Gilmore, has written to all consultant members:

"Dear Colleague,

I am acutely aware that the completion of the first round interviews of junior doctor posts now underway (so called round 1b) is causing not only a huge and unwelcome workload for physicians but also concerns as to whether they are doing the right thing in cooperating with what is widely agreed to be a flawed MTAS process. College Council has just met again and confirmed that the basis on which we are now continuing to encourage consultant participation is first and foremost for patients – to ensure that doctors will be in post on 1st August. Secondly, we believe that much of the anguish of our trainees and hard work of our consultants should not be wasted and that the compromise arrangements being worked out by the Review Group have some merit as an interim measure. Finally, we believe this gives us the best chance of true engagement for a radical overhaul not just of the appointments system but also of the training programmes for next year and beyond.

But this cooperation has to be subject to an agreement that our professional advice will not be ignored or sidelined in the future. I attach below an open letter that I have sent to the Secretary of State for Health, Patricia Hewitt in which this is made quite plain. It would be extremely helpful if you would share this letter with your trainees.

I hope you will support this approach."

Essentially appeasement is the order of the day, I wonder is Prof Gilmore a member of the BMA? If so, he may be one of a rare breed; a member that is being represented by the BMA's current stance. Is he really so naive that he trusts this government to stick to its word to listen properly next time or next year? He continues with more of the same in a letter to our beloved Patricia Hewitt:

"The basis on which we are now continuing to encourage consultant participation is first and foremost for patients – to ensure that doctors will be in post on 1st August.

We have however repeatedly expressed concerns and caveats that have gone largely unheeded. There has been consultation but little true listening"

This line of apologetic appeasement has been a consistent one from many of the royal colleges the BMA during the MTAS scandal. This line is always justified by stating that withdrawal is simply not a practical option, as 'negotiation' and 'cooperation' are the only way ahead. It strikes me that this justification relies on some exceptionally dubious reasoning.

It seems the government know that these medical bodies will never withdraw from proceedings under any circumstances. The government therefore knows that it has nothing to fear from not listening and pushing through unmodified policies. The process of 'negotiation' and 'argument' has become purely a token affair; as the option of a unilateral withdrawal, the only power of a negotiating body, has been cast aside.

Even if one assumes that the leaders of the BMA and the royal colleges have the best interests of their members at heart, then by using these tactics they will never be able to represent their members adequately. However the refusal to unilaterally withdraw could be interpreted differently, it could mean that the leaders of these organisations are too closely allied to our politicians and that they really have no intention of representing their members' views.

Either way, there does come a point where appeasement is no longer an option. That point was passed long ago, the malignant quango PMETB has been used by the government as a tool to force through their cynical policies. It is such a great shame that appeasement is still the order of the day, as if the option of a unilateral withdrawal had been exploited earlier then a lot of damage may have been averted. We trust this government's word at our peril.