Saturday, 26 May 2007

from whose cake hole?

This interesting speech has come to my attention:

"Mr Simon Eccles
Tuesday 29 June 2004

Good afternoon, or perhaps I should say Good Evening. And I’m reluctant to talk for too long for fear of restricting our debate.

And as I stand here halfway through our 101st ARM, can I give full credit to George Rae for introducing more open debate and more opportunities for exploring our views to this year’s ARM?

But there is a limit to what the Chairman of RB can do. We must all be brave and venture out of the nineteenth century and into the twenty-first.

The Junior Doctors have started this process already. Our conference this year, under the Chairmanship of Jason Long, broke new ground. In a one and a half day conference we spent less than two hours debating motions. And yet the conference gave my committee the strongest policy direction we could have been given.

We, the BMA, must be pro-active and not just reactive.

So what have the Junior Doctors Committee being doing this year?

We have been calling for a reform to post-graduate medical education in this country for many years. We have demanded a better start to training and to an end to the abuse of the PRHO grade. We have been asking for an end to the bottleneck from SHO to SpR training. We need assessments to accurately reflect our abilities to do the job not our willingness to fund college port collections. We need to revitalise Academic Medicine whilst ending the need to do research to obtain a training number.

Modernising Medical Careers is potentially offering us all this. This IS good news. We should make the most of this opportunity and to that end; I, Simon Calvert and the Education and Training team have been working with MMC. We must continue to do so.

Sadly the implementation of these reforms has not been so positive. Even as I speak: 4th year medical students are applying to their August 2005 Foundation Programmes, via early matching schemes.

These programmes are compulsory and yet they don’t know - which specialties will be included, - whether or not the jobs will be recognised for subsequent training in these specialties; - what salary they’ll be paid - or where, geographically they’ll be based.- 5 out of the 7 precious pillars of MMC are not yet fully defined.

So what are we doing about it?

Joint guidance from MSC and JDC went out to students at the start of this month. The MMC team has agreed to set up four ‘think-tanks’ to explore these issues and produce solutions in a very short timescale, for all parties to comment on.

We achieve most when we work together. The early implementation may have been quite dreadful and astonishingly poorly coordinated but this process offers us everything this association has been demanding for years.We should not waste the opportunity.

Moving to the other significant area of our work this year - the EWTD

JDC has managed to lead the way on possible solutions to this overly-restrictive directive.
- From the Hospital at Night project which has achieved compliance, enhanced training and improved patient care;
- through handover for safe transfer of information,
- and good monitoring practice to know what’s really happening;
- to the DH compendium of guidance, which we rewrote.

The JDC has set the agenda to ensure training is of the highest standard and patients get the best care we can offer whilst complying with the law.

I’d like to finish by returning to the Post-graduate training reforms. The BMA has been ‘reassured’ that there is no attempt to dumb-down the standards of consultants.

Let us be clear about our reasons for saying no to a different end-point of training. This is not just JDC saying no to any change. We support the reform of training as I said before. This country and our patients need their consultants to be able to offer the full range of cover in the event of their becoming unwell. We do not have enough doctors in this country to have multiple tiers of specialists on-call in any given field.

At 3 am the consultant covering Trauma does not have the ‘phone-a-friend’ option open to them. When the numbers have increased, when the networks are more in place, then perhaps it will be different.

Not now. We have the very highest standards of medical training in this country to produce the very highest standards of consultants to offer the very best service to our patients.

We must not ruin this on the altar of political expediency."

It is a shame Dr Eccles has not kept true to his last sentence, it's amazingly ironic that this comes from a man who seems to spend more time on this altar than perhaps any other practising medic. The speech talks of the brilliance of MMC and the opportunity of working together to improve medical training. It's just a shame that in Dr Eccles eyes 'working together' may be interpreted as building his own CV at the expense of junior doctors throughout the country. The virtues of the dangerous cost-cutting Hospital at Night scheme are trumpeted, it's a great pity that there is no evidence to back these statements of 'fact' up.

How sycophantic does Dr Eccles look now, in retrospect? It's been no surprise that Patricia Hewitt has been caught quoting him to back up her argument that the medical profession is largely behind her destructive reform agenda, he's one of only a small handful of apologists who are always willing to back the government up. The BMA seem to have churned out quite a few of this politically expedient sort in recent years, and is seems to be pretty symptomatic of their deeply unrepresentative nature.

I wonder what Dr Eccles' junior staff think of him, would he command their respect with his unique devotion to government reform? I would be amazed if he managed to sleep at night, but then again he has never demonstrated possessing a conscience with his actions in his numerous medicopolitical roles; maybe some people just care purely for themselves.

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