Medicopolitical Digest

Medicopolitical digestConsultants object to government's actionBMA seeks amendments to Health BillCasualty departments to get faceliftCampaign will raise awareness about suicide

BMJ 1999; 318 doi: (Published 27 February 1999) Cite this as: BMJ 1999;318:609

Consultants object to government's action

The chairman of the BMA's Central Consultants and Specialists Committee has written to all consultants in the United Kingdom pointing out that the government has singled out consultants from all other groups in the public sector by declining to implement “a highly significant recommendation which recognises the particular workload pressures that the consultant body is under.”

Earlier this month the government decided not to accept the recommendation of the doctors' review body that =A350m should be available annually from 2000 to reward individual consultants for increases to their workload (6 February, p 347). It said that it would consider the proposal in the light of the negotiations on a new consultant contract. The health secretary said, “We are willing to make an investment in rewards and incentives if the negotiations deliver a better service to patients.” Dr Peter Hawker has called the action “unnecessarily provocative.”

In his letter Dr Hawker points out that the review commissioned two independent reports on consultants' workload. These provided substantial evidence of increases in volume and intensity and the review body was convinced by the evidence. He says that it was not the review body's intention that the =A350m should be used to price any agreement on a new contract. Dr Hawker was due to meet the health minister, John Denham, this week.

BMA seeks amendments to Health Bill

The BMA has been putting down amendments for the committee stage of the Health Bill, which started in the House of Lords this week. It has been working closely with the General Medical Council and other regulatory bodies to ensure that the bill does not allow the health secretary to set up separate professional regulatory machinery (20 February, p 482).

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Much of the bill concerns GPs and the General Practitioners Committee is anxious that progression from primary care groups (PCGs) to primary care trusts (PCTs) should occur only with the overwhelming support of GPs. Proposals for PCTs should be taken forward for consultation only if there is support from the relevant PCG. The committee also wants local medical committees (LMCs) to be consulted. It will put down amendments to ensure that if PCTs take on health authority functions they take the advice of LMCs. The bill provides PCTs with the power to compulsorily purchase property and the GPC wants to control the exercise of this power to protect GPs' interests.

The BMA wants amendments to the section of the bill dealing with patient confidentiality and the absolute privilege which would attach to statements and publications of the Commission for Health Improvement.

The BMA also wants a meeting with the health secretary about the claim that he made when the bill was published that it would revolutionise how the NHS works. Mr Frank Dobson said that PCTs will “result in groundbreaking new services for patients,” introducing walk in health centres on the high street, more use of convenient day surgery in health centres close to home, top quality health checks, and joined up health care (see p 555).

Casualty departments to get facelift

A =A330m programme to refurbish one third of hospital casualty units in England in the next 12 months was initiated last week. The money will be spent on 80 schemes in 67 casualty departments. In addition the Department of Health is to set up a team to develop improvements in casualty departments, which will be headed by a senior consultant in accident and emergency. By covering nearly 70 units, the initial programme goes further than the 25% target first planned last autumn.

Schemes will include improved layout and new technology to enable fewer waits on trollies; dedicated assessment units; treatment areas designed for children; better privacy; and features to ensure staff security.

The project was launched by the prime minister, Tony Blair, on a visit to the North Hampshire hospital which is to spend =A3600 000 on new resuscitation bays, an x ray machine, a children's waiting area, and redecoration. Mr Blair said that of the 15 million people who visit casualty departments each year, too many had to wait too long in overcrowded and inconvenient departments.

Campaign will raise awareness about suicide

The number of young men who killed themselves between 1980 and 1992 rose by 80%. The Doctor Patient Partnership has linked up with the Men's Health Forum and the Samaritans to raise awareness of the problems facing young men and to encourage them to seek help. Posters will be put up in bus shelters, housing benefit offices, job centres, pubs, and GP surgeries.

The chairman of the partnership, Dr Simon Fradd, said, “Young men are often reluctant to talk about their problems. …The message of our campaign is young people shouldn't be ashamed to approach their GP for help and any conversation is strictly confidential.”

Simon Armson, chief executive of the Samaritans, said, “We all have a responsibility to acknowledge that young men can suffer despairing and suicidal feelings, although they might try to hide them. We must give men the time and space they need to talk openly about those feelings.”

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