Medicopolitical Digest

BMA calls for renewed action on debt reliefMedical schools must not be overcrowdedScottish GPs reach some agreement on LHCCsRefugee doctors in United Kingdom need helpBMA secures equal pay victory

BMJ 1999; 318 doi: (Published 20 March 1999) Cite this as: BMJ 1999;318:815

BMA calls for renewed action on debt relief

The BMA has written to the chancellor of the exchequer welcoming his plan to reduce the debt of the poorest countries, but asking him to renew his efforts to persuade fellow world leaders at the G8 summit in Cologne in June to cancel debt outright.

The BMA is a member of the Jubilee 2000 coalition for the cancellation of debt and believes that the burden of debt is one of the major factors sustaining the poverty which condemns millions of people to ill health and early death. In his letter to Mr Gordon Brown, Dr Mac Armstrong, the BMA secretary, says that the association is particularly concerned about the effects of structural adjustment programmes, which often force governments to cut social spending and fail to take into account explicit human development targets. He says that the government's millennium challenge—to cut debt and increase aid—can be the first step in achieving the goal of poverty reduction.

Medical schools must not be overcrowded

The UK government has agreed that 1000 extra medical students should be trained each year, and this month was the deadline for educational bodies to submit bids for a share of the expanded student numbers. All the 17 English medical schools have applied for a share of the increase. The medical students committee, which represents the 11 000 student members of the BMA, says that the increase must not be achieved by cramming additional students into medical schools without extra resources.

The committee fears that incorporating the extra students into current facilities will put pressure on teaching resources and have an adverse effect on the quality of medical education given to our future doctors.

The chairman of the committee, Lizz Corps, has written to the deans of medical schools asking for a commitment that education will not suffer. She said, “In some cases students are forced to sit in aisles in lecture theatres or have lectures relayed to them…. There are problems with access to library and computing facilities.” She also said that some patients in teaching hospitals were refusing to allow students to take part in certain aspects of their care as firms were so large and impersonal.

The BMA believes that it is essential to establish at least one new medical school to accommodate the proposed increase in students.

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Scottish GPs reach some agreement on LHCCs

As a result of negotiations between the Scottish General Practitioners Committee and the Scottish Office guidelines will be issued shortly on those areas of agreement which have been reached over the introduction of local health care cooperatives (LHCCs).

GPs will be paid for LHCC activity at a rate equivalent to £77 a half day session plus locum payments, including intrapractice locums. The budgets for GP practice staff, premises, and computing will be ring fenced. The present legislation precludes GPs from being non-executive directors (now called trustees) on primary health care trusts. The Scottish minister for health, Mr Sam Galbraith, has said that legislation will be introduced to allow GPs to become trustees in a personal capacity. Health boards will be encouraged to include joint investment funds in their health improvement programmes and to ensure that the appropriate mechanisms are developed to ensure that where activity is transferred resources are also transferred.

There are still some areas on which national agreement has not been reached. The Scottish GPC has received no guarantee that planned prescribing savings will be available for LHCCs' use or that adequate resources will be available to improve general practice. The role of GPs in commissioning secondary care is also unresolved.

Refugee doctors in United Kingdom need help

The BMA has called on the Advisory Group on Medical Education, Training and Staffing (AGMETS) to consider measures to help refugee doctors rebuild their careers in the United Kingdom.

There are no formal statistics on the number of refugee doctors, but the BMA points out that once given refugee status and the attendant right to remain in the United Kingdom these doctors would be a valuable resource. The General Medical Council is already looking at how refugee doctors can receive information about routes to registration other than the Professional and Linguistic Assessment Board (PLAB) test and at the problems arising from the administration of the test.

The BMA has asked AGMETS to consider what measures could be taken to raise awareness of the needs of refugee doctors; whether financial support and resources could be provided to enable refugee doctors to improve their English language skills and to study for the PLAB test, and for support and study groups; and how NHS trusts could be encouraged to provide clinical attachments free of charge for refugee doctors and to meet travel and accommodation expenses where needed.

BMA secures equal pay victory

The BMA has secured equality in pension rights for 850 part time mental health officers. The association had claimed that the different treatment amounted to indirect discrimination because the majority of part time staff are women. The health secretary conceded equality in advance of an employment appeal tribunal which will have to hear arguments about backdating pension payments and about the way in which the benefits are to be calculated.

Doctors, nurses, and clinical psychologists, who work in psychiatry, are entitled to mental health officer status. For entrants who joined the service before March 1995 this conferred important benefits, including the right to retire at 55 and a doubling of pension benefits for each year after 20 years of service. Until the health secretary's decision part time mental health officers, the majority of whom are women, had been denied parity with their full time colleagues.

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