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GMC could investigate striking doctors if they risk patient safety

Junior doctors have been urged to consider the impact of next week’s five-day strike on patient safety, with the General Medical Council (GMC) hinting that it could investigate them if they fail to fulfil their duties.

The British Medical Association (BMA) announced the unprecedented strike, due to start on 12 September, after its members voted to reject a new contract they had agreed with the government.

Today the GMC, which plays no official role in the negotiations, warned that the action is likely to have a more severe impact on patient safety than previous strikes.

Niall Dickson, outgoing chief executive and registrar of the GMC, said: “The question each doctor must ask before taking action is whether what they are proposing to do is likely to cause significant harm to patients under his or her care or who otherwise would have come under his or her care. This is a matter of professional duty and we expect each doctor to comply with it.”

He reminded junior doctors that the Medical Act 1983 gives the GMC the power to investigate and place sanctions on junior doctors who consistently or seriously fail to “put their patients first and protect them from harm”.

Dickson urged junior doctors to “pause and consider the possible implications for patients” of further industrial action. He added: “Where we are presented with evidence that a doctor’s actions may have directly led to a patient or patients coming to significant harm, we would be obliged to investigate and if necessary take appropriate action.”

Dickson said, as he did before the first total withdrawal of care by doctors in April, that junior doctors should return to work if to do otherwise would put patients in danger.

He also issued guidelines for doctors in leadership positions, saying they should “do everything possible” to make sure patients are protected during the industrial action.

Professor Terence Stephenson, chair of the GMC, said: “The health service is under huge pressure. During previous industrial action all doctors went to considerable lengths to make sure that patients continued to receive a good and safe level of care. We know that doctors will again want to do their utmost to reduce the risk of harm and suffering to patients.

“However, it is hard to see how this can be avoided this time around. To suggest otherwise would be a disservice to the enormous contribution made by doctors in training to the care and treatment of NHS patients every day. We therefore do not believe that the scale of action planned at such short notice can be justified and we are now calling on every doctor in training to pause and consider the implications for patients.”

In addition, NHS Providers and the NHS Confederation called on the BMA to reconsider the strikes.

Chris Hopson, chief executive of NHS Providers, said the strikes would lead to 125,000 operations and over 1m appointments being cancelled, and agreed with the Academy of Royal Medical Colleges that the strikes were “disproportionate.”

“With barely any notice for trusts to prepare, this unprecedented level of strike action will cause major disruption and risk patient safety,” he added.

Stephen Dalton, chief executive of NHS Confederation, said: “We believe these strikes are disproportionate. We also don’t think there is a strong mandate for the additional strikes given they go well beyond the initial planned action. This will only cause further disruption to patient care and services and we urge the BMA to reconsider.”

(Image c. Andrew Matthews)

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Sam   05/09/2016 at 16:31

The BMA have moved the negotiations to a high stakes game in response to a contract their previous leadership agreed, and have done so in a most rapid period. In doing so, with the voting numbers and lack of peer support, the BMA has left each member incredibly lonely as they must now decide as individuals, and not as a collective, whether they will support the strike action, or not. The junior doctors are in real danger of destroying their standing in society. I think the MBA has made many wrong moves during the negotiations, culminating now in the most extreme actions. Worse, these actions appear not to have the support of anyone and not even the definitive support of the rank and file BMA members, given only two thirds voted and 58% supported further action. The PR has been poor throughout: I think it has been difficult for those not knowledgeable on healthcare to understand the broader issues the BMA has been arguing for. There is a lack of clarity, in simple terms, as to what safety issues the latest contract – or the earlier version – will perpetrate. While working hours were mentioned, these are regulated for doctors. Although Brexit may now leave these rules in question, the contract has been disputed long before this and without much, if any, reference to Brexit. Sadly, the typical representative seen through the media appear to be young, nice-looking, well-spoken, and perpetually well-educated, which could easily lead a member of the public to thinking it’s just about the salaries and lifestyles of privileged kids; which although, in reality, this is NOT the case, it is how it can come across. The lack of clarity beyond sounds bites and spin has the potential, as this action drags on, to remind patients of the days when doctors told them the bare minimum of conclusions about their healthcare. The scandalous leaks regarding the tactics related to the first strike, could easily give the impression that junior doctors have become strategic politicians. This is contrary to the image they need to permeate of being above such actions and only focused on patient care. The latest militant response needs to be curtailed before it is too late. Should real harm come to a patient as a result of the industrial action, it is now more likely that the public opinion will blame the doctors before the politicians. The politicians will then, most likely, respond with draconian laws outlawing industrial action for healthcare workers. While a different context, there are some lessons for the BMA to learn from the miners’ strike. For starters, ensuring a significant majority of public support is paramount. I don’t think they are achieving this. If the BMA doesn’t go back to the negotiating table and then, if necessary, only implement reasonable action, they are not only in danger of having their fourth leader in the last 12 months, but being relegated to irrelevancy. Although, given the backlash, and previous missteps, it may be too late.

Angus   06/09/2016 at 22:46

It is amazing how many senior people e.g. Niall Dickson, Prof Stephenson, Dan Mortimer and senior figures in the AoMRC keep directing pointed comments towards junior doctors and the BMA about how dangerous and undesirable a strike is, but none of them publicly ask Mr Hunt to withdraw his plans to impose his "contract" and instead return to the negotiating table.

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