Ways for BMA members to broaden their horizons

This post will hopefully be of interest to most of our members, but it may be of particular interest to junior doctors, who may find it a bit easier at the start of their careers and whilst still relatively ‘young’ (not that I want to in any way be ageist here!) to head off to another country. I just want to highlight some new guidance issued by the BMA about doctors working in developing countries.

’Broadening your horizons: a guide to taking time out and work and train in developing countries’ outlines national policies, as well as examples of best practice. It’s aimed at both doctors and those in medical education and employment. It supports doctors at all stages of their careers to take time to work in developing countries and make it a valuable part of their NHS careers.

The guidance is available on the BMA website at http://www.bma.org.uk/careers/working_abroad/broadeningyourhorizons.jsp

How much worse does binge drinking have to get before our politicians take action?

This article in the Wales on Sunday makes for disappointing reading for the BMA and its members, who deal on daily basis, with the very real consequences of alcohol misuse. The fact that many Assembly Members don’t think that raising the cost of drink won’t in any way help prevent binge-drinking, is quite staggering.
I hope this doesn’t stop the Welsh Assembly Government from continuing to support the idea of setting a minimum price on alcohol, with the Social Justice Minister, Dr Brian Gibbons saying he’d like to see a graded form of tax on drink, where a lower tax is placed on weaker alcohol and a higher tax is placed on stronger alcohol.
Last year the BMA published a report ‘Alcohol misuse: tackling the UK epidemic’, calling on governments in the UK to implement a full range of effective control policies that will reduce the burden of alcohol misuse.

It highlights how recent governments have worked too closely with the alcohol industry, pursuing policies of deregulation and liberalisation regarding alcohol control, contributing to the destruction of many people’s lives. It causes family breakdowns, is a major factor in domestic violence, ruins job prospects, is often related to crime and disorderly behaviour and it kills.

Alcohol misuse is related to over 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems. The government approach has led to increased consumption levels and alcohol-related problems and demonstrates a failure in the political drive to improve public health and order.

As well as the human cost, it also costs the NHS millions every year, treating and dealing with alcohol problems and the criminal justice system also spends similarly large amounts dealing with alcohol-related and drink-driving offences.

Key recommendations from this report include:

• Higher taxes on alcoholic drinks and this increase should be proportionate to the amount of alcohol in the product.
• An end to irresponsible promotional activities like happy hours and two-for-one offers.
• Standard labels should be displayed on all alcoholic products that clearly state alcohol units, recommended guidelines for consumption and a warning message advising that exceeding these guidelines may cause the individual and others harm.
• The legal limit for the level of alcohol permitted while driving should be reduced from 80mg/100ml to 50mg/100ml throughout the UK.

Mass public awareness campaigns, which some AMs seem to be pointing to as a possible solution, may be politically attractive and increase knowledge about alcohol misuse, but they are very expensive and ultimately ineffective if unsupported by broad based policy. Targeted approaches are vital, including measures to reduce the availability of drink.

And we are not calling for minimum pricing of drink, to be killjoys, this is just part of it. The BMA also recognises that preventing alcohol-related harm requires accurately pin-pointing those who misuse alcohol. Yet, there is currently no system for routine screening and management of alcohol misuse in primary or secondary care settings in the UK. So, we would like to see a more comprehensive system of identifying patients at risk which could be done through screening questionnaires, when individuals visit their GP, or attend for a general hospital appointment, or when they go to A&E. So, if the WAG wants to continue with its plans for dealing with alcohol misuse, it has our full support.

Read the BMA’s report on this in detail http://www.bma.org.uk/ap.nsf/Content/tacklingalcoholmisuse

Reminder about the GMC’s Specialist Register and the restoration of the Existing Specialist Route

I blogged on a letter from the GMC about its Specialist Register and the restoration of the Existing Specialist Route back in January, but I think it’s probably just worth bringing it to members’ attention again.

The contents of a letter are as follows;

Eligibility for Inclusion on the GMC Specialist Register: restoration of the Existing Specialist Route

Since 1 January 1997 it has been a legal requirement that, in order to take up -as opposed to continuing to be employed in -a consultant post (other than a locum
consultant appointment) in a medical or surgical specialty in the UK health service, a doctor must be included in the GMC's Specialist Register.

When the legislation was introduced to create the Specialist Register, those who were already consultants were entitled to apply for specialist registration by virtue of their status as 'existing specialists'. However, later legislation introduced in 2003 prevented those who had not already applied as 'existing specialists' from doing so without being able to demonstrate that their past specialist training and/or qualifications met the present standards required for the award of a Certificate of Completion of Training (CCT).

This mechanism was never intended for established senior consultants who are already in post and quickly proved to be inappropriate for specialists whose training had been undertaken so long ago. These changes in legislation have left a small number of consultants in a position where they are either unable to move posts or with a straightforward means to have their names included in the Specialist Register.

Earlier this year the Government consulted on proposals to amend the relevant legislation which would enable the restoration of the existing specialist route; Parliament has now agreed this change and the GMC has consulted on a scheme for the registration of persons who were consultants before 1 January 1997.

The scheme will come into force on 2 March. If you are aware of any consultants (other than locums) who were appointed in the National Health Service or the Armed Forces on or before 1 January 1997, who are not currently included in the Specialist Register, we would be grateful if you could draw their attention to the scheme,

Expressions of interest in taking advantage of the scheme can be made by emailing the GMC at pre1997scheme@gmc-uk.org.

The wait goes on for hundreds of people in Wales on the organ donor register

Hard-hitting health campaigns can nowadays, seem to lack the very ‘shock’ factor they are trying to illicit. But I think the latest TV advert by Kidney Wales certainly should get across the point to viewers about just how important it is anyone considering signing up to the organ donor register does so, NOW. The fact that one person dies every 11 days waiting for a transplant really does illustrate how time is of the essence for anyone on the transplant list.

I also think this just goes to prove again how important it is that we move towards a system of presumed consent, as chairman of Kidney Wales Roy J Thomas says “We are in the grips of an organ donor crisis in Wales”. I still think the best way of tackling this crisis is to change the system as it stands now. And that’s why I welcome the private member’s bill on presumed consent being debated in the House of Commons tomorrow (put forward by Jeremy Browne, MP).

The BMA backs the idea of presumed consent, which would see all adults having the opportunity at every stage, to make it known if they do not want to donate their organs after death. Among the safeguards proposed - high profile publicity campaigns which would make everyone aware of the choices. Consent to donation would only be presumed, if individuals expressed no objection. Families would also be consulted and donation would not proceed if relatives would be seriously distressed. Doctors would consult with patients’ and their loved ones, every step of the way.

Some 90% of people say they would be willing to donate their organs. Unfortunately, this does not translate into people who actually sign the register - that stands at roughly 30%. And there lies the crux of the problem, it seems people want to be donors, but for whatever reason, they just don’t get round to signing the register. Of course, that wouldn’t be an issue with a presumed consent system and that is how a change to legislation, could make all the difference to anyone left waiting on the organ donor register.

Find out all about the BMA’s position on presumed consent by reading the BMA’s briefing paper on organ donation

Sign up to the organ donor register

National No Smoking Day is still needed

It’s that time of year again when smokers are urged to kick the habit. Some people may be surprised that we still have such National Days as, fortunately, many of us never come into contact with cigarettes and smoking since the introduction of the smoking ban in Wales. National No Smoking Day is still very much a necessary and worthwhile day however, with thousands of people continuing to smoke here.

Despite the fact we’ve had the ban on smoking in enclosed public places for almost two years now, thousands of people here are still dying each year from smoking-related illnesses. And it is our members, doctors that see first-hand the devastating consequences of developing such a deadly habit.

The planned legislation to ban the display of cigarettes at point of sale in Wales and England needs to happen sooner, rather than later, to try and help prevent the next generation here from starting to smoke. Children who do so face years of tobacco addiction that can lead to life-threatening diseases and premature death. So awareness-raising days will continue to serve a purpose, until we’ve convinced everyone of the dangers of smoking.