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Independents' Day

BMA highlights NHS 'culture of fear' in new vision for reform

The BMA has set out its new vision for reforming the NHS, which they chastise as ‘unsafe’ and ‘underfunded’, as well as having a ‘persistent culture of fear’.

The trade union used its Caring supportive collaborative: a manifesto for change report to reiterate that GP and hospital doctors alike are working in settings that are ‘hugely understaffed’ and promote a culture of bullying and blame. 

This forms part of wider research into the state of the NHS, via a year-long study titled Caring Supportive Collaborative: Doctors' Vision for Change.

Calling for ‘radical change’, BMA council chair Dr Chaand Nagpaul said healthcare services are struggle to cope after ‘years of funding investment failing to match patient demand’.

He continued: ‘Nine in 10 doctors tell us that staffing levels are inadequate and that they work in environments where they fear the toxic combination of ever-increasing demand for services and lack of staff capacity will lead to mistakes.

‘They tell us there is a persistent culture of fear across the NHS, where blame stifles learning, contributing to the vicious cycle of low morale so staff leave and then there’s a problem of recruitment.

‘This unsafe, underfunded environment is as damaging for patients as it is for doctors.’

The report has been followed with a manifesto, sent today to health secretary Matt Hancock and other MPs. With a focus on changing the accepted culture and ultimately improving patient safety across the health service, its key recommendations are: 

  • Addressing the funding gap by increasing spending across the UK by at least 4.1% per year to put the NHS on a sustainable long-term footing, equating to an extra £9.5bn by 2023/24,
  • Legislation in England ensuring accountability for safe staffing levels and that individual clinicians aren’t blamed when the system places them under unmanageable pressure,
  • Reviewing the CQC with the intention of introducing reforms which will deliver a truly proportionate regulatory system,
  • Investing in a comprehensive IT programme so the NHS has access to the right IT equipment and facilities to provide the best care for patients, including basic IT infrastructure, access to high-speed broadband and full digitalisation of all patient records.

As well as the Government and parliamentarians, the project authors intend for it to reach commissioners and those occupying leadership positions throughout the NHS, in order to develop a ‘truly sustainable’ system characterised by ‘adequate funding’ and ‘decent terms and conditions for doctors’.

Earlier this month, the BMA also warned that a no-deal Brexit will ‘irreparably ravage’ the medical provision. 


Readers' comments (6)

  • the government and daily hate mail created this mess backed by the GMC and lack of support from the useless RCGP. BMA are pointless. Patients demand more and more and if you say no you get an immediate complaint. PCNs will increase the bullying culture rather than help it. the NHS is toxic as an employer. it needs a radical re think and a massive boost in funding and policy on how to manage patient expectation ie reduce it massively and give back the power to NHS staff to remove patients who are abusive without being castigated by the GMC, to be able to discuss mistakes without fear of litigation and live in an environment where innovation and experimentation of health care is encouraged and supported. It requires adequately funded training and time for reflection and learning with rest breaks that are funded and not interrupted. when a workload is too much the immediate response should be to either find extra staff or close the service. the amount of emotional blackmail fired at staff to do more and more unpaid when tired and demoralised is shameful and dangerous. As for whistleblowing - you do it you know its the end of your career progression no matter what anyone says. no has been listening for the past 11 years despite being fully aware this is a major issue. the results are plain to see. NHS staff have had enough and voting with their feet. Counting down the days, only 2 more appraisals to go and I am done.

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  • D in V that is the same for an awful lot of us both medics and nurses.The establishment doesn't want to acknowledge the shi@storm,including the BMA to negotiated the current underfunded over worked terrible contract.This hand wringing by the BMA will not work when the contract they have signed us up for is a blank cheque for workload and peanut in funding.Pathetic it will not wash BMA.Stand up for your members ,you should be really ashamed of your performance.If you were being appraised id be reporting your to the LAT.

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  • Vinci Ho

    You see
    This feels like the chief executive officer of Hong Kong government finally withdrew , in totality, the infamous extradition law causing the mayhem in last 3 months .
    Problem is : too little , too late , Robocop .
    As I wrote before , we had been sleepwalking into this scorched earth politics which is nobody wanted to see . The inevitable damages to NHS could not be undone in short space of time .

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  • The obvious mechanism to increase funding and limit demand is to do what most of the civilised World does and introduce top-up fees or co-payments; but the BMA will always prioritise "saving the NHS" ahead of the interests of Doctors.

    The NHS is the fundamental problem, a monopsony that abuses staff who have little choice of alternative employment.

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  • In response to the lack of staffing, we will raise standards by creating more rules to cause more tests, more monitoring and more treatments. We will create more rules to make the job impossible and as an additional whip, make them pay to work and raid their pensions. We will do more surveys and encourage more litigation and complaints to waste staff time. The GMC will look at more issues that are non medical to raise standards. Nothing short of a saint will do. This will create the BEST healthcare system in the world that is second to none. Best Healthcare....The Best.....from the bottom.

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  • The dictum "patients come first" has to change to "staff come first" for the NHS to survive.

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