Wining, dining and debating the issues of modern medicine

Published on Monday 21 July 2008 20:24

THE BMA's annual conference is over for another year. Doctors from across all branches of medicine and from all corners of the UK have now returned to their hospitals, surgeries or offices.

For outsiders looking in, it may seem this conference is little more than an annual get-together, an opportunity for camaraderie and fine dining. They would be wrong. The four-day conference includes a lot of hard debate on issues that challenge us ethically, professionally and personally.

Holding a UK conference in Edinburgh is a bonus for BMA Scotland, even if the hotel prices are rather high. One of the highlights was when Nicola Sturgeon, our own Secretary for Health and Wellbeing, addressed a special fringe meeting where around 200 doctors from across the UK hung on her every word.

Sturgeon, dressed in her red power suit, gave the audience a tour de force. She espoused the virtues of community ownership of the NHS, emphasised the need for co-operation and collaboration rather than competition, and made it clear the English model of privatisation was anathema to the Scottish Government. How the BMA delegates loved it.

Usually, polite yet muted applause greets government spokesmen. However, to receive two standing ovations in an hour from a bunch of cynical medics indicates you've either been reading too many medico-political journals, or you really have been listening to what doctors have been saying for years. Sturgeon is a consummate politician and could it be that, for the time being at least, many of her policies and those of the medical profession coincide?

But enough of politicians. What else went on behind the closed doors of conference? There was, of course, the usual outrage and disgust. Junior doctors' residency rights have been withdrawn causing an effective 4,000 pay cut to doctors in their first year of training, while medical students seem to be incurring ever increasing debt before actually getting on to the career ladder. It appears 50,000 is the current personal cost of pursuing a career in medicine. Morale and recruitment may dip when potential medics realise how little governments value the new generation of doctors.

International affairs were also high on the agenda, with important debates on the role of the Chinese Medical Association in Tibet and the rights of failed asylum seekers to free health care while still in the UK. There were also debates on the need for common immunisation schedules for children across Europe, and the perverse situation which insists doctors from the US or New Zealand must pass an English test, but if you're from Germany, Italy or any other EU country there is no bar to working in the UK whatever your language skills. Officialdom gone mad?

Of course, at these conferences medics love telling others how to do it right, but they do occasionally get it wrong. This was evident in the debate on co-payments. Much passion was expended on this contentious and ethically complex issue. If you decide to buy a drug which is not available on the NHS to treat a serious medical condition (ie cancer), the rules state all related care and treatment must then be in the private sector. This effectively means, for many, that you would be excluded from NHS treatments.

The counter argument is that two patients could end up on an NHS hospital ward receiving different treatments for the same condition because one could afford to buy the extra treatment. But what is the answer? The delegates couldn't decide either.

The new BMA policy is a bit of a fudge, stating that the subject needs to be looked at further and: (a) patients should be allowed to buy additional treatments and continue to receive NHS care; (b) but we shouldn't tell the government to implement this policy.

Hopefully, by the time we travel to Liverpool for next year's BMA bash, our view on this issue will be clearer!