Are Patients ‘At Risk From Thousands Of EU Medics?’

On 24th September 2016, the Daily Mail headlined with the following:

This follows on from a number of previous articles published earlier in the year by the paper concerning doctors in the NHS who come from other EU countries.

Whilst the paper has never been overly fastidious with the truth, this arrangement of falsehoods and scare-mongering is not only irresponsible but immeasurably dangerous to the National Health Service.

As a doctor who works in the NHS, I fear to imagine how we would manage if my colleagues from Ireland, Italy, Greece, Poland or Spain left their jobs as consultants, clinical fellows, registrars or house officers. It would certainly expand the existing staffing voids to breaking-point. The straightforward issue of workforce numbers aside, we would also lose the countless continental talent who contribute so much to our hospitals and research.

I wonder if Sophie Borland, the Health Correspondent for the Daily Mail, could visit hospital for a few days and witness first-hand the contribution of the 10% registered doctors and 4% registered nurses from other EU countries working in the NHS.

But what of the central premise of the Daily Mail’s campaign, that EU doctors work in the UK without safety checks and constitute a risk to the public? The Daily Mail quoted the head of the UK’s General Medical Council, Niall Dickson:

“Some European doctors – because we haven’t checked their competency – may struggle when they practise here and that could put patients at risk. We are able to assess their language skills but we cannot check their competency to practise. That’s just a reality.”

The article curiously missed out the following from the GMC: “UK patients are more protected than they used to be and the European Commission deserves credit for bringing in the fitness to practise alert mechanism, which allows regulators across Europe to share concerns about the fitness of practise of health professionals, and for giving the UK and regulators in the rest of Europe the power to require health professionals to demonstrate their ability to speak the language of their patients before granting them entry to practice.”

The GMC goes on to say “it is important to remember that employers also have a responsibility to carry out thorough pre-employment checks and make sure that the doctor is qualified and competent to carry out the duties they are being given, including having the right language skills for their particular role.”

This states the obvious: that the obligation lies with the employer for ensuring a rigorous application and interview process and then monitoring a doctor’s practice, and this should be the same whether the doctor is from the UK, Europe or the rest of the world.

However, the obvious can be ignored when a vendetta is being waged, and so the Daily Mail not only overlooks this but contraindicates itself by publishing the GMC figures:

“GMC figures for 2011 to 2015 show that just 0.55 per cent of doctors who qualified in the UK were struck off, suspended or given a warning. This compares with 1.01 per cent from the EU and 1.1 per cent from elsewhere in the world”, In summary, there was more action against non-EU doctors than EU doctors (and still a small proportion).

In a riposte to the Mail, the European Commission states in its article at “It is out of the question that EU rules would require the UK to let linguistically or medically incompetent doctors practise. In fact, the rules – recently further reinforced in agreement with the UK – expressly require Member States to prevent such people from being employed”

This headline brings two negative consequences – firstly, patients become needlessly worried about EU doctors, which may lead to delays in seeking appropriate and timely care. Secondly, an incorrect stigma is fostered against a large group of doctors and nurses. Since Britain voted to leave the European Union, there has already been a marked reduction in applications from EU healthcare staff to work in the NHS. If those who come here from Europe and work to save lives and cure illnesses feel that they are no longer welcome and leave, then patients will really be at risk.

My article was originally posted on the Huffington Post


So… just who will be made accountable for this Brexit lie: “£350 million/week to NHS”

I just don’t understand how people or groups cannot be made accountable for such flat out lies (350 million /week for the NHS).

If the polls show that so many people voted based on that piece of complete fiction then a valid challenge needs to be made through all the available routes.

This isn’t just post-truth but the polar opposite of truth.  Medications have already become more expensive and Article 50 hasn’t even been invoked yet. We all know doctors, nurses and research staff in key positions who have resigned to return back to their countries or move to other countries in North America or the Antipodes. Rota gaps have become even worse over the last few months and the burden on service has had a tangible effect.

Just WHO will be made accountable for this?


More garbage from the Daily Mail: Junior Doctors

Screenshot 2016-09-06 00.06.10

Where’s Joseph McCarthy when you need him to sort out all these evil treasonous commie junior doctors? #Redperil

Here is the chap who wrote the piece:


Interestingly, back before he joined his spiritual home (The Daily Mail), he was admonished by his future employers for failing to read Twitter’s terms and conditions:


He seems like a fastidious proponent for the truth, doesn’t he?


Studying The Kiwis: Could Britain’s Junior Doctors Learn From New Zealand?

As the British Medical Association (BMA) prepares for another meeting to discuss further industrial action against the government’s proposed junior doctor contract, the New Zealand Resident Doctor’s Association (NZRDA) has also announced a campaign for a better contract for junior doctors, with the threat of strikes on the horizon. Can British Doctors and their union learn from New Zealand?
Following a year-long stalemate punctuated by brief periods of attrition, Britain’s junior doctors remain locked in a dispute with the government over a proposed new contract, warning of “escalated” industrial action should the Government refuse to address concerns over patient safety and fairness. This is likely to encompass a rolling programme of strikes, starting in September. The BMA Junior Doctors Committee claim that worries have been repeatedly raised and not addressed, including concerns about weekend working and pay for those working less than full time.

JDC chair Ellen McCourt has said:

“Forcing a contract on junior doctors in which they don’t have confidence, that they don’t feel is good for their patients or themselves, is not something they can accept”.

Echoing events in Britain, New Zealand’s Resident Doctors Association (NZRDA) called for changes to junior doctor working patterns, including the number of potential consecutive 10-hour night shifts to be reduced from seven to four, and the number of consecutive day shifts to be reduced from 12 to 10.

The campaign is focusing entirely on patient safety and has centred on a strong social media presence with clear statements and images:

Highly publicized figures from NZRDA’s survey of its 3600 members reported that 300 doctors had fallen asleep behind the wheel on the way back from work, and more than 1000 doctors had made a mistake which affected patient care due to exhaustion. The NZRDA has warned that if there are no changes to rosters, there will be industrial action for the third time after previous strikes in 1992 and 2006.

The NZRDA was originally founded in 1985. In contrast to Britain’s BMA it represents only Junior Doctors, not all doctors. British doctors moving to New Zealand are often surprised about the power and proactive nature of the organisation. The face of the NZRDA for the last few decades has been the organisation’s National Secretary Dr Deborah Powell. She is perceived by doctors, media and public alike as a fiery and uncompromising battleaxe who persistently wields clout in negotiations.

These negotiations have yielded a number of benefits over time for junior doctors in New Zealand, which have included: consistent increases in pay, final year medical students being given a salary, free canteen food during working hours, training and membership costs being covered, presence of cross-cover and relief doctors to cover short-term absences, ease in going out-of-training for family or travel. There is even a motivation for hospitals and clinics to ensure that their junior doctors claim all of their annual and study leave, as the amount not used becomes “cashed out” as a payment.

In the few instances when conditions have deteriorated, the NZRDA has been aggressive. In April 2008, they gave notice of a nationwide 48-hour strike over pay, conditions and ongoing issues of retention, as 40% of Kiwi doctors were moving to Australia. At the time, a first year house-surgeon in NZ earned 88,000 NZD (£40,000) on average. Junior doctors sought a 10% pay rise over three consecutive years (twice that of other health service workers) rather than two rises of 4% over two years.

The strikes were widely seen as a success which brought the desired outcome for the doctors, caused no harm to patients (indeed, emergency department waiting times were markedly reduced), has improved retention of doctors and made New Zealand a very attractive destination for British and other doctors. They have also underlined the power of the NZRDA to fight annually for better conditions.
The success of these victories is reflected by a reversal in the exodus of Kiwi doctors to the United Kingdom, such that British doctors are now flocking to New Zealand at record levels. We can only speculate whether a single-minded force such as Deborah Powell may have challenged the various events which have taken place over the last decade and reduced morale of British junior doctors to such an extent: Loss of House Officer Accommodation, shortages of training posts, the ill-received Medical Training Application System (MTAS), pay increases below inflation, consistently increasing GMC and examination fees.

How would the NZRDA manage if metaphorically transplanted onto the negotiating table closer to home? Their use of punchy statements and images, peppered with some humour, has helped the public clearly identify the junior doctors’ argument. Based on their track record, would they have hesitated to legally challenge the UK government: particularly on Jeremy Hunt’s early assertion that we do not already have a seven-day emergency NHS, a proclamation which has already led to well-documented patient harm?

Watching the British and New Zealand negotiations developing in parallel will be an interesting comparison of the relative power of government and employers’ union in both countries.

Also published here:


In this junior doctors row, even real doctors can become spin doctors.


Dr Sarah Wollaston is Conservative MP for Totnes and Chair of the Commons Health Committee. She is a former GP and teacher. Her daughter, a junior doctor, left the NHS last year with 8 of her friends to go to Australia. She has consistently voted in favour of easing restrictions on private companies to deliver healthcare in the United Kingdom:

Dr Wollaston has penned a “balanced” piece for The Guardian, looking to apportion blame for the junior doctors strikes on both the government and junior doctors:

This attempt is about as impartial as Bill O’Reilly’s “No-Spin Zone” programme on Fox News, with a combination of subtle spin and phony ignorance.

Here is a dissection of some key points in her article:

“Sick people seem an afterthought as the government and the BMA pursue an unnecessarily toxic debate”

No they don’t, the BMA and junior doctors’ entire motivation is to safeguard the future of care in this country.  The BMA are well-supported, but if anything much less powerful than other doctors’ unions around the world.  This has come about following years of erosion and in-fighting. If anything, junior doctors are upset that the BMA have not been going far enough:

“Many of my daughter’s colleagues are not planning to join her on the journey home next year and there has been a marked increase in the numbers applying for certificates to work overseas.”

I wonder why?

“The dispute looks set to erupt into a dangerous full walkout by junior doctors. The British Medical Association claims that the contract will harm patients by stretching doctors too thinly across seven days while reducing their take-home pay. The government insists that patients are being put at risk by understaffing at the weekends and that the contract reduces doctors’ maximum hours and consecutive shifts while increasing basic pay by 13.5%.”

She knows better than anyone that net pay will go down for many, yet uses the same smoke and mirrors technique used by her colleague Jeremy Hunt meant to fool the public – “increasing basic pay by 13.5%”. She is being disingenuous here because anyone who has looked at the contract knows that out-of-hours pay is cut significantly so net pay is down for many fields, especially emergency ones.

And how could the government set up the world’s first and only routine national health service when it has been reducing funding for the NHS since it took power?


“It seems to me that the contract is more about the manifesto commitment to a seven-day NHS and the perceived barrier of premium Saturday pay rates”

Well no argument here.

“Mine was the last generation of doctors to endure crushingly unsafe 120-hour working weeks and I have no romantic nostalgia for the 72-hour shifts commonplace in the late 1980s”.

But we have her on record insinuating that “doctors today shouldn’t complain, we had it worse in our day” and this is the crux of her emotion when it comes to this issue – she doesn’t think these unsafe hours are “all that bad” compared to what she went through. A former doctor who has this kind of attitude should not have this role, because they are using their own personal experiences to influence their judgment. There are many doctors much more experienced than her who had it a lot worse and know that this logic is at best irrelevant (the world is different now), at worst dangerous.

“Pressing ahead with a full walkout however, will serve only to harden attitudes and solves nothing. Most importantly, it will be disastrous for patients”.

New Zealand had a full walkout for 4 days a decade ago – patient waits were shorter, and emergency outcomes were better when staffing was only done by consultants and staff grades. It achieved the desired effect perfectly as New Zealand vastly improved its junior doctor contract, halting an exodus to Australia and attracting hordes of British doctors (when the net flow was previously the other way round).


“How can it be argued that patients will be safer only if all Saturdays are paid at the premium rate, however infrequently worked? Given the scale of concessions and protections on maximum hours and consecutive shifts, the BMA could have declared victory and moved on to focus on the deeper and longstanding causes of discontent.”

More spin – No one is saying this. And also this isn’t about some childish notion of “victory”. Furthermore, do you not think protections against tired doctors aren’t a worthwhile concession? Or do you want your daughter returning from her jaunt in Australia working unsafe shifts?

“Many more of their duties could be shared with others such as pharmacists, physician associates and admin staff”

Well in many hospitals we are seeing physician associate posts advertised (with salaries twice those of junior doctors) but the erosion of junior doctors’ work to become what it is today has happened over two decades now so this is going to take a long time to fix, and people like you who have taken roles in politics should have been coming out a long time ago.

“In some hospitals, such as Salford Royal in Manchester, electronic patient records are finally reducing the scandalous waste of time and resources that come with duplication and paper trails.”

In other hospitals such as Addenbrooke’s in Cambridge, electronic patient records have cost hundreds of millions and effectively bankrupted the hospital, introduced too quickly and with many, many glitches, effectively slowing down and losing continuity for patients.


“A constructive relationship between doctors and government will take time to rebuild; it cannot be imposed and it will not happen unless both sides put patients first and start listening. Saving lives must take priority over saving face.”

And as someone who is a former doctor and part of this government, you should practice what you preach and not keep coming out with this spin (feigned under the guise of a balanced inbetweener of two warring factions), when you know how much of a disgrace these proposals have been, you know how much the NHS has been wilfully under-funded and you personally have sanctioned the many Private Finance initiatives popping out like fungus on a damp corpse.


Jeremy Hunt’s 7-Day NHS lie


Jeremy Hunt wants the world’s first 7-day routine health care service.
This is a hollow manifesto promise. It is as fantastical as baby unicorns for all 9 year-olds.

He is using this as his fuel to put pressure on frontline healthcare staff, which is already causing many to leave, and will render the NHS unsustainable.

This will open the sluicegate for wide-scale privatisation of the NHS. The evidence of his intentions is clear for all to see.

Please don’t let this happen.

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