The BMA Bop

In August my new trust sent an email asking for candidates to become the hospital's Junior Doctor representative on the BMA local negotiating committee. I sent a very non-committal email back saying I was interested and would like more information. I was fully expecting that in the current climate there would be a deluge of willing volunteers and someone louder and more polished than me could give some soaring oratory to get the post. In the last trust I worked in we had 9 applicants for the post and an election had to be held. I had underestimated the apathy in my current institution.

After 6 weeks nobody had gotten back to me from the BMA so I assumed that they had found someone or hadn't got my email. If a week is a long time in politics, 6 weeks is an age. In this time the BMA had gone from losing a ballot, declaring strike action then cancelling said strike action. It was fair to say I wasn't overly enamoured with them as an organisation for declaring strike action then cancelling it in quick succession. They were entirely right to call action if 58% had not accepted the contract, but where the 4 x 5 days figure was plucked from and why it was called off I'll never know.

It was therefore to my immense surprise when I receive an email saying I had been voted in as JD rep at their meeting (which I hadn't attended and didn't know about) as nobody else had come forward. So in late September I was made junior LNC rep and had to hastily organise a picket and ensure departments could cover their work. I figured the situation must still be salvageable at a national level (despite only hearing about press releases through BBC) so I decided to give it my best shot.

I started by trying to gauge reaction to the idea of 5 days of strike action, in order to represent the views of local members. If you look back to my previous post I had originally planned not to strike. This was due to the financial implications of losing potentially 4 weeks pay as well as my training record; Health Education England had sent us an email reminding us we may fail our training appraisal if we missed more than 2 weeks of work. I sent an email out to all junior doctors and spoke to the juniors in my department of O&G as well as nearby specialities like paediatrics and anaesthesia. I also tried to get a view of the FY1s at their teaching sessions. From my conversations I got the impression that nobody really wanted to strike for 5 days even those who had voted the contract offer down. From my email to 150 doctors, I received a solitary reply, echoing these sentiments.

I had gone from someone who was not planning to strike and wavering on whether to keep my BMA subscription going to somebody visibly representing the BMA within the hospital and trying to organise a picket. Then it got very difficult for me. The job lot of strikes was cancelled (again I found out via BBC) without anything in it's place and without an explanation. I enquired higher up and advised that a JDC meeting a month away would clear everything up. At this point O&G registrars were being started  on the new contract. It appeared there was no going back. But hey, at least we got the now infamous stickers in the post to proudly wear whilst nothing happened.

The stickers that launched no ships at all

So whilst the JDC were navel gazing I had to face my colleagues at the junior doctor forum and tell them that I knew nothing about the cancelled strike action and no plans were in place. I was rightly given some upset words from my colleagues. I waited for news of our next move, my proud sticker starting to curl on my lapel. The next meeting of the JDC only served to lose another chair. I waited some more and on radio 4's today show Dr Porter effectively ended our dispute with the government. With the new chair of JDC assuring us we are still in dispute and are back at the negotiating table, you can forgive me for not holding my breath.

In the absence of any guidance I made a decision at this point to work with the trust to ensure that they had all the statutory systems in place required for the contract to be imposed, and hold them to account if they didn't. It is to be said that the trusts are innocent bystanders in this and with pay protection actually stand to lose a fair amount of money over the next few years because of the new contract. Here is where I feel I've actually been useful as a BMA representative.

Along with the very helpful Industrial Relations Officers I have been involved locally with almost every aspect of the new contract. I've helped to appoint a guardian of safe working, I've tested and decided on which exception reporting software is to be used. I've looked at FY1 rotas to ensure they are compliant. I've broken down the contract and it's minutiae with our first cohort to be imposed upon to reassure them that nobody is getting a pay cut or a change in their rota. I've reviewed the equality impact assessment from the trust - interestingly it being inherently unfair on LTFT workers was not mentioned.  We've agreed with the trust to postpone most doctors going onto the new contract until August 2017.

My hope is that the contract is an unworkable disaster. The exception reporting relies heavily on educational supervisors to discuss and change work schedules as needed, which is all potentially a lot of new work. They will receive no extra time or money for this. Trusts may well find educational supervisors sign off exception reports as one-offs and give the payments to the doctors as it is the easiest way to solve the problem. Once the money starts accruing we might see something positive happen in terms of working conditions. I would therefore recommend any junior doctor reading this to fill out exception reports for EVERY alteration to your work and training schedule and then keep hassling your managers, supervisors, medical staffing and payroll to get every bit of extra money you are owed. Your BMA rep should help you with this. If you are an educational supervisor I suggest you lobby the consultant negotiators to increase the time in your job plan for educational supervisor activity or vote with your feet and stop being a supervisor if the work is too onerous or not remunerated enough. If enough people are annoyed and enough money is being lost then government will have to listen. I fully intend to pile up exception reports on the trust,  as the juniors at every hospital I've ever worked at, work above and beyond their "rostered  hours". It's not unprofessional to be paid for what you work and the well of goodwill has run dry.

So considering I wasn't a fan of the JDC I still think there is positive work I can do for juniors locally within the  BMA. I believe in Unions and being a BMA rep isn't just a line on my CV.  I've been on the JD Facebook forum and there is a lot of ill feeling towards the BMA. Good. Once again, people need to vote with their wallets or nothing changes. If they start losing money by cancelled subs then they might realise they can't get away with treating our contract negotiations like a student debating club. There is a lot unharnessed anger on there but words (he says writing a blog), twitter rants, stickers, YouTube raps and candlelit vigils achieve very little.

It leads me to wonder what I would change about the BMA as clearly they have missed the mark nationally with the JD contract negotiations. As far as I was concerned the JDC were doing a great job up until they embarked on a roadshow to get a "yes" vote in June's contract referendum. It was this point they could have just accepted the contract or kept neutral in any referendum campaign. Then on getting a no vote they could have continued with the 2 day strike actions that had worked earlier in the year. The BMA isn't just a union, it's statement about Scottish Whiskey today shows that they try to be public health watchdogs; which is what I thought Public Health England were. I wonder if the make up of the JDC sets us up to fail. We are all unpaid volunteers with medical careers which as far as I know trump our role as BMA reps. It therefore is natural that having such a major national role for JDC can be full of distractions and conflicts. I'm not sure about this but I don't think the JDC chair gets to work on the job full time and take time out of training. Maybe having more legal or union minded non medics or even full time medics seconded to the role full time for a period  may help when developing a negotiating strategy. Lastly, the communication from BMA is patchy and leaky at best. Their email server tends to send mail out in slow batches so people get news in dribs and drabs, when we were getting news at all. I like the step that the new chair as taken to get himself added to the regional chat forums in order to get news and views directly to him.

 It was always going to be difficult job not to get screwed over as eventually I want my certificate of completion of training and already put up with a lot to get it. If there is a silver lining then the May 2016 contract is a sight better than the November 2015 contract and I'm not too ashamed to throw away my BMA badge holder. You never know where I could end up if I fell into this role so accidentally. I hear the catering at BMA house is fantastic; it must be as it comes out of my considerable subs!