Daily Insight: I want some more, says BMA

BMA seek more from government

Following the earlier significant leak of private WhatsApp messages between British Medical Association junior doctors’ leaders, HSJ on Friday revealed the resignation letters of two doctors who left the very same junior doctors’ committee executive earlier this month.

They raise serious concerns about the leadership of Johann Malawana, chair of the JDC, who is accused of being undemocratic and acting politically and dishonestly.

HSJ has also learned the JDC has been pushing for further wins from the government, even up to Thursday morning, when a meeting took place between health secretary Jeremy Hunt and Dr Malawana. The BMA asked the DH to add fully funded shared parental leave to the juniors contract. This was declined. 

In one resignation letter, Charlotte Elliott said: “I have struggled to deal with and accept the direction that you have led not just the JDC/Exec but all of the junior doctors in England. This is not about getting the best deal for junior doctors any more, rather it is a political game that at times has been a dishonest one.

“You have overlooked and dismissed several opportunities to improve on the contract whilst presenting no alternative but strike action and in the process are damaging the years of prestige which the BMA holds.”

Conan Castles, who also resigned from the executive, said he had been expressing concerns for many months, but that as a non-voting member of the executive, he had felt “my opinion counts for nothing when decisions have been made”.

He added: “My other concerns have been around how exec has been functioning. My perception is that decisions are being made elsewhere, exec are not getting told anything about what is happening before the decision, yet we are then presented with these decisions, seemingly fait accompli, to claim that is an ‘exec decision’.”

The BMA and Department of Health were approached for comment but declined to respond. 

Six weeks to save specialised

As the National Audit Office rehearsed in its recent report, the tale of NHS England’s specialised services commissioning efforts is not a particularly happy one.

After nationally defining service standards, then identifying that hundreds of services were not meeting them, it has not found a way to do much about it - and has stopped publishing information on which are still falling below the bar.

This week the national commissioner put a strategic framework before its board. It covers a lot of ground and is pretty vague in places, like any good strategic framework.

However it does spring a bit of a surprise for those working on sustainability and transformation plans, by stating a requirement for them to propose service change priorities, and new provider “configurations”, for specialised services, in their submissions.

Presumably STP leaders have been given a bit of advanced notice of this. But even so, given NHS England hasn’t found a comprehensive way to sort out specialised provision in the past three weeks, it might be asking a lot for STPs (often smaller patches than needed for specialised), to deal with it in the less-than-six weeks to the end of June.