This is not live aid, it's reverse aid

In a message setting a "very clear moral and ethical priority for the new Government as it chairs the G8 summit", the leader of the UK’s doctors, BMA Chairman James Johnson yesterday (Monday 27 June) criticised developed countries for draining skilled health professionals from some of the world’s poorest countries. The "rape of the poorest countries must stop" he said.

Speaking to an audience of 450 doctors at the BMA’s annual representative meeting in Manchester, Mr Johnson condemned "the obscene exploitation perpetrated by the English speaking nations of the North on some of the world’s poorest countries. "In the UK we have around 120,000 doctors practising medicine. The USA employs over 50% of all English-speaking doctors in the world. In Australia, a country of 20 million people, they have 48,000 doctors. In Ghana, which also has a population of 20 million, they have only 1500 doctors in the entire country. In Mozambique, with the same number of people, it is even worse. They have just 500" he said.

"This is not live aid, it’s reverse aid" said Mr Johnson.

He stressed he was not talking of closing doors to overseas colleagues because international exchange and collaboration must continue. But he warned "It is completely pointless for the UK to give USD 300 million in aid to Africa if we then systematically rob them of their most precious resource – intellectual capital and the practical ability to prevent and treat disease."

On domestic health issues, James Johnson urged doctors to make their voices heard in health reform. He said that the BMA had worked hard to reassert the voice of the clinician in health policy. Mr Johnson chose treatment centres as a key example of reforms that could work well if properly planned but would work against patients’ interests unless independent and NHS providers compete on a level playing field and provision was properly integrated.

"Treatment Centres are here and probably here to stay given the cross party consensus on diversity of provision. We should take pride in the fact that NHS, not the treatment centres, will continue to pick up the most complex and difficult cases. It is what we do best. But if we are going to have a multi-provider NHS then competition must be fair and the playing field levelled out - no more sweetheart deals that disadvantage NHS hospitals and leave patients, primary care trusts and GPs with no choice but to refer their patients to the treatment centre."

He warned government that NHS reforms would not work unless health professionals were involved.

"My message to the government is simple and clear. Let the professionals help you modernise the NHS to which we are passionately committed. Work with us and your reforms will have a much greater degree of acceptance – and they might just work. Without us they cannot work" he said.

Choose and Book (the government’s planned electronic booking system for hospital appointments) was an area which had to have professional input. Mr Johnson said: "It has been a fiasco so far, because people who do not work with doctors or patients have devised a system which does not begin to understand the basis on which GPs refer and hospitals organise clinics. This is just a mini example of the much bigger mess that could be coming our way with Connecting for Health, if the new systems are not planned with the involvement of the nurses and doctors who deliver the services to patients."

Mr Johnson continued: "The main reason for failure of large IT projects is failure to involve the people for whom the system is designed in its development – doctors, nurses and of course patients. And this is precisely what has been going wrong with Connecting for Health."

He went on to say: "if Government is really willing to consult and involve doctors in planning the new system, we can help to get it right both for patients and doctors and save a lot of heartache, embarrassment and wasted expenditure."

Commenting on a BMA poll which showed the public place cleaner hospitals at the top of their wish list for NHS investment, Mr Johnson said: "How have we got to a stage when in a 21st century health service, resourced as never before, patients are frightened to go into hospital – not because of worries about the procedures, but because they are terrified they will catch a life threatening infection. We have to help change that."

The BMA wants to see the introduction of a total ban on smoking in enclosed public places. James Johnson said: "There is every indication that – given the right messages – the government will bring in a total ban. I call on you today, and on every doctor in the country, to give the government the message that if Tony Blair wants to leave a legacy for the public the single most effective thing he could do to protect people’s health is to ban smoking in all enclosed public places."

In conclusion, the BMA chairman called on doctors to get involved in NHS reforms. He said: "I believe in the NHS – you believe in the NHS – we have given our lives to it. We don’t fear change, we welcome it. But let us make sure the changes are ones that really work, for the managers, for the nurses, for doctors but most important of all, for the patients. Let’s get inside the room where decisions are made and help shape the future."

The full text of the BMA Chairman’s speech is available from BMA press office and will be on the BMA website at: http://www.bma.org.uk/ap.nsf/Content/ARM05ChCo

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