First, everyone should watch Bob Gill’s outstanding talk at a meeting organised by Holborn and St Pancras 4 the NHS on 10th April. The meeting was chaired by Crispin Flintoff and shown on the Crispin Flintoff show the following Sunday. https://x.com/CrispinShow/status/1912626430896120052
He also spoke later that night to RealMediaUK: https://www.instagram.com/reel/DIj8Gs2qwER/
Privatisation of ophthalmology doesn’t work
“A leaked Department of Health and Social Care (DHSC) briefing for ministers, marked “official sensitive”, detailed concerns about the effect the five main companies — SpaMedica, CHEC, Newmedica, Optegra and ACES — were having on existing NHS services.
It warned both money and doctors were being drained from the health service, leaving some NHS hospital trusts unable to deliver comprehensive eyecare services, including for children.”
Physician Associates: (a) shocking evidence submitted by BMA (British Medical Association) AND (b) shocking decision by the High Court to a BMA judicial review
- The BMA on 3rd April issued published testimony of doctors’ concerns for patient safety due to NHS use of Physician Associates (PAs) and Anaesthetic Associates (AAs). This evidence was collected between November 2023 and February 2025 and was submitted to the Leng Review on physician associates as “evidence that there is a clear disconnect between how PAs are meant to be working and the way they actually are showing that the NHS has failed in its duty to ensure patient safety.”
The evidence showed: “PAs making incorrect clinical decisions in place of doctors; PAs introducing themselves as doctors; PAs dangerously prescribing medication (something they are not permitted to do; PAs taking part in surgical procedures for which they were not qualified.”
The BMA provided explanatory notes for a few extracts from the testimony. You will need a strong stomach for this:
https://www.bma.org.uk/media/j5bfuny1/03042025-pas-portal-submissions-explanatory-notes.pdf
But you will need a still stronger stomach to read the full 600 submissions:
https://www.bma.org.uk/media/p13leadh/20250208-bma-reporting-portal-submissions-v3.pdf
- On 17th April a High Court ruling sided with the GMC which now regulates not only the doctors it was set up to regulate plus PAs and AAs. In its General Medical Practice guidance it refers to all of these as ‘medical professionals’. The BMA sought a judicial review claiming that such term for very different training paths risked conflating the roles of PAs and fully qualified doctors and thereby put patient safety at risk.
Following the judgment the BMA is considering its position and noted in a statement: “During the hearing the GMC was at pains to stress that it had no enforceable statutory duty to protect patient safety: a terrible statement from the medical regulator, though in keeping with its determination to ignore the blaring alarm bells sounded by doctors, coroners and patients.“ https://thedoctor.bma.org.uk/articles/life-at-work/bma-considering-next-steps-after-disappointing-high-court-ruling/
Useful article from Sqwawkbox: https://skwawkbox.org/2025/04/21/high-court-judge-gives-gmc-govt-green-light-to-keep-presenting-non-doctors-as-doctors/
The function of the GMC – more detail for those interested.
The BMA argued that the roles of PAs and AAs “ should be clearly distinct from doctors and, in the absence of a scope of practice for associates, the public should not be potentially misled into thinking that associate professions can do everything a doctor can.” As Part of its submissions on patient safety the BMA submitted the testimony in the links above.
One part of the argument related to the function of the GMC as laid down in the 1983 Medical Act which states: “The over-arching objective of the General Council in exercising their functions is the protection of the public”.
The BMA argued that: “The issuing of single guidance of application to doctors and associates, without distinguishing between them or between their separate and different training and skills, carries the potential for public confusion as to who is and who is not a doctor and associate and on this basis the GMC has….. failed to act in accordance with the statutory objectives in relation to patient safety and confidence”
The GMC argued that the duties of the GMC in the Act had the characteristics of ‘target duties’, namely “the open textured framing of a duty; the requirement for a person who owes the duty to act “with a view” to achieving a particular result……They are framed as objectives and, whereas a duty concretises as an object which must be achieved, an objective is something which must be pursued. As such it is, or is similar to, a target duty: aimed at the public at large, expressed in the broadest possible terms and conferring a very wide discretion on the defendant as to how best to pursue the animating purpose of the statute.”
The judge (Mrs Justice Lambert) sitting alone decided that: “in producing shared standards, the GMC acted to further patient safety”. She then cited the evidence submitted by the GMC of research and lengthy consultation and concluded that “The history of the development of the policy clearly demonstrates that the GMC acted at all stages with the aim of promoting the statutory purpose.”
Finally she considered that “There is no evidence that serious patient safety concerns are the result of the decisions under challenge.” The lengthy evidence of patient harm resulting from conflating the roles of doctors and PAs is amply demonstrated in the BMA testimonies above.