Monday 25 November 2019

Notes from RCGP Council meeting 23 November 2019


For the first time, members have been able to access on the RCGP website proposals for approval by RCGP Council.

Readers of this page will know that this is something I have been pushing for ever since I joined Council.

I am grateful to Victoria Tzortziou Brown, Jonathan Leach, other Officers, and staff including Michael English and Martyn Schofield who worked so hard to overcome technical and other challenges to make this happen.

Hopefully papers will appear online more than a few days before the next meeting!

Brunei Serious Event Review

Thank you to Simon Gregory and the team for this thorough and considered piece of work. I would like to make suggestions following on from three of the recommendations.

Recommendation 16
Classification and publication of policy papers and minutes is a matter that Kirsty Baldwin and I gave some thought to when we presented to Council our first paper on balancing transparency with information security in June 2015.
I see that the cover page of Council papers has had a bit of a make-over since our last meeting, to include - no doubt coincidentally - some of the features that we had proposed. I would suggest the addition of:

  • Version numbering
  • A field explaining why the paper has been restricted or not,
  • And another field suggesting how the distribution might change after approval.

My understanding was that the vast majority of approved papers are not restricted, and it would be great to see these made available online in an easily accessible and searchable format.

Recommendation 17
I welcome the suggestions to improve the accuracy and detail of minutes. Necessarily however, minutes cannot be published until they have been approved by the next meeting, a delay that hinders transparency. Any interest a member had in the meeting may well have long since dissipated by the time the minutes are published!
I note the observation in this report that minutes, not being a Hansard-style verbatim transcript, tend not to capture the full range of views expressed.
We are starting to get more of a flavour of Council debate from the contemporaneous tweets that are put out.
Most of us here write our own notes of Council meetings and share them with our constituents, and the Hon. Sec. publishes a post-Council letter.
I have a radical suggestion that may help to combine the advantages of all of these approaches, but would not replace any of them. Why don’t we operate a Wikipedia-style collaborative system of note-keeping that each of us can use to record our notes on a voluntary basis. Viewers can they choose to read everyone’s records or just those of individual Council members. We would need some IT support, but I’m fairly sure the technology is available and the software is free of charge.
We would need to make clear that these were merely the recollections of individual members and not approved minutes, but it may help to capitalise on any interest generated by a particular meeting and enhance transparency.

Finally, I note and respect that this paper has been marked confidential. I trust that my suggestions, being generic in nature, would not be considered sensitive.

Strategic Plan

Could I suggest that we add “Equity” to our list of values? It might be implied by some of the other items, but equity really is central to the list-based work of GPs, who are perpetually aware of opportunity cost: while we are helping one patient we are not available to our other 2,000 patients; this is one of many reasons why we must guard against overdiagnosis and unnecessary medicalisation.

Brexit update

I’m grateful for all the work that is being undertaken relating to Brexit. As the summary reminds us, Council called in November 2018 for a “people’s vote”. Could you please reassure me that College will continue to campaign for a people’s vote in line with our policy?

International Strategy

Would it be possible to incorporate the recommendations of the Brunei Serious Event Review into this overview? I refer not least to recommendation 6 of the Brunei report calling for annual reporting of international visits, including rationale, expenses and funding. It would be good to receive the first such annual report in November 2020.

Recommendation 9
I’d like to make a suggestion arising from recommendation 9 of the Brunei report, but it seemed more relevant to the international strategy.
I note the concerns that social media activity might not be representative of members. I think this is something that all of us here grapple with, especially perhaps those of us who are nationally elected.
I note from the international strategy update that our international strategy is due for review in 2021.
I note from the Trustee Board minutes that international members comprise 6.3% of our membership, and yet one gets the impression - rightly or wrongly - that more than 6.3% of our activity is directed overseas.
Much as the Brexit 2016 referendum has reminded us of the pitfalls of direct democracy, might I suggest that we find out what the views of our members actually are regarding our international strategy before 2021? I would suggest a formal consultation of all members, probably mainly qualitative, to determine to what extent they feel their College should support activity abroad, and how international and UK-based members respectively should influence our policy. At the same time, we could similarly take the opportunity to test members’ views on expanding membership to non-GPs.

Prohibition of the defence of reasonable punishment

This was a motion from RCGP Wales calling for physical discipline of children to be criminalised. I had not planned to speak to this item but on hearing the debate was alarmed by potential for misunderstandings and false accusations. I therefore announced that I whilst I would want parents to receive enhanced support in using non-physical disciplinary methods, I would vote against criminalisation and associated further state-intrusion into family life.

My view was clearly in the minority, as the motion was passed almost unanimously.

Declaration of interest as a condition of registration

It is an honour for me to second this motion. We should be immensely grateful to Margaret for her indefatiguable resolve over many years to make declarations of interest by doctors routine, public and now universal.
From a practical point of view, to have just one central register of interests could save each of us the trouble of remembering to update the register of each organisation we are associated with - and the potential embarrassment of forgetting to do so.
New members of Council - welcome! - will no doubt have been reminded of the Nolan principles of public life to which we must adhere. One of these seven principles is “openness”.
I’m sure no-one in this room, therefore, would hesitate to show leadership in this area. I’m hopeful, therefore, that we will embrace this proposal enthusiastically.

The motion was passed almost unanimously.

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