Commons
Doctors’ Association survey finds ‘deeply disturbing’ misuse of govt’s non-doctor roles
Danger to patients and conflicts of interest as government continues to push for expanded use of ‘associate’ roles – with help from the Royal College of Physicians
A survey by the Doctors’ Association UK (DAUK) has revealed ‘deeply disturbing’ ‘scope creep’ in which – as warned by the British Medical Association (BMA) and others – ‘physician associates’ (PAs), who are not qualified as physicians, are being used and acting as doctors.
A statement by the group warns that PA are not only overstepping the boundaries in which they are meant to operate, but also being used by NHS trusts and health companies to fill positions that require fully-qualified doctors:
PAs are overstepping boundaries, putting patient safety at risk, and impacting doctors’ training. This is shocking in itself, but made far worse by recent events at the Royal College of Physicians… Doctors at Torbay report PAs being used as “middle grades” – clear scope creep.
According to a doctor recruitment agency:
Doctors in speciality training programmes are known as Middle Grade doctors. Junior Middle Grade doctors are trainees who have completed their foundation training and are now in the early years of their speciality training. They are: ST1/ST2: ST stands for Specialty Training.
According to survey responses from doctors at Torbay and South Devon NHS Trust, as well as being used as ‘middle grade’ doctors and putting patients at risk by acting outside their competencies, PAs:
- work without adequate supervision
- consent inappropriately
- participate in unsafe clinical activity
- treated severe infective colitis with antibiotics and steroids simultaneously
According to NHS Scotland, steroids “shouldn’t be used if you have an ongoing widespread infection. This is because they could make it more severe.”
The DAUK also linked the survey results to this week’s fiasco at the Royal College of Physicians (RCP), where attendees of an extraordinary general meeting (EGM) regarding concerns about PAs linked the behaviour of the RCP’s panel, which was accused of ‘contempt’, shutting down discussion and even filibustering, to the RCP’s financial conflict of interest in the millions of pounds it reportedly makes from administering PA examinations.
The RCP is hiding their full survey data from FRCP and Council until after the EGM vote. This lack of transparency is unacceptable…
The RCP Registrar, who sets RCP professional standards, works at this Trust. (Important note: there is no indication she was involved in this case [of steroid/antibiotic administration].)
Doctors at Torbay report PAs being used as “middle grades” – clear scope creep. Yet the Registrar, whose job is to “create consensus” & uphold standards, has been involved in withholding critical data that potentially sways the EGM vote. This is not leadership.
The Registrar’s own job description emphasises “accountability for clinical and professional affairs” and “…setting and maintaining professional standards.” How can the Registrar fulfil these duties, ensuring patient safety and upholding standards, when those very standards are being violated in their own Trust? This is an untenable conflict of interest.
In our view, the Registrar has failed in their core responsibility for transparency and integrity of RCP decision-making. We call for their resignation to restore trust in the RCP. The RCP’s position on PAs is currently compromised.
The statement concludes with a call on all voting members of the RCP to vote to support all the motions tabled at the EGM calling for a rethink on the issue of PAs:
Lastly, we are asking that Fellows vote in favour of all five motions as presented, to ensure that a safe revaluation of the PA role can be conducted to ensure patient safety and to ensure continued viable training of the medical profession moving forward.
The use of PAs, which is considered by nine out of ten doctors to be dangerous to patients and confuses many patients, who do not realise that they have not been seen and treated by a fully-qualified medic, is being pushed by the government as a way of ‘downskilling’ the NHS, reducing costs and allowing increased profits for private providers, under the guise of the so-called ‘NHS Workforce Plan’ as part of the ‘Integrated Care Systems’ (ICS) project.
ICS, formerly called ‘Accountable Care Organisations’ (ACOs) after the US system it copied, were renamed after awareness began to spread that ACOs were a system for withholding care from patients and that care providers were incentivised to cut care because they receive a share of the ‘savings’. The system remained the same, but the rebranding disguised the reality.
The government used a ‘statutory instrument’ (SI) to pass these changes, avoiding proper parliamentary scrutiny, but both the Tories and Keir Starmer’s Labour support these and other measures to cheapen the NHS for private involvement and only independent MP Claudia Webbe spoke against them during the brief SI debate. Green peer Natalie Bennett’s motion in the House of Lords to attempt to kill the instrument was defeated by the Tories with the help of Labour peers.
At least two people have already died avoidably because of misdiagnosis by PAs. Emily Chesterton, 30, who didn’t realise she wasn’t seeing a doctor, was treated for a calf strain when she had a deep vein thrombosis that led to a lethal embolism. Ben Peters, 25, was sent home from A&E with a ‘panic attack’ that was really a serious heart condition. A doctor’s Twitter/X thread includes details of others said to have died because of issues around PAs.
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Hoyle’s excuse for ignoring Abbott amounts to ‘no time after the white folks had their say’
Speaker’s office’s excuse drips condescension and white privilege and ignores that HE’s the one who decides how long a debate or PMQs session lasts
White Commons speaker Lindsay Hoyle opted today to ignore Diane Abbott as she constantly rose to try to speak during a discussion among MPs about the appalling racism shown toward… Diane Abbott by the Tories’ biggest donor.
Hoyle refused to call Ms Abbott, Britain’s first Black woman MP, while a succession of white MPs droned on – and about any old nonsense, not even just about racism, through the whole PMQs (Prime Minister’s Questions) session – and the whole sorry spectacle was caught on video.
Hoyle – already a subject of disgust and derision for colluding with Starmer to allow Labour to hijack a vote on an SNP motion for a ceasefire in Gaza and to replace it with an Israel-friendly version – has rightly been the subject of an avalanche of criticism for the condescension of allowing white MPs to talk about racism to a Black woman MP while preventing her from speaking for herself.
And his excuse, which he presumably thought would make things better, instead makes them even worse – dripping with condescension and white privilege:
‘There was not enough time to call all members’ ignores a) that this wasn’t about ‘all members’ but the one member who was being talked about and who has suffered disgusting racism, while white MPs were given free rein; and b) that the person in the Commons chamber who decides how long PMQs lasts is… Speaker Lindsay Hoyle.
Basically, Hoyle is admitting that he decided there wasn’t enough time for the Black woman to speak once the white folks had had their say.
Pathetic and appalling.
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Racist Labour uses Tory racism against Abbott (to whom they’re also racist) to raise money
Starmer’s repulsive party has no shame or morals and is taking members for fools
Keir Starmer’s Labour party – that gives impunity to just about every type of racism rampant among the Labour right – is using a Tory donor’s racism against Diane Abbott, Britain’s first Black woman MP, to try to milk cash from gullible members.
In an email to members, Starmer criticises the blue-Tory version of the anti-Abbott racism as an excuse to beg for donations:
Starmer’s letter was dishonest as well as shameless – his party fawns over billionaires for their donations
The email does not mention that Ms Abbott is suspended from the Labour party for fighting anti-Black racism, which Labour disregards under Starmer who, in today’s PMQs, brazenly tried to score political points against the Tories for their racism toward Abbott.
While Starmer and a string of white MPs discussed racism toward Diane Abbott, Starmer’s pet Speaker Lindsay Hoyle prevented Ms Abbott getting a word in, ensuring that she was unable to point out the abuse of Starmer’s front bench toward her or the foul racism exposed by the leaked Labour report and barrister Martin Forde’s inquiry into it, which Starmer continues to ignore despite commissioning it.
The red-Tory version of racism is a non-issue to Keir Starmer, who has presided over wholesale deselection of Black candidates, suspended and sacked Black and Brown MPs like it’s going out of fashion – and has driven yet more to resign in disgust:
Some of the Black and Brown MPs sacked or driven out by the Starmer regime
While Starmer’s party drones protect racist councillors and functionaries, Starmer himself welcomes racist MPs back into the party – including one with an extra side of sexual harassment – with impunity and promoted Wes Streeting, whose ‘disgusting’ and ‘disgraceful’ rant in Ms Abbott’s face left her ‘shell-shocked’.
And he and his Shadow Cabinet did not even bother to contact Abbott when the news of Tory donor Frank Hester’s disgusting racism and threatening words toward her broke – but that did not (of course) prevent him using the situation to try (not very competently) to score points.
Labour is a racist and opportunist cesspit under the rule of its hard-right faction.
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Video: Speaker Hoyle repeatedly ignores Abbott – while MPs are discussing her
MPs talked about racism toward Diane Abbott today – except for Diane Abbott, who couldn’t get a word in for herself, despite wearing an eye-catching red jacket…
One of the many times Diane Abbott stood to speakr today – in a bright red jacket in a sea of blue – and was ignored
During Prime Minister’s Questions today, MPs discussed the appalling racism toward Diane Abbott, Britain’s first Black woman MP, by the Tories’ biggest donor.
Except for Ms Abbott herself, anyway. She stood repeatedly – at least 46 times – throughout the question session, wearing a bright red jacket amid a sea of mostly blue suits – and was ignored, every single time, by Commons Speaker Lindsay Hoyle, forcing her to sit and listen as others discussed her without being able to speak for herself:
I guess Lindsay Hoyle didn't notice the left wing black woman wanting to speak while other MP's spoke about her. I mean, what other explanation could there be? pic.twitter.com/IRkagSVs4D
— Saul Staniforth (@SaulStaniforth) March 13, 2024
Keir Starmer tried to use the session to make political capital about Tory racism, but has overseen widespread racism against Black and Brown MPs among the Labour right and has let disgusting behaviour toward Abbott by right-wing staff and MPs – including Shadow Health Secretary Wes Streeting – go unpunished.
Perhaps Hoyle was worried Ms Abbott would point this out. The Speaker recently disgusted many MPs by breaking Commons protocols to allow Starmer to hijack a Commons vote on an SNP motion for a Gaza – and tried to excuse it by claiming, ridiculously, that he did it to keep MPs safe. Former party adviser James Schneider and others saw the link and commented:
Countdown to a tearful Lindsay Hoyle @CommonsSpeaker addressing the Commons to say:
"I'm sorry I didn't call Diane Abbott to talk about her own abuse when others were. That was wrong.
"But I WILL NOT allow another 9/11 terror attack on this HOUSE.
"MPs must be protected."— James Schneider (@schneiderhome) March 13, 2024
Speaker's excuse for overriding an SNP day was his concern for MPs safety.
Yet he doesn't allow Diane Abbott to question the PM who is saying an apology from a man who called for her to be shot should be accepted. Not the PM's right to accept any apology it's up to Diane Abbott.— Colin Patton (@colinpatton10) March 13, 2024
Saul Staniforth, who compiled the video, has posted examples of some of the egregious establishment racism and mistreatment toward Diane Abbott, who has long been the most abused MP:
Anyone else remember how Jess Phillips bragged to journalists for years that she'd told Diane Abbott to fuck off. Diane has said Phillips made it up. pic.twitter.com/36u3rDVPc6
— Saul Staniforth (@SaulStaniforth) March 13, 2024
Anyone remember how, during the warm up to a program in 2019, QT host Fiona Bruce implied Diane Abbott got the job as shadow home secretary because of a previous personal relationship with Jeremy Corbyn
But its ok, because sneering abuse is just light hearted bantz, apparently. pic.twitter.com/UjORiI7ifx— Saul Staniforth (@SaulStaniforth) March 13, 2024
The time when a white person impersonated a black Labour MP (one of the most abused MP's in parliament), while three other white people laughed along – one of those three being a fellow Labour MP. pic.twitter.com/EuXwyiZvLh
— Saul Staniforth (@SaulStaniforth) May 31, 2022
Skwawkbox is attempting to reach Ms Abbott for comment.
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The Commons of Ameland: An Uncommon History.
There is no ‘tragedy of the Commons.’ But a tragedy of the absence of Commons-as organizations, let’s call it ‘the tragedy of uncommons’, does exist. Below, I will provide the example of the island of Ameland in the Northern Netherlands, in line with the historical examples of successful Commons mentioned by Elinor Ostrom (especially those […]
Starmer reported to parliamentary Privileges Committee over Hoyle threat
Starmer alleged to have threatened Speaker Lindsay Hoyle with removal under Labour government if he refused to break Commons protocol and allow Labour to hijack SNP Gaza ceasefire motion
Keir Starmer has been reported to the parliamentary Privileges Committee over his alleged but widely-reported threat to remove Commons Speaker Lindsay Hoyle under a Labour government, to force Hoyle to include Labour’s weasel-worded, Israel-friendly ‘ceasefire’ motion in yesterday’s SNP ‘Opposition Day’ debate.
While the SNP motion was clearly worded and condemned Israel’s war crimes as well as causing for an immediate ceasefire, Labour’s version gave Israel an effective veto over any ceasefire and prioritised Israeli lives and security above the slaughter, ethnic cleansing and oppression faced by more than two million Palestinians in Gaza.
Starmer’s manoeuvres and Hoyle’s compliance led to no vote being taken on the SNP’s motion, triggering a walk-out of SNP and Tory MPs – and a motion of no confidence in Hoyle being lodged on Thursday morning and already signed by 67 MPs at the time of writing.
But now Alba party Westminster leader Neale Hanvey has reported Starmer to the Privileges Committee, saying that it is “essential to establish if Starmer coerced the Speaker” into putting the Labour amendment through for debate and that it would make Starmer guilty of contempt of the House of Commons if so.
Hanvey’s letter to the committee reads:
Dear Ms Harman and committee members,
In the course of the last twenty-four hours, it has been reported in the media and to the chamber that the Leader of the Opposition and/or those acting on his behalf applied unwarranted and unacceptable pressure on the Speaker of the House for political purposes.
It has been alleged that this course of conduct was pursued to ensure that the Labour amendment to the SNP motion for an immediate ceasefire in Gaza was given priority as the Leader of the Opposition sought to prevent his members voting against the Labour party whip.
Furthermore, it has been alleged that the Speaker was subjected to coercive threats relating to the support he could expect to receive from the Labour Party in any upcoming General Election to force his hand to break with convention and act against the advice of the Clerk of the House.
In order to reassure the house, I am asking the Committee of Privileges to initiate an urgent and rapid investigation into the allegations set out above, including any and all related matters.
I would also request that any such investigation specifically examine the actions of Leader of the Opposition and consider whether the Rt Hon member’s conduct amounted to a contempt of the House.
The Privileges Committee featured in headlines last summer when it concluded that former Tory PM Boris Johnson lied to Parliament about his and his office’s breaches of lockdown rules during the coronavirus pandemic. Johnson resigned from Parliament rather than face censure.
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Breaking: 55 MPs (so far) sign motion of no confidence in Speaker Hoyle
Wednesday’s farce and chaos after Speaker allowed Labour to ‘hijack’ SNP’s opposition day motion calling for Gaza ceasefire leads to ‘Early Day Motion’
Fifty-five MPs – and counting – from the SNP and Conservative parties, plus one independent, have signed a motion of no confidence in Commons Speaker Lindsay Hoyle this morning, including more than half of the SNP’s Westminster MPs, after last night’s fiasco in which Hoyle broke parliamentary protocol to allow a Labour amendment to enter the debate and derail the SNP’s ‘Opposition Day’ motion calling for an immediate ceasefire in Gaza.
Labour’s amendment, which watered down a motion condemning Israel’s war crimes in Gaza into an Israel-friendly version that gave the apartheid regime an effective veto over any ceasefire, should have been ruled out by the government’s own attempted amendment, leading to a straight fight between the SNP and Tory versions. But Hoyle – allegedly under threat by Labour whips of removal under a Labour government – allowed Labour’s amendment to stand. It passed without a formal vote after Tory and SNP MPs stormed out in protest amid chants calling for the return of Hoyle’s predecessor John Bercow. SNP Westminster leader Stephen Flynn said last night he would ‘take significant convincing’ to believe it was tolerable for Hoyle to remain in the role.
The Speaker position is held during a parliament until death or resignation, but a large proportion of the Commons signing the motion would be likely to put immense pressure on Hoyle to step down. His position already looks untenable after he allowed Keir Starmer to hijack a vote on a situation in which some 34,000 Palestinian civilians have been murdered and hundreds more are being killed each day.
Update: in the few minutes since this article was published, the number of MPs has risen to 57.
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Commons chaos as SNP, Tories walk out over Hoyle’s help for Starmer over Gaza
Hoyle selected Labour’s weak Gaza amendment for debate , against Commons protocol
MPs swarm.out of the Commons chamber
Tonight’s Commons vote on the SNP’s call for a ceasefire in Gaza has collapsed into chaos, with both the SNP and the Tories walking out of the Commons chamber in protest at Speaker Lindsay Hoyle’s decision to allow Labour’s amendment to go onto the agenda.
Parliamentary protocol dictated that the Tories’ amendment should have ruled out Labour’s weadel-worded attempt to dress up a motion calling for a pause when it suits Israel as an amendment to the SNP’s clear condemnation of Israel’s genocide.
But Hoyle selected Labour’s amendment, allegedly after threats from Starmer and his team that they would try to remove him as Speaker if he didn’t accede. The announcement led to chants from some MPs for the return of John Bercow, the previous Speaker.
The Tories said they would ‘play no further part’ in the vote. SNP Westminster leader Stephen Flynn said he would ‘take significant convincing’ that Hoyle’s position was not now untenable.
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Starmer tries to make SNP Gaza ceasefire motion all about Israel’s feelings
Labour amendments betray Gaza’s murdered and oppressed civilians and uses classic asymmetric language to value Palestinian life less than Israeli
Keir Starmer – after days of posing to try to bring Muslim and other decent voters onside by mouthing ceasefire language – has yet again betrayed the two million people in Gaza suffering violence and starvation and the more than 100,000 people murdered and maimed by Israel.
While the ‘mainstream’ media speculated whether Starmer would order MPs to support the SNP’s motion demanding a ceasefire, which is being debated in Parliament tomorrow, more realistic observers knew it was inevitable that Starmer would do the minimum he hopes will fool voters opposed to Israel’s genocide in Gaza, while protecting the interests of the pro-Israel right.
And so he did: Labour has tabled amendments to the original motion that gut it of its impact and has gone as far as making the motion more about Hamas’s supposed guilt and the feelings of Israel and its supporters. And the amendment uses the classic tactics of politicians and ‘mainstream’ media to present Israeli lives and suffering as more valuable than Palestinian.
In Starmer’s worldview, Palestinians are not being murdered by Israel – their lives are just ‘lost’, as if to a natural disaster and not to a campaign of mechanised mass murder. The sheer number of their deaths is presented as ‘intolerable’, but the loss of Israeli lives to Palestinian resistance is ‘horror’. Israelis have the ‘right to assurance’ against attack, but there is no mention of a Palestinian right not to be murdered by the occupation regime. Israel ‘cannot be expected’ to stop fighting if Hamas does not stop – but there is no acknowledgement that Hamas’s violence takes place against a backdrop of decades of wanton violence and oppression by the occupiers. Israel must be ‘safe and secure’ – but a Palestinian state only merits ‘viable’.
The SNP motion is an exemplar of directness and simplicity and rightly focuses on the many tens of thousands of civilians slaughtered by Israel, as well as on the forced displacement of 1.5 million Palestinians into Rafah, where they remain under constant bombardment and the threat of an all-out ground assault:
Labour’s lickspittle version calls resistance ‘terrorism’ but does not mention the Israeli terror state’s genocide and other war crimes, or the fact that so many are dying in Rafah because they were forced to cram there under bomb and bullet – and clearly hasn’t even been proofread, calling for ‘the UN Security Council to be meet urgently’:
Starmer is trying to mask his support for Israel’s war crimes and hoping that the millions in this country disgusted by that support will be fooled. His disregard for the true plight of Palestinians and his complicity in the war crimes being perpetrated against them by Israel is beyond contemptible.
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Video: Webbe challenges govt over support for Israel already flouting ICJ ruling. Meaningless reply
Leicester East MP continues strong record on Gaza and Palestinians, challenging government to say what it is doing to obey ICJ when Israel is already murdering hundreds more civilians – and government continues abject collusion
Leicester East MP Claudia Webbe has been one of the few MPs to stand up strongly for Palestinians and to challenge the government over its complicity in Israel’s genocide and other war crimes in Gaza. In Parliament today, during urgent questions, she asked the Tories what they are doing to protect Palestinians when Israel is already killing hundreds of Palestinians a day and intensifying its genocidal incitement despite the International Court of Justice’s (ICJ) explicit order to take every measure to prevent them being killed.
The answer was utter, meaningless platitudes:
In fact, the UK continues to aid and abet Israel in its wanton slaughter of innocent Palestinians and to impede the arrival of desperately needed food, fuel and medical supplies – while attempting to accelerate then death rate from hunger and disease still further by smearing the UN relief agency UNRWA. The UK, like the US, has cut off its funding to the vital relief organisation on which millions of desperate Palestinians are relying, despite Israel’s long record of blatant and already-discredited lies to excuse its actions – and the prospect of a change of government sometime this year promises more of the same, as so-called ‘Labour leader’ Keir Starmer is just Pavlovian in his support for the apartheid colonisers.
Few MPs bothered even to turn up to the ‘urgent question’ session.
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