thank you for re-electing me

please bear in mind that there is no point repeating stuff someone else has said (unless you like the sound of your own voice etc etc )

so this is just what I said – rules are you can report what you said, not what someone else said, until the minutes are agreed

On Brunei. 

I have been reading about the origin of the college, and the spirit of ensuring quality, supporting doctors, and raising standards. There was an independence and steadfastness in the mettle of the GPs who built the foundations. It provided a route towards a shared ethics in terms of how we practice. 

I understand is that decisions made in the past belong to another time. Often the people who made  decisions have left their positions. But the impact of those decisions lives on. 

What I am talking about is emphatically not blaming individuals, who I know to be working extremely hard. What I am worried about is systems. Our system. 

I read from a minute C-131A, that the first companion of the college was to be awarded. 

“It has become apparent from these confidential exploratory meetings that personal

recognition of His Majesty the Sultan of Brunei is an important part of any donation.”

Babylon, who have falsely advertised, who have launched an unvalidated app, are allowed to sponsor the conference.

Concerns had been raised about Emma’s Diary, with GPs a conduit to product place it,  that the company profited through selling on mailing lists. But it took an external regulator to make the college act. 

Recently a lobbying organising paid thousands of pounds to host a non evidence based learning resource on the RCGP website. It was only removed after myself and other members happened to see it. There was not enough quality control placed on this once the decision was made to accept the money. 

We have had promotion of non evidence based screening by individuals but who were simultaneously self employed as consultants to the pharmaceutical industry, with the express aim of increasing prescribing by GPs. 

I understand that the College has its charitable objectives. But we need a review of how these are fulfilled. I have heard it said that the purpose of the College is to raise money to fulfil its’ objectives.  This is not the fault of individuals: I am absolutely NOT talking or blaming any individual. This system of ours, has, I think led to decisions like these, profoundly unpopular with many members and a matter, I think, of regret by many. 

two reasons. 

The first. We have slipped into a grey area where decisions are justified on the basis of fundraising.  We need strict, red lines, over which we do not cross. We should be leaders in maintaining the independence of spirit, thrift, and quality, as at the foundation of this place. We do not need more money to do that. We should do better with what we have. we cannot justify unlimited fundraising. This cannot be right. 

The second is purpose. Who is the college for, and why? Is it to fulfil the wishes of external organisations? It is still unclear to me about how things get done. I admire and respect the officers, members and staff who work extremely hard and who I know get up early and leave late in order to do valuable work for us all. Yet it is often unclear to me who makes decisions, and where power is held. Faculty boards tell me they do not seem to get minutes of Trustee Board. Decisions about papers are made without the writers’ input in a process I find intellectually and emotionally difficult because the rules seem to keep changing. 

I ask that we consider a review not of what the charitable objectives are, but how we fulfil them, and what price, in terms of our collective, vocational soul, we are willing to pay. 

2) SPONSORSHIP REVIEW

I said 

• it’s great
• but I wish the paper would go further
• though I know how much hard work Victoria has done on this and i approve it wholeheartedly 
• we should create a blank space on RCGP website for each council member to fill in their COI on whopaysthisdoctor.og and make it obvious if it’s not there
• but it’s not a good enough site, it needs developed to improve functionality, search, annual reminders 
• so we are as of this hour crowdfunding to pay for it
• but we also need to hold GMC feet to fire and campaign for the review of the Medical Act to include statutory DOIs, we want to work with the policy team to do this

3) TRANSGENDER CARE

I spoke to the paper

– of course we need to treat each individual with respect and dignity -should go without saying

• expressed my concern that a new cohort are presenting, esp young women,  and we lack high quality evidence to ensure we are offering evidence based medical interventions : we need to be clear on this; medicine has a long sad history of intervening with good intentions and without evidence, creating long term harm to patients
• sex and gender are different: I do not identify as what society says women should/shouldn’t do, my chromosomes are unalterable, and I reject all the gendered roles society assigns to me, I want everyone to be able to do that
• sex based rights need protection ; think about the female foetuses aborted in some countries due to them being ‘valued’ less – this is not to do with identity but biology