A ‘Tory front’? Hardly… Remedy UK speaks up

When Matt Jameson Evans heard that doctors last week were calling Remedy UK, the self-proclaimed ‘voice for grassroots doctors’  which he helped found five years ago, a ‘Tory front’, he was fairly amazed.

‘It was amusing,’ he says. ‘There have never been – well, my guess – a single Tory vote among the Remedy committee. A link to any party would have been insane. We were formed at a time of great anger, and it’s true that during 2007, when Remedy UK was most active, we had good relationships with the teams of [libdem] Norman Lamb MP and [conservative] Andrew Lansley (now Secretary of State for Health). But given that we were trying to fight the changes being made by Labour, that’s not surprising.’ Yet, Matt, who left practising medicine when he had made registrar – but before becoming a consultant in his chosen specialty of orthopaedics, admits: ‘I can see why there was so much fury.’ A lot of anger was expressed via Twitter, with many medics furious that Remedy UK, which claims to represent 9,000 mainly junior and middle-grade doctors, had not supported the BMA strike (called for June 21).

Worse, a Remedy UK spokesperson was quoted in The Daily Telegraph saying: ‘Going on strike will not just be ineffective, it will be positively harmful. Striking over changes to our pay would undermine everything that it means to be a professional.  It would demean us in the eyes of the public and, at a time of recession and general economic uncertainty, it would portray us as avaricious and greedy.’

‘I can see why people have been upset,’ says Matt. ‘But as an organisation, we  never chose the easy path. We have often said out loud the things others have thought. To have that opportunity has been our good fortune, but of course, not everyone will agree.’

To complicate matters, Remedy UK is officially no more, having formally closed down on May 15. This, too, has exasperated medics who feel they are still fighting, albeit via the BMA.

Yet, every organisation needs to grow, and the initial four doctors who set up Remedy UK at the end of 2006, are all deeper into their careers (the others – Matthew Shaw, Richard Marks, Chris McCullough – have stayed in delivering medicine; Matt is now Director of online healthcare firm HealthUnlocked). When they looked to pass the baton, there was no one willing to take it up.

A research student when the organisation began, Matt was inspired to action by the proposed changes to medical training, under the Modernising Medical Careers (MMC) programme and its implementation through the Medical Training Application Service (MTAS).

‘Most changes to professional training happen slowly – tweaks to the curriculum. But this was huge; it was a clear misjudgement. The great and the good had decided medical training was inefficient and mired in the Old Boy Network and careers were determined by connections not capabilities.

‘But in the experience of juniors, this was already no longer true. The middle-class stereotype had started to change quite naturally.’

The MMC shortened training so newly qualified doctors found them competing for far fewer jobs – 8,000 were thought to have been left with no job to go to, despite university bills of up to £40,000. Moreover, computerised applications were shambolic, with points awarded almost haphazardly, leading to experience and qualifications being ignored.  Some highly qualified junior doctors were not offered a single interview. Others were offered interviews for which they did not apply. Some had to reapply for their own jobs.

But the young doctors were also dismayed by the response of the official doctors’ trade union, the BMA, and professional associations (Royal Colleges of Medicine) which they felt were ineffective, and had given up the fight.

‘There was a sudden realisation that a whole generation was at risk.  Fifty per cent of doctors going through training were cut out of career prospects.’

Matt and his friends wanted to unite dissenters. And they had a stroke of luck. ‘The Royal College of Surgeons emailed everyone affected by MMC. But they didn’t do a blind CC so I had the email addresses of all the people affected by it – in their thousands.

‘We put out a survey and found an absolute consensus of opinion, which was published in the Guardian. We chose our name Remedy UK, and then built an email list of 13,000.’

They were also the Facebook generation with social media helping the network to spread.

Matt’s research supervisor was sympathetic and his work was not consuming. ‘If I had been doing a surgical rotation then, I simply couldn’t have fitted it in,’ he admits.

Weekly meetings at his flat of 30-40 key volunteers followed and they learnt how to build case studies and pre-wrap stories for the press who were largely sympathetic.

In March 2007, Remedy UK organised the largest public protest by doctors in British history. An estimated 12,000 junior doctors marched from the headquarters of the Royal College of Physicians to the offices of the Royal College of Surgeons of England in London. A parallel protest was organised on the same day in Glasgow.

The team organised an Early Day Motion explicitly backing Remedy UK’s concerns about MMC and MTAS, which was signed by 127 Members of Parliament.

And then, in April, a mass lobby of Parliament aimed at pressuring individual MPs and to raise awareness of the issues surrounding recent reforms to medical training in the UK. I wrote about the wider battle between Westminster and medics at the time here.

The final roll of the dice was a judicial review in May 2007 challenging the legality of MTAS and MMC in court. They lost the case but the Judge described the reforms as “disastrous” and suggested that individual doctor’s cases should be open to scrutiny by employment tribunals.

In the next few years, other issues came up and were fought: the introduction of the European Working Time Directive, which clearly shortened the amount of time doctors could train in any specialty.  The creation of a junior (and therefore cheaper) consultant grade was deplored.

‘In a way,’ says Matt, ‘you can see where the problems of the past five years have been heading. When you hear doctors’ anger now about pensions, what you are really seeing is the culmination of years of frustration at the way the profession has been attacked.

‘This is the summation of seven years of angst, about aspirations and motivation, not pensions.    Doctors have to have that passion to offer great care long term – it is awful when you see it being eroded away.’

Matt believes we’ve not seen the end of the result of MMC either. ‘It’ll be a big story over the next three years. Doctors who were unlucky to get caught in MMC, then qualified in a mushroom of over-supply of doctors when there is an under supply of jobs. I know of several talented newly qualified doctors who are already facing unemployment. Where will they go?’

Remedy UK may have lost the war but they won some impressive battles. They forced a review of MMC and the selection process was amended to be fairer.

It also became a part of the establishment in the end, being called in to offer policy advice and the recent Future Forum (organised as a review of the Health and Social Care Bill, before that was pushed through government.)

In this case, they decided to target those areas involving training rather than attacking the Bill wholesale.  Matt doesn’t sound sure this was the right move now. ‘As it went on we realised the flaws outweighed the positive points of patient-centred care.’

Now, Remedy UK is making news again speaking out against a strike which has been hugely popular with grassroots doctors.  ‘But it is strategically the wrong move,’ says Matt. ‘To talk about pensions, when money is not the main driver for doctors, is a mistake.’

The response of those doctors has now been seen all over Twitter with many disillusioned by an organisation they felt they owned. Hence the cries of ‘Tory front’.

Matt is unrepentant. ‘Our role is to say things that aren’t being said. This is an own goal for the medical profession.’

Sadly, neither he nor anyone else from Remedy UK will be commenting again. ‘We had to close,’ he explains. ‘I don’t think we lost our function but it wasn’t sustainable without new members to take over. Perhaps our crime was not to try harder to recruit more people – it would have been lovely to have passed it on.’

But he adds: ‘What Remedy is will be taken on in another shape or form. There will be a need for a different voice to the existing institutions. It just needs the right sort of spark.’

Where will they come from? He nods to the NHS restructuring. ‘How will this major reorganisation work?  How will services be delivered? What will it mean to be a doctor – GPs or anyone involved? Where will training happen, how fragmented will services be? We need unified approach to outcomes – not just patient results, but training too – how can we check how well prepared our young doctors are?’

He is also concerned about medical unemployment going forward – ‘what will the climate around being a doctor be? This has been demoralising for the profession.’

Matt himself left medicine two years ago: ‘I didn’t like the future. I could have gone on – but it probably would have been difficult to get consultant’s job in the South East, and the experience with Remedy had opened my eyes to life outside hospitals.’

His new company HealthUnlocked is ‘like a Facebook in healthcare – where those with different conditions can share information about experiences on our platform, and plug into clinical data. Experts can track patients over time, and create databases among them or through clinicians.’

He also has a baby girl to spend time with by his Chilean art curator wife

And he has hope. ‘Personally, I think there is a huge amount of opportunity developing for doctors to be more creative about practise medicine.  How they structure their practice and their research. There will be huge changes in the next five to 10 years, not all of them bad.’

About the Author

Victoria Lambert has been a journalist for more than 20 years, and specialises in health and medical matters. She writes for the Telegraph, the Times, the Sunday Times, the Guardian, the Mail and the Mail on Sunday. She contributes to Saga, Geographical and First Eleven magazines – where she is the agony aunt.

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