Why doctors should vote to remain in the EU on 23 June
BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3302 (Published 14 June 2016) Cite this as: BMJ 2016;353:i3302All rapid responses
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Some are irate, irritated and miffed by BMJ’s view on referendum which is well referenced and not mendacious. The BMJ need not provide any explanation or defence. It is well known, though owned by the BMA, BMJ has been granted editorial freedom, thus it need not canvass the views of BMA members or any doctors before it comments on any issue. After all, the editor and colleagues’ view is not the official BMA-view and if one needs to know the BMA’s view on referendum, then it could easily be found elsewhere. In any event, it is unlikely that any reasonable doctor would entirely rely on BMJ’s view to decide which way to vote and further we all know that neither the editor nor her colleagues are pundits in this arena of politics. Those who think, BMJ’s view is unbalanced and biased, have an ample to opportunity to express their views via rapid responses which some have already utilised without much inhibition--thanks to ‘freedom of expression’, Article 10, ECHR. All including doctors can vote to their heart’s delight on 23rd but there is little justification for berating the editor or BMJ. Surely, does one really expect an editor of a leading journal to remain silent on an issue that could have so many ramifications?
Competing interests: No competing interests
Ms Steven's rapid response calls for an editorial response.
I remain undecided. Both sides are telling porkies.
Competing interests: Bewildered
Can it be explained perhaps how a collective position on the campaign (or any campaign) is arrived at, at the BMJ ? There are only four authors of the article - can so few express an opinion on such a serious issue on behalf of everyone who works at the BMJ? Is the article more of a 'personal opinion' if the membership have not been canvassed?
Could there not have been a poll to gain a view of more readers - 'in or out'?
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Dear Dr Godlee,
I have been a member of the BMA for 34 years. Over that time I have seen various members of the great and good within the BMA give opinions to the media in their capacity as officers of the organisation without reference to the membership.
You have published an article as to why we should vote remain. I think it is outrageous that you should do so without a counter argument. I do not recall my opinion or any of my colleagues' opinions being sought with regard to this. In your ivory tower you may not see the effects of health tourism on the NHS. A few years back one of my colleagues, a professor of infectious diseases, informed me that of the 28 patients on the AIDS ward, 24 were 'illegal'. Many people in poor areas cannot get GP appointments because of the huge influx of immigrants. For those of us living in comfortable suburbs, this is not an issue. For those living in poor areas, where there is already a problem with provision of services, it is a huge problem. This country cannot continue to absorb an annual increase in population equivalent to a city 1 1/2 times the size of Southampton year on year.
More importantly, I wish to live in a self governing democracy. As you are well aware, the European Parliament can not propose or initiate legislation, merely debate legislation passed on by the E.U. Commission. You are also aware that 55% of our laws originate in Brussels, and that the introduction of certain drugs, essential for cancer treatment and trials is severely curtailed by Brussels.
May I remind you of the late Tony Benn's comments on power and the EU:
Asked of anyone in power (including senior officers of the BMA and media editors):
“What power have you got?
Where did you get it from?
In whose interests do you exercise it?
To whom are you accountable?
And how can we get rid of you?”
If you cannot get rid of the people who govern you, you do not live in a democratic system.”
On the EU:
“My view about the European Union has always been not that I am hostile to foreigners, but that I am in favour of democracy ...
I think they're building an empire there, they want us to be a part of their empire and I don't want that.....”
Your article should be not have been published without an opposing article putting the alternative view.
Yours
Mike Wilkinson
Consultant Orthopaedic Surgeon
King's College Hospital, London SE5
Competing interests: No competing interests
Brexit or No Brexit : Bellies or Bins fed by NHS
I do not identify myself as an overseas doctor rather I identify my self as a UK Tax Payer and am compelled to write this response.
The only strong argument in favour of BREXIT is extra load on NHS services. Its a very valid and strong argument that NHS is under pressure due to massive immigration which allows free access to healthcare.
Contrary to this argument, what I have observed is that NHS is suffering in the hands of its own management in following ways.
1: Unrealistic and non-achievable targets are given to doctors and departments and then more managers are employed to achieve those targets. The midwives / nurses are taken out of clinical jobs and are given the roles which sound and look good on paper but are zero benefit to the patients, rather leaving less nurses / midwives on the ward floors.
2: The managers introduce the policies and schemes which may benefit their own CVs and help them to get new job in future rather than benefiting the departments in the long term. There is no loyalty to the trust or to the workforce.
3: In case of vacant posts, internal locums from departments are paid like peanuts but the same posts are filled by locums recruited through locum agencies: feeding the '' Big Bellies of Locum Agencies''. Our NHS is like heaven for these locum agencies and it;s beyond comprehension why someone would waste Tax payers' money by throwing money in the form of external locums down the drain. Sometimes the pay difference for the same job offered to external locum as compared to internal is £30-40 per hour.
4: Huge sum of money is wasted on introducing the I.T devices like iPads/ iPods for Vital signs recording, etc. These flashy gadgets may be good for private/ insurance based health systems but in the NHS, which is run by Tax Payers money, we should prioritise our needs.
Immigration is definitely a contributory factor but it's the mis-management of the NHS which is costing all of us.
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I regard the BMJ of 18th June as an abuse of editorial privilege, and an intrusion into a referendum which is directed at personal and private voting intentions.
There is no point in seeking to counter many of the points made by the editorial staff and other contributors, because my objection is more basic. The debate is essentially that of a political nature. Even if it can be argued that BREXIT would be harmful to the NHS and national health, this is not the only or chief issue involved. Could there not be others of a greater degree of importance to the nation? Please treat your readers as people who are capable of independent thought.
Why does the BMJ refrain from being so interventionist at times of a General Election, when the government which is elected has direct effects on the NHS - as in the last election?
Your cover cartoon on the danger of BREXIT is a disgrace.
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I was shocked to see the article regarding EU in British Medical Journal. I felt it was very cynical and undermining the doctors intellectual level.Yes it is a trade union but unlike other trade unions for underground or for other workers . Recently the other trade unions started supporting the remain campaign for various reasons without any robust evidence. It is unfortunate that the BMA too decided to support the remain campaign without any logical and strong evidence at the last minute. There is no doubt they knew that by the time next BMJ comes on next Friday it would be too late for the responses to be justified. There were 2or 3 news items in the last few weeks by the same free lance journalist writing in favour of remain group. It would have been much better and honest journalism , had they publised independent YES/NO debate in the last few weeks. Instead , they waited until the last minute to support remain campaign scaremongering tactics portraying the DANGER TO LEAVE in the front cover. The article was written by deputy editor leaving to Germany and the other one former European commissioner for public health. Any conflict of interest? secondly -DANGER TO LEAVE!! scaremongering ? any difference between the main political parties and the BMA?
I have witnessed very constructive discussion in the hospital with regard to the benefits and risk of remaining in EU. The doctors are not stupid, they search for evidence , analyses and decide what to do. Unfortunately , the BMA has behaved just like our main political parties. The front page - DANGER TO LEAVE! scaremongering tactics ? The previous cover page within the last few weeks had similar biased front cover!
it would be pointless to mention the reasons to stay or remain. There is not anything new or different from what we see and hear in other media. HOWEVER THE DOCTORS WOULD DECIDE TO STAY OR REMAIN BASED ON WHAT THEY SEE EVERYDAY AND LOGICALLY THINKING ABOUT THE LONG TERM SUSTAINABILITY of patient care and the quality of life of doctors.
It would be interesting to reiterate the contribution by the BRITISH before they joined the EU. Therefore it would not be appropriate to underestimate the strength of BRITAIN if they decide to leave.
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Bravo to the BMJ for acknowledging the arguments are all on one side in the referendum debate. To be a remainer is a no-brainer.
From Stephen Hawking to Barack Obama, from the Bank of England to the International Monetary Fund, to remain in Europe is the logical conclusion of nearly all those with some expert knowledge and credibility. The leave camp's line-up is somewhat less impressive, to say the least.
It’s a pity that the BBC can’t follow the BMJ’s example. Their coverage is surely a case of ‘false balance’ a well recognised pitfall whereby equal weight is given to sensible ideas and opposing crackpot notions, in a bid to seem impartial.
The BBC gives us plenty of informative programmes about evolution and Darwinism without subjecting us to equal amounts of creationism. They enlighten us about the weather and climate change without feeling obliged to give equivalent airtime to climate change deniers. So why do they give a platform to these Europe–deniers who, after all, can already shout their strident messages through the megaphone of the Sun newspaper?
What we need is a few Attenborough style documentaries, impassioned pleas for the survival of the EU, which is now a threatened species.
There is a new anti-German sentiment circulating, reminiscent of the world wars. Let us not forget that the Germans are our brothers, one of the most tolerant and educated peoples on earth. Like us, they are probably fed up with the remote bureaucrats in Brussels, but together we can surely effect improvements.
What would solve our problems? A new threat – possibly a deadly virus, averted by a team of European researchers, led by Great Britain. The threat unites us against a common enemy, and immigrants are seen as our friends again – they are probably part of the research team. Or maybe a new drug, effective against hyperbole and bias, having been trialled on tabloid editors. But with only days to go, it better arrive quickly.
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Does the BMJ editorial team have any sense of irony or any understanding of how ordinary human beings ( from Hull not Hampstead to paraphrase Andy Burnham) think or behave?, Is the stuff they are peddling in this week's BMJ actually a cunning plot to get doctors to vote for Brexit? Doctors are human beings and enjoy being hectored by bien pensant metropolitan elites just as little as the next person (well actually rather less than the next person in my case).
The front cover of this week's BMJ could be from a satirical magazine "DANGER A BREXIT VOTE COULD SERIOUSLY DAMAGE HEALTH". On page 475 Fiona Godlee warns of the evils of nationalism - now resurgent in eastern and central Europe as well as the political unrest in the Ukraine with the clear implication that this will all get much worse if the UK leaves the EU and that we will then be to blame. It does not seem to have occurred to her that forcing nations into a federal Europe and pretending that national identities don't matter to people could be even more counterproductive. Tony Delamothe tells us in "Editor's Choice' that "if the referendum results in Brexit I'll be off too. As a Commonwealth immigrant married to a German, I've vowed to sell up and move to my wife's house in rural Germany" . What can one say?
I'm inclining to Brexit but I see good and bad points on both sides of the argument. I am influenced by a deep distrust of overweening and largely unaccountable bureaucracy that mostly serves the purposes of self-interested elites. Like others posting here I do not expect the BMJ to tell me what to vote but, as they have seen fit to do so, I'd like to provide a little balance for any readers through linking to this.
http://www.civitas.org.uk/publications/the-eurosceptics-handbook/
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Re: Why doctors should vote to remain in the EU on 23 June
Reading the responses to this brave editorial reminds me of scrolling through a 'Remainers' twitter feed, lots of angry 'Brexiters' venting their spleen at a piece that dares to voice a conflicting opinion. It should surely come as no surprise that a forward facing an international body like the BMJ are pro-remain. How could they seriously embrace and endorse an isolationist perpsective.
However the 'leave' camp won anyway, but someone should really tell them as it feels like they do not realise this fact. Their prominent campaigners have all quit and retreated, the country feels like it is in mourning and suddenly no-one dares to actually leave and start the withdrawal process. Simply because there was absolutely no plan offered by vote leave during the campaign.
Yes Britain will survive, and yes we are still geographically part of Europe. Yet it just seems like we have now got to endure a decade or more of uncertainty and economic stagnation to simply get to the level we were at before. As Great Britain turns inward and absolves itself of international co-operation in favour of petty in-fighting and false patriotism, the NHS will continue to grind on. Only it will still be without the mythical £350million extra per week falsely promised by 'vote leave', and with a few more barriers thrown up when trying to recruit more desperately needed new staff.
The BMJ should continue to offer its view on political matters that greatly and significantly effect our health service, it is only a view (a well informed one of course) and we can either agree or disagree with it. But the BMJ abdicating responsibilty by not addressing the referendum at all would be very wrong.
We do not want the BMJ to become another bland and 'balanced' body. It has a duty to stand up for the UK's clinical well-being.
Competing interests: No competing interests