Forensic Medicine Committee

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Chair's speech at ARM 2017

Rachael Pickering speech 16x9

Chair, RB,

Everyone here today is well aware of the challenges facing the medical profession and the health service.

From contract disputes to cuts, external pressures have seen fostered a greater unity among doctors, with the phrase 'We are one profession' a common rallying call.

This is no less true of the vast array of highly dedicated and experienced doctors who make up the forensic medicine workforce.

I am pleased to say that, under proposals set to be endorsed by this conference, this ethos will continue and the remit of our committee will be expanded to include all doctors who work within justice and detention settings.

This will include those who provide care in prisons, young offender institutes, psychiatric hospitals and sexual offence services as well as those reviewing deaths in custody.

By transforming the FMC to the FSEC – the forensic and secure environments committee, we will be able to give a voice to those doctors who have previously had no specific representation within the BMA, as well as continuing to influence improvements to the healthcare of patients these professionals care for.

The battle for achieving equivalence of care between community and custodial settings is one that, regretfully, is still needing to be fought.

I recently had the opportunity to spell out the challenges facing doctors attempting to treat people in prison and other custodial settings, in evidence given to the parliamentary justice committee's inquiry into education and healthcare commissioning.

These include the lack of funding and clinical time along this particular patient population's clinical needs such as mental health, substance abuse and violence.

Despite our continued lobbying, there remain no agreements over the basic standards of care that must be provided within police custody settings, and the resultant risk of below standard care that this entails is obviously unacceptable.

Over the coming weeks and months we will continue to press for parity by writing to police and crime commissioners across England and Wales, recommending that all forensic physicians and HCPs working in these settings hold at least the minimum training recommended by the Faculty of Forensic and Legal Medicine.

This year has also seen our committee at the forefront of ongoing efforts to reform the death certification process.

The BMA has been calling for an improved system to scrutinise the certification of death for many years, but securing these changes to death certification has been as drawn out a process as it is important for patient safety.

While it was heartening to see a Government commitment to introducing the Medical Examiner, system ministers have yet to publish their response to a consultation launched over a year ago.

Despite these setbacks, our committee, along with colleagues in the professional fees and medico-legal committees have continued to work towards formulating a coherent BMA stance on the reforms.

Our focus has been on the proposed medical examiner roles; how these will be funded, and how we can best work with the Government to secure these aims.

I would also like to thank all members of the committee and the secretariat for all of their dedicated and tireless support.

RB, I know that the challenges we face can sometimes appear to be overwhelming, but we have so much already to show for our efforts.

Going forward over the next twelve months as a larger and more representative body than ever before, I am confident that we can continue to show resilience as well as build upon the achievements that we have already secured, in the areas that matter to us and our patients.

RB, I move.