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t has been a pleasure meeting man of ou during MDS Road sho s all o er the countr . The second phase of MDS as launched in Manchester on 31st Jul 2010. This Phase pro ides indemnit co er to GPs and Dentists. We are grateful to the Chairman of BIDA Dr Bachi Sarker and the Secretar of IMA Dr Anita Sharma for their support to MDS. Indemnit co er is no also a ailable for Consultants.

An inappropriate number of International Medical Graduates continues to be referred to the GMC. The are also the subject of the orst outcomes. The GMC is not making satisfactor progress to rectif this situation. We are planning to take it up again ith the GMC. BAPIO is concerned about the Go ernment suggestion that the GMC should continue its adjudication as ell as its in estigati e functions.

The GMC is mo ing on ith implementation of its re alidation agenda and responsible officers (RO) are likel to be in post across the countr b Januar 2011. BAPIO has e pressed its concerns and suggested that the RO s should not be Medical Directors.

The Go ernment s management of medical man po er continues to be disastrous. On the one hand there is a major shortage of middle grade doctors all o er the countr and on the other hand the Go ernment has imposed a ne immigration cap. We hope iser counsel ill pre ail and the Go ernment ill reconsider medical immigration hich is fair to the NHS as ell as to International Medical Graduates.

The re-launching of our Welsh di ision in Cardiff, and our North East di ision in Ne castle ere a great success. Thanks to Mr. Kesha Singhal and Dr Hasmukh Shah from Cardiff and Dr Sethu Madha ant and Dr Nandu Bhatt from Ne castl

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WALES DIVISION REVITALISED

MESSAGE FROM THE PRESIDENT

In Jul , under the banner of the White Paper Equit and E cellence: Liberating the NHS the coalition go ernment un eiled a programme of dramatic change to the National Health Ser ice. At BAPIO e are discussing if this White Paper opens the door to the comprehensi e pri atisation of healthcare and the end of the NHS as a national ser ice, or the a for ard to free the health ser ice from bureaucrac , put famil doctors in the dri ing seat and hand po er to patients. The consultation ends on 11th October.

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Dr Ramesh Mehta, Dr Hasmukh Patel, Dr Dr Ashish Wagle and Dr Kesha Singhal (LR)

The Second Phase of Medical Defence Shield as launched on 10th Jul 2010 in Manchester. This phase offers the indemnit co er that is popular ith GPs. MDS is a unique ser ice for doctors and dentists. Its comprehensi e package includes ad ice and legal protection, tailored to the requirements of the modern medical professional.

Partner organisations of MDS include BAPIO, Lockton International (Largest independent Insurance Broker), Amicus Legal (Leading Legal e penses Insurance Compan ) and Linder M ers (long established firm of Solicitors). For more information isit .mdsuk.org.

Dr Ramesh Mehta President BAPIO

The deadliest floods in Pakistan's histor ha e left the countr in tatters. The three eek s disaster has affected 20 million people, and has destro ed crops, infrastructure, to ns and illages. Without a doubt this ma also lead to the serious possibilit of epidemics to add to the suffering. BAPIO, at times of disasters, has endea oured to pla its part. Support at this hour of trial for Pakistan ill be er much appreciated. To ensure that support and donations are used effecti el and properl e ha e joined hands ith the All British Pakistani Doctors Forum.

Please send our donations to:

A B P D F ABPPA : B B S : 20-49-76 A N : 737 709 82 Please Mention BAPIO in our message and if possible inform the BAPIO office admin@bapio.co.uk

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BRITISH ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN

September 2010

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NEWS IN BRIEF BAPIO DIWALI CELEBRATIONS

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British Association of Physicians of Indian Origin is a national voluntary organisation which was formed in 1996.

Its aims have been amongst mant to gelp members achive clinical excellence, akkow professional networking and liaise with statutory and other organisations to improve the delivery of helath care.

BAPIO DF E E The Young Doctors Forum of BAPIO are organising the ne t educational e ent "Getting Published: What ou need to kno " in Manchester in earl 2011. This e ent has been organised in Cambridge and London in the past and received

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positive feedback from delegates. If you would like more information about the Manchester event or want to share your ideas and suggestions regarding future events and workshops of the Young Doctors Forum, please email Dr Abrar Hussain, Chair BAPIO YDF at abrar71@yahoo.com.

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BRITISH ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN

B : Many doctors from all over the world have previously come to the UK for training under the Permit Free Training (PFT) arrangement. In March 2006, the Department of Health (DoH) changed their policy which led to thousands of Doctors from non-EU countries having to leave the UK. Subsequent to the mass exodus of non-EU doctors, together with the overhaul of medical training by the MTAS, there is again a shortage of doctors in the UK. This was further compounded in August 2009 with the implementation of the European working time directive which restricted the number of hours junior doctors could work.

Current situation There are two main categories of job available for doctors in the UK, training jobs and service jobs.

Although these jobs look the same on paper, there is a substantial difference in career progression.

Of the many vacancies advertised overseas, most are non-training jobs for service. There are a small number of training positions available throughout the UK for non UK/EU doctors.

It would be correct to state that the demand of the NHS is for doctors to fill service jobs, and not training positions.

There are currently two main routes for non-EU nationals to work in the UK: Tier 2 work permits and Tier 5 work permits.

Tier 2 (Sponsored Skill Workers) is for doctors coming to the UK for service provision and is as such sponsored by individual trusts. On rare occasions they can take up a training post if there is no EU doctor available for the post, and if the deaneries support such an application.

Medical training initiative (MTI) comes under Tier 5 (Temporary Migrant Workers) and this is for overseas doctors who are coming to the UK for up to two years at a time. These posts are recognised for training by various deaneries. There seems to be no indication of numbers involved as the DoH believes that workforce planning is not required in employing these doctors, as these jobs do not offer any permanent career prospects in the UK. To be recognised outside the UK, training must usually be completed in full and result in the CCT (Certificate of Completion of Training) or entry into the specialist register of the GMC. As training to CCT standard in specialities takes anything from 8 to 10 years, it is unlikely that any doctor will achieve this via the MTI route.

Even for doctors recruited under Tier 2, or those already on HSMP/Tier 1 visas issued after Feb a 2008, he i a ca ie a e d e e a i g N a id f d c i ai i g . F he e doctors to successfully obtain a training post is the exception - only when there is no UK/EU applicant available to recruit.

There is, therefore, no current visa category that allows non UK/EU doctors to progress in a career leading to CCT/Specialist Registration.

Scope of MTI The e Medica T ai i g I i ia i e d e i ead j i d c i be ie i g ha he e i lead to a recognised Specialist qualification. The new initiative may be detrimental to the careers of those junior doctors who do not have Specialist accreditation in their home country. Individuals should be made aware that a brief period of training / service, even if this means obtaining membership examinations like MRCP or MRCPCH, may not allow them specialist accreditation, as membership examinations alone without higher specialty training and entry into the Specialist register in the UK are not recognised in India, or many other countries.

While doctors recruited under MTI may gain some skills, it is unlikely to fulfil their career aspirations as this stint does not lead to specialist accreditation either in the UK or in their parent country.

International recruitment According to the code of practice for the international recruitment of health professionals published by the DoH in 2004, there has to be explicit government to government agreement before developing countries are targeted for recruitment of healthcare workers. These rules are also applicable to the agencies recruiting on behalf of the NHS. This agreement only affects the government actively recruiting from countries such as India, but does not prevent individuals from applying for positions of their own accord. The current recruitment drive in India has not been explicitly discussed with the Indian Government, as has been laid down in the code of practice despite widespread advertising and recruitment in India.

All active international recruitment must be with agreement of both governments involved and follow the DoH code of practice.

Q e f m BBC J e UK S B Michael B cha a BBC Ne Radi The W ld A O e D c h age ee ne ec i men d i e in India The dea h f d c ha bee ec g i ed b he De a me f Heal h Rame h Meh a a a ked hel ec i m e j i d c f m I dia The W ld a O e ha lea ed ha i a ached he B i h A cia f Ph icia f I dia O igi BAPIO eeki g i hel ec i e e al h d ed j i d c f m I dia BAPIO ag eed hel he g e me - a l g a he I dia medic e e all ed a a d ge ai i g f be ee h ee a d f ea a he ha he ea limi c e l i lace D Rame h Meh a he P e ide f BAPIO e ed he im a ce f all i g he I dia d c e gh me ge e ai i g i he UK a he ha im l i g hem l g h le i a The De a me f Heal h aid i ha d a e ed aid D Meh a The blem i a he H me Office The De a me f Heal h i e m ch illi g e e d hi i a e i d b he a e a i g ha he bl ck i a he H me Office Ha i g failed ge he cha ge i a l ki g f BAPIO ef ed hel he D H

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BAPIO position BAPIO recognises that these short term jobs under MTI might benefit people ho ha e personal reasons to accept these jobs. Jobs ma be tailored to suit indi idual training requirements, and ma benefit senior doctors ho ould like some focussed training in a particular field. The ob ious ad antage is that indi iduals ha e a job prior to arri ing in the UK. That said, BAPIO has concerns about the mechanisms of mentoring, support and monitoring of trainees ho might arri e in the UK on MTI as there is no statement or polic regarding this that is a ailable for scrutin . MTI also does not figure in the DoH s orkforce planning.

BAPIO understands, and is s mpathetic to, the UK s need to recruit doctors from o erseas but it does not ish to see a generation of non-EU, subconsultant grade doctors in the UK because of the potential fla s in the process. The DoH must recognise the need to be honest and fair in this process and a oid e ploitation of the medical orkforce from the de eloping orld to fill in ser ice gaps in the UK NHS. Once doctors are recruited b the NHS, the should be able to progress solel based on merit. This should be complemented b sensible orkforce planning.

BAPIO P The DoH should discuss the recruitment initiati e ith the Go ernment of India and BAPIO, as mentioned in the code of International recruitment.

Doctors contemplating a mo e to the UK should be able to qualif at Consultant le el based solel on merit, even if this means that these indi iduals cannot take up a permanent position in the UK after obtaining CCT. There is a precedent to this suggestion. In the 1990s in the NHS there as a pro ision for Visiting Training Number (VTN).

The Medical Training Initiati e (MTI) could continue for a small number of senior doctors ho ould like specialit e perience ith the pro ision that: - The terms of isas and job contracts should be clear and transparent.

BAPIO could assist ith this.

- MTI is a misnomer and it should be renamed. E amples: NHS Specialit E perience NHS Medical E perience BAPIO NHS

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BRITISH ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN

September 2010

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The M D S team launched its first ne sletter The Shield in Jul 2010.

An electronic cop ill be distributed to members of MDS on a regular basis and ill feature a case stud dra n from the e perience of the medico-legal ad isers orking ith MDS. Dr Paul Lambden, one of the medico-legal ad isors said, It is not designed to frighten but to gi e pause for a moment s thought to help a oid the prospect of an error hen such a patient turns up in the surger , the A&E department or the hospital consulting room. The aim of The Shield is to help readers decide hat ent rong that can sa e them from a potentiall significant problem in the future. Its thought pro oking contents ith case stud and comments are ritten b e perts in medico-legal issues from the MDS ad isor team.

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NHS Manchester has recently published a book on the role of black and ethnic minority (BME) clinicians in Manchester since the creation of the National Health Service (NHS) in 1948. Professor Rajan Madhok, who is Chairman of BAPIO and the Medical Director of NHS Manchester, had commissioned the book and c e : Thi b k i a ib e he a ge numbers f BME clinicians who have made major contributions to health services, and a unique resource charting, as it does, not only the experiences of doctors but also nurses. The role played by the latter has not always been recognised or celebrated. Although we have become more aware of racial equality issues and things have definitely improved over the last few years, there is a lot more to do still to ensure that the NHS becomes a true meritocracy."

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P Dr Ramesh Mehta P Dr Sat inder Basra C Prof. Rajan Madhok

Lord Nigel Crisp, former Chief Executive of the NHS, ha b i hed a b k e i ed T i g he W d U ide D . . I i a e ce e i d c i g ba hea h issues.

Prof Rajan Madhok, Chair of BAPIO, Lord Crisp with his book, with Dr Ramesh Mehta, President of BAPIO, and Prof J a ha M g e a BAPIO A a C fe e ce i

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Against the Odds by E Jones and S Snow is distributed by

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Carnegie Publishing

Turning the World Upside Down can be ordered from RSM Press/ Hodder Education

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BAPIO Annual General Meeting 2010

J T Dr Chandu Prasannan M Dr Paresh Lathia Dr Chinnaiah Yemula Dr Sam Murnal Dr Kishor Te ar Dr Raj Verma Dr Parag Singhal Dr R K Rao Rebbapragada Dr Jo deep Gro er Dr Raj Kathane Dr Virendra Soni Dr Subodh Da e (Chair Education Forum) Dr Vinita Manjure (Chair Women s Forum) Dr Abrar Hussain (Chair YDF)

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Dr Jo deep Gro er, Dr Saja an Mrs Par ati Raghuram Dr PSR Redd Dr Vinita Manjure Mr Buddhde Pand a MBE Send our feedback and suggestions to office@bapio.co.uk

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The meeting of BAPIO s THINKTANK ill also be held on this da . The ThinkTank is an ad isor forum. Its members are selected for their e pertise and asked to reflect on major polic and de elopment issues, and to ad ise the E ecuti e Committee.

This ear the Grand Ad isor Council ill include senior members of Specialit organisations, of Indian origin, and ill e plore co-operation and joint orking opportunities.

P blished b and circ la ed o members of

BRITISH ASSOCIATION OF PH SICIANS OF INDIAN ORIGIN 178 Ampthill Road, Bedford MK42 9PU United Kingdom Tel: +44 (0)1234 212 879, Fa : +44 (0)1234 480025 Email: admin@bapio.co.uk .bapio.co.uk