FAIR’S FAIR

It is New Year’s Eve and you are the most senior doctor on duty. You are hugely under-staffed, owing to sickness. During the night, you have three cardiac arrests and five MET calls. You phone eight people to tell them their relative has died. And you are still a junior doctor.

Medicine today can feel very unfair – for that Sussex registrar, for patients on waiting lists, for an overstretched, underpaid workforce.

Amid shocking inequalities and scant resources, talk of fairness in medicine might seem pie in the sky.

But it’s precisely at times such as these that values should be discussed and defended. That’s the belief of former BMA president Raanan Gillon and current council chair Phil Banfield – and they want to start a conversation about how to make medicine fairer.

‘For me, fairness sits above all other BMA values,’ says Prof Banfield. ‘It’s central to how we do business, how we behave with each other, how we interact with society, how we practise medicine.

‘It’s important to talk about this now because our health service is being actively dismantled – and we need to be crystal clear about what we stand for if we’re going to try to preserve all that’s good about the NHS.’

Their timing is not arbitrary. The WMA (World Medical Association) recently added ‘fairness’ to its International Code of Medical Ethics, thanks partly to Prof Gillon’s lobbying on behalf of the BMA.

But does fairness as a principle translate into the British context of a failing health service and an increasingly unequal society? Is it even possible to try to uphold it?

Professors Banfield and Gillon suggest that it is – and offer their thoughts as a discussion-starter.