Junior doctors could be struck off over industrial action, warns GMC

Junior doctors have been told by the General Medical Council (GMC) that they should call off their planned five-day strike for later this month and that putting patients at risk of significant harm could lead to them being struck off.

The GMC issued the unusually severe warning on Monday in advice issued to doctors contemplating taking part in the strike, starting on 12 September, and to other doctors who may be affected by the industrial action.

It expressed reservations before previous walkouts by junior doctors this year, but today’s statement is its bluntest yet, prompted by fears that the length of the strike, the relatively short notice given about it to management and the fact that emergency care is included mean that the risk of patients suffering is greater than before.

The GMC does not have the power to prevent doctors from going on strike, but it exercises considerable power as a regulator and its statement contains an implicit threat that doctors who withdraw care could be putting themselves at risk of being sanctioned, including possibly struck off, for unprofessional conduct.

In a statement urging doctors to call off at least the strike planned for September Prof Terence Stephenson, chair of the GMC, said: “We know that doctors will again want to do their utmost to reduce the risk of harm and suffering to patients. However … it is hard to see how this can be avoided this time around.

“We therefore do not believe that the scale of action planned at such short notice can be justified and we are now calling on every doctor in training to pause and consider the implications for patients.”

Junior doctors have already staged six walkouts this year as part of their campaign against the proposed new contract being imposed on them by the government, but Stephenson said the BMA was now planning “a substantial escalation” of the dispute.

From 12 September junior doctors will go on strike for five days in a row, from 8am until 5pm each day, with emergency care as well as elective care affected. Further five-day strikes are planned starting on 5 October, 14 November and 5 December.

In its advice to doctors contemplating strike action the GMC said they must take “reasonable steps” to satisfy themselves about the arrangements being made to protect patients while they are not working.

“Given the scale and repeated nature of what is proposed, we believe that, despite everyone’s best efforts, patients will suffer. In light of this, the right option may be not to take action that results in the withdrawal of services for patients.”

Senior doctors and managers had to be given enough time to put in place alternative arrangements, the GMC said. “Action without warning or with inadequate warning is not acceptable.”

The GMC also said in its advice that, if it became clear in a particular area that patients were at risk because of inadequate medical cover and that if doctors were asked “in good faith” to return to work, the GMC would expect them to do so.

In a statement issued alongside the advice, Niall Dickson, the GMC’s chief executive, said it was being issued to doctors under the authority of the 1983 Medical Act and that doctors could face sanctions if they acted unprofessionally.

He said that doctors had a right to take strike action, but that they also had a duty to make the care of patients their first concern and that “the question each doctor must ask … before taking action is whether what they are proposing to do is likely to cause significant harm to patients under his or her care or who otherwise would have come under his or her care.”

He went on: “The GMC has powers under the [Medical] Act to investigate and apply sanctions to any doctor whose behaviour has fallen consistently or seriously below the standards required. Where we are presented with evidence that a doctor’s actions may have directly led to a patient or patients coming to significant harm, we would be obliged to investigate and if necessary take appropriate action.”

In its press notice setting out the advice, the GMC said that its job was to protect the public, not doctors.

Junior doctors could be struck off over industrial action, warns GMC

Taiwan Industrial Hub Confronts "Relaxed" Land Use Guidelines After Fuel Line Explosions

With the fires out and hundreds of folks getting taken care of for injuries right after deadly gasoline pipeline explosions last week in Taiwan’s significant industrial city, interest has turned to blame. Prosecutors are chasing a petrochemical firm and its propylene supplier for a possible position in the chain of blasts that killed 28 in Kaohsiung on July 31. But the actual villain could be a historical past of permissive development guidelines that have permitted industrial-use gasoline lines and dense housing tracts on the same streets.

That implies the city has allowed gas lines to run below crowded urban residential streets and let developers construct on every attainable parcel just over the buried pipes. After the gas lines that blew up final week were accepted in 1990, the city nonetheless faced stress to increase. Nearby Local factories necessary staff, for one issue. Says a city worker who asked not to be named: “Kaohsiung was an industrial improvement site, and possibly things were a lot more relaxed back then.”

Kaohsiung, Taiwan (Photo credit: Wikipedia)

Kaohsiung, a port city with 2.eight million individuals now, has much more gasoline pipelines near people than the rest of Taiwan, says central government spokesman Sun Lih-chyun. Its only other peer is the two million-individual northern county Taoyuan, where industrial oil lines run beneath urban neighborhoods. Pipelines elsewhere in Taiwan preserve their distance from massive populations. Taiwan has a total 23,000 kilometers of gasoline pipelines and four,322 kilometers of lines for oil, the central government says.

Kaohsiung is aware of now the past shouldn’t lengthen into the long term. Mayor Chen Chu said after the explosions that the ruptured gasoline lines should not be rebuilt in the exact same community of four,602 shell-shocked households. City officials will think about barring any new human-intensive growth near gas lines and may possibly demand that any new pipelines detour close to dense neighborhoods, the worker said.

Awareness of risky land use mixes was already spreading in Taiwan. Tens of 1000′s of activists acquired the government to cease building of a nuclear power plant this 12 months simply because they feared an accident there would chance the lives of north coast towns close by. In 2010 and 2011, a series of fires at a Formosa Plastics Formosa Plastics Group naptha cracker in central Taiwan drew protests from 1000′s of neighbors fearful of more blazes and pollution-borne well being hazards.

Two firms currently being investigated for a attainable part in the fuel pipeline explosions may reroute the lines on their personal, paying an unknown bill to avoid obtaining stuck in a policy dispute, says Liu Chia-jen, petrochemicals analyst with KGI Securities in Taipei. Kaohsiung’s district prosecutor is investigating LCY Chemical Corp., which wants propylene for a neighborhood factory that makes petrochemical products for export to China, and its gasoline supplier China General Terminal and Distribution Corp. LCY Chemical had utilised the exploded lines to get propylene, ten metric tons of which leaked into the air in excess of two hrs ahead of the explosions, the city says. State-run oil business CPC Corp. made the pipelines and may possibly be investigated later on. The prosecutor says its operating complete velocity to discover fault.

Kaohsiung will wait longer for change that would start off disentangling gas pipelines from residential areas. Relocation of petrochemical plants to a specific district, per a single program, would expense the firms and lengthen commutes for employees. A twenty-year mission to phase out hefty industry and foster a cleaner economy primarily based on culture or leisure is moving slowly due to the city’s reliance on factories for jobs and revenues. New urgency now? “In the past, we didn’t know about the security of what was below our feet, and now we will spend attention to both what’s above and under,” says George Hou, a Kaohsiung native and associate media scientific studies professor at the neighborhood I-Shou University.

Taiwan Industrial Hub Confronts "Relaxed" Land Use Guidelines After Fuel Line Explosions

"Chemical-free" sanitization is trending in the industrial and personal sectors

Randy Reed, deputy assistant director of housekeeping at North Carolina State University, North Carolina’s largest campus, often fretted about the effects of chemicals on the 300 housekeepers as they cleaned. While nobody was ever seriously injured, he fielded several reports of rashes, occasional respiratory problems and headaches, possibly caused by exposure to the harsh smells the cleaners omitted.

The Occupational Safety and Health Administration, a government agency, warns of this in its public safety warnings (pdf). Cleaning chemicals, OSHA states, can cause dangerous gases causing headaches, dizziness, wheezing, even lung damage. With this in mind, two years ago, Reed replaced traditional industrial cleaners such as Diversey Glance and Comet Cleaner with Orbio SC 5000 split stream water technology to clean floors, surfaces, even urinals.

This new system uses a salt-based, chemical-free process, where water passes through the system giving it an electrical charge. The solution cleans and sanitizes surfaces leaving it 99% germ free, Reed explains. “On our first trial our hygiene meter monitored the bacteria count on a urinal and found the technology removed as many germs as a regular sanitizer.”

Orbio SC 5000 uses a salt-based process, where water passes through the system giving it an electrical charge. Photo: Courtesy of Orbio

NC State is part of a larger trend in which universities, retailers, sports facilities and large corporations are not just cleaning with greener chemicals, but without chemicals at all.

Companies including Coca-Cola Enterprises in the Netherlands; ISS, one of the world’s largest commercial facilities services providers; and Chapman University, (pdf) one of California’s oldest private universities, have made the switch. Examples include sanitizing facilities with technologies such as steam vapor systems, spray and vac systems using pressurized water to remove and loosen soils along with ozonated and electrolyzed systems using electricity to turn water into a cleaning agent. The use of microfiber cloths and mops, which require only water to remove germs, grime and bacteria also make up the trend.

While industry numbers don’t yet exist, Stephen Ashkin, executive director of The Green Cleaning Network, a non-profit working with corporations to green the cleaning industry, estimates that, based on his client research and surveys, 30% to 50% of corporations and institutions across the US, now clean their facilities with eco-friendly chemical cleaners or cleaners without chemicals at all.

“The professional cleaning industry has changed,” he says. “The newer trend experts are seeing is cleaning without chemicals.” Ashkin believes cleaning products minimizing chemicals will never replace floor finishes, heavy-duty cleaning chemicals or graffiti removers, but this is a “tool in the toolbox for creating a healthy and clean environment while leaving a minimal footprint.”

Defining Chemical-Free Cleaning

The trend is so new that even the description of these products is controversial; while some call them chemical-free, others say eco-friendly. Ashkin rejects the term “chemical-free” cleaning because no cleaning product or device completely avoids chemicals.

“Chemical-free cleaning is a marketing term versus a technical term,” he says. Case in point is companies offering chemical-free cleaning products, such as Tennant, maker of the Orbio systems, which use their own technologies to define “chemical-free.”

OSHA defines green cleaning as products certified by independent organizations as safe to use and less harmful to your health and environment than conventional alternatives such as bleach and ammonia.

Wherever the definition lies, all this means good business for the big players. In April, Tennant posted quarterly results showing growth year-on-year. Other brands including Tursano, maker of the popular Lotus Pro device (similar to the split stream water technology), and the larger company Ecolab also reported positive first-quarter earnings. Makers of chemical free antibacterial microfiber cloths have good customer following as well. Norway-based Norwex, now in multiple markets including Canada, Australia and the US, sells microfiber towels and cloths, microfiber scarf clips for cleaning tablets, glasses and jewellery (instead of toxic sprays and wipes) and dry polyester floor pads for mopping.

But much of this market is in the commercial sector. Based on his client work, Ashkin estimates that residential cleaning remains only around 1-5% of the core eco-friendly and chemical-free cleaning market, probably because the conversion payback is higher for large corporations. Purchasing a chemical-free cleaning device for a commercial space can cost up to $ 5,000, a worthwhile investment, if used daily. A Lotus Pro split stream water technology cleaning device for your home averages $ 150 retail, too much for a parent worried about putting food on the table, Ashkin adds. Commercial facilities also have employees to compare costs, and review and analyze the cleaning products they buy, which the household consumer often lacks.

Homemade Chemical Free Cleaning

Another growing trend is Americans making their own cleaning products, with limited chemicals. Senior account supervisor at MMI Public Relations in North Carolina, Jennifer Fair ditched Clorox and other harsh cleaners for recipes she found on Pinterest such as pairing vinegar with baking soda. The vinegar dish soap concoction gets her shower super clean, she says. Other recipes suggest using baking soda, sprayed with water, to clean ovens.

This interest is valid given the Environmental Working Group, a non-profit group, has found through their Hall of Shame (pdf) study that 438 of 2,000 assessed cleaning products contain at least one chemical that the non-profit group Association of Occupational and Environmental Clinics identifies as an asthmagen.

The worst offenders, the study claims, were those labelled as “green cleaners” such as the Simple Green Concentrated All-Purpose Cleaner (labelled as non-toxic and biodegradable) when one of its ingredients is 2-butoxyethanol, a solvent which can cause red blood cell damage and eye irritation. EWG also cites several studies showing pregnant women are more at risk for birth defects when exposed frequently to cleaning chemicals, especially window cleaner and air deodorizer sprays.

Effectiveness of greener cleaning products

Ashkin doesn’t believe home cleaning product recipes work well. “We have a romanticized view that because we can eat it, it’s good for you,” he says.

And can we say split stream chemical-free technologies clean as well as eco-friendly chemicals? Tennant doesn’t know the answer to this question, and Ashkin says it’s too early to know. However, companies are evaluating the technologies, comparing the impact to chemicals and other devices along with the wattage. He suspects the environmental benefits of chemical-free cleaning devices and technology will outshine chemical cleaners.

“Conventional cleaning requires extracting the raw materials, turning these into ingredients, shipping to a formulator who mixes everything into an effective cleaning product before putting the chemicals into packaging (with their own environmental impacts) and finally shipping to the end user. Through green cleaning those impacts go away.”

Debbi McCullough is an independent writer, editor and owner of Hanging Rock Media based in North Carolina.

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"Chemical-free" sanitization is trending in the industrial and personal sectors