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Meldrum earning his spurs

BMA chief shrugs off awkward start and talks tough on polyclinics and regulation

By Steve Nowottny

BMA chief shrugs off awkward start and talks tough on polyclinics and regulation

Dr Hamish Meldrum, newly installed chair of the BMA council, is keen to reassure Pulse readers and the public at large on one very important point.

‘I never used the word greedy,' he says with a sigh.

He is referring, of course, to an interview last month which caused outrage among the circumferentially challenged and sparked a national debate after he reportedly said fat people were ‘greedy' and that pills were not the solution.

Dr Meldrum insists he was misquoted and was warning of ‘the dangers of over-medicalising things like obesity and giving them fancy medical-type labels'.

Nevertheless, for many GPs, feeling increasingly besieged by a remorselessly negative media, the story seems to be symptomatic of a wider problem – anti-doctor spin resulting in damaging headlines and a public backlash.

Stopping that kind of headline and preventing a public backlash is one of the top priorities for Dr Meldrum, a GP in Bridlington in East Yorkshire and now the public face of doctors across the UK.

Shortly after the ‘greedy' headlines, misleading and inaccurate details of a GP workload survey were leaked to the Sunday Times and Daily Mail ahead of publication – something Dr Meldrum describes as ‘quite unacceptable'.

He says: ‘I think I'm satisfied that the authorisation to leak did not come from the highest parts of the Department of Health. But there is obviously an individual or individuals, I suspect somewhere within Government, who feel leaking this sort of erroneous stuff is a good idea.'

While he remains hopeful the culprit can be ‘brought to book', the incident has been part of a difficult start to his working relationship with the new secretary of state Alan Johnson, who took office the same day as Dr Meldrum.

One of Mr Johnson's first acts as health secretary was to launch a wide-ranging review of the NHS – again.

‘I think the initial response was ‘‘Oh God, another review, how's that going to be different?'',' says Dr Meldrum.

‘But I think to be fair we have to reserve judgment and see if actually things are going to be different.'

But Dr Meldrum is less forgiving about suggestions that health minister Lord Ara Darzi, the surgeon who is heading up the review, could extend the polyclinic model – outlined in his recent Healthcare for London review – across the country.

‘I would be concerned for two reasons: one, because we're not at all convinced polyclinics are the right solution for London, and second, we're not convinced that a London solution would be right for the rest of the country.'

Next big battle

It is regulation, rather than polyclinics, however, that Dr Meldrum describes as the BMA's ‘next big battle', with the proposal to move to a civil standard of proof in fitness-to-practise cases massively controversial with its members.

‘We can sit here and discuss until we're blue in the face the difference between the criminal standard and the civil standard,' says Dr Meldrum. ‘What people need to know is what sort of judgments will be used, particularly in cases where their livelihood may be threatened.'

In other areas he is less bullish. An annual representatives meeting motion he was far from comfortable with was one calling for the BMA and GPC to ‘actively oppose' alternative provider medical services.

While he will ‘take note' of the decision, Dr Meldrum says as GPC chair he always backed ‘the possibility' of APMS.

‘If there are areas where there are inefficiencies in service and the present service isn't able to deliver, then it's a wee bit difficult to argue that because of the political stance you've taken you won't find some alternative way of providing that service to patients,' he says.

Dr Meldrum is mindful, though, of his predecessor's fate. In May, Mr James Johnson was forced to quit as head of the BMA after he unilaterally decided to back the chief medical officer over the MTAS affair.

‘To make a statement saying he was supportive was to say the least unwise,' says Dr Meldrum.

And as he settles into the most challenging role of his career, the old-school Scottish family doctor seeks inspiration from a rather unlikely role-model: the pugnacious Dutch manager of Tottenham Hotspur, Martin Jol.

‘These days perhaps surviving might be quite an achievement in itself,' says Dr Meldrum. ‘People do want results and it's a complicated and a difficult world, so I'm not for a moment pretending that I won't have criticism and lots of problems along the way.'

Meldrum on... the civil standard Dr Hamish Meldrum on the civil standard

What people need to know is what sort of judgements will be used, particularly in cases where their livelihood may be threatened

Meldrum on... Lord Darzi's NHS Review Dr Hamish Meldrum on Lord Darzi's NHS Review

I think the initial response was 'Oh God, another review, how's that going to be different?'

Meldrum on... his predecessor Dr Hamish Meldrum on his predecessor

To make a statement saying he was supportive was to say the least unwise

Meldrum on... learning from Martin Jol Dr Hamish Meldrum on learning from Martin Jol

These days perhaps surviving might be quite an achievement in itself

Meldrum's CV

- Elected BMA chair in June 2007
- Former GPC chair (2004-2007)
- GP in Bridlington, East Yorkshire since 1978

Dr Hamish Meldrum: tough talk on polyclinics and regulation Dr Hamish Meldrum: tough talk on polyclinics and regulation

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