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The waiting game

The BMA must reconnect with grassroots members

Dr Kailash Chand

Dr Kailash Chand

The BMA meets in Brighton this week for its annual representatives meeting (ARM), amid growing concern about representation of its grassroots members. 

For over 175 years, the BMA has represented doctors and promoted good healthcare for all. It was founded in 1832 by Sir Charles Hastings, a doctor in Worcester, as the Provincial and Medical Surgical Association. Hastings wanted a ‘friendly and scientific’ forum where doctors could advance and exchange medical knowledge. In 1855, that organisation became the BMA, and its weekly medical publication became the British Medical Journal. An early leading role for the BMA was in the Medical Act of 1858, which created the General Medical Council and the Medical Register.

In 1974, the BMA was recognised for the first time as a trade union and campaigned vigorously for improvements in junior doctors’ pay and conditions.

As a recognised trade union for doctors in the UK, no one better understands the day-to-day challenges facing the healthcare system and the working lives and demands doctors face. Over half of practising UK doctors are members; individual members receive employment advice and protection in the workplace, while the BMA also ensure the collective interests of all doctors are defended and promoted. 

A significant section of the membership of the BMA is either disengaged or feels disenchanted

Although the BMA agreed in principle with the establishment of the NHS, it objected to the administration methods and the lack of consultation and negotiation with doctors regarding the scheme and the effects that the NHS would have on doctors’ lives. Since the inception of the NHS, the BMA has been formally recognised for collective bargaining purposes within national negotiating machinery and by individual employers at local level. This means the BMA is not just the voice of the profession but has responsibility for negotiating pay and other conditions of service at both a national and local level.

The stated mission of the BMA is: ‘We look after doctors so they can look after you.’

In the past decade, grassroots doctors have been angry about staff shortages, underfunding, service cuts, privatisation of the health service, unresourced plans for a seven day NHS and a host of other issues, including the implications of Brexit on the NHS. General practice is under incredible strain with many GP practices struggling to cope with rising patient demand in a climate of stagnating budgets and staff shortages. The Government is on a warpath with profession. It has vilified our junior doctors, just as it has vilified GPs, senior hospital doctors and every hard-pressed member of the NHS staff.

I have been part of the BMA for the past quarter of a century. The perception that the BMA is serving its members poorly is increasing. The handling of junior doctors’ dispute, opposition to Lansley’s reforms and the bullying of the profession by health secretary Jeremy Hunt have added to the frustration of doctors. The crisis in general practice is at a breaking point.

The BMA has not done enough to combat institutional racism and it represents doctors from ethnic minorities poorly. There is growing frustration with the lack of wholehearted support for whistleblowing, and effective representation for doctors who face disciplinary issues. 

A significant section of the membership of the BMA is either disengaged or feels disenchanted with the direction of travel. Members want deeds, not just words. A barometer for this is in the recent BMA election; the turnout at council elections has been steadily dropping for the past 20 years, and in electing the largest ever Council with such a low turnout this gives critics more ammunition about the lack of democratic representation across the membership. The electoral apathy is of great concern and seems to reflect the disconnection that many doctors feel with their own trade union.

However, this ARM with a new expanded council and new reforming chair has the golden opportunity to bring back the glory days of the BMA, to unite the profession and reconnect it with its disillusioned membership. The trade union credentials of the BMA need to be re-established. There’s much in the phrase ‘united we bargain, divided we beg’. 

Dr Kailash Chand is a retired GP in Tameside  

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Readers' comments (8)

  • Left this renewal after 14+ year of sub-inflation rate increases in funding I have decided there are better things to do with approx £500 a year.They have not represented primary care very well for over a decade.After what they didnt do for the Juniors decided to vote with my wallet.

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  • Vinci Ho

    (1) Fact , we are medically trained by default . Things we learnt in medicak schools are largely based on medicak science and its evidences. Politics is a totally different kettle of fish .
    (2) Political wisdom and sensitivity are , at best requiring visions and tactics , at worst requiring ruthlessness and deception. It is difficult to know those representing doctors are really equipped to get their hands ‘dirty’ time to time.
    (3) NHS is a tax-payers’ money funded socialist health system , fundamentally a left-wing ideology. But there must be a ceiling where beyond which will become unaffordable, especially in a country of western democracy. Democracy is currently suffering from its previous successes . The rise of the ‘illiberal democracy’ in various parts of the world demonstrates how easily voters and taxpayers can be ‘brainwashed’ to support even something unjust and immoral . NHS is always a theme park for politicians to exercise their political games for their agendas . It is despicable and shameless that people are still talking about using ‘Brexit dividend’ today for this new funding NHS desperately needs(of course , you will disagree if you fundamentally want the health services to be privatised ).

    Yes , BMA is an establishment after all these years . But it is still about its telos , purpose . It is this purpose which reflects the conflicting notions of virtues and BMA should decide which are the ones it wants to honour and reward . Last thing we want is a toy being exploited and used by politicians ........

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  • After more than a decade of 'not being in touch' with grassroots and persistent resilience to changing with times, BMA should dissolve and vaporize - it won't improve until you sack the whole Board and the leaders at the local level who are stale and musty.

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  • Take General Practice. Item of service payments have fallen 50% per item in 13 years. [ Decreasing profits, increasing workloads]
    The measure of the BMA is reflected in the collapse of Practices. NHSE admits that over 2000+ practices need resilience funding!! [ under the watch of our Union]
    When any doctor sees 40+ patients a day and needs resilience bail outs, it is a sad and awful reflection of the doctor's Union and the poor pay and conditions.
    The BMA were asked to come up with resignation a couple of years.
    They chose not to, but put up with more Hunt's penance.
    Correct Kailash, if you do not look after doctors, they won't be there to look after you.

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  • AlanAlmond

    The BMA is not functioning as a union. It doesn’t know what it’s there for. It thinks perhaps it’s an educational body, or a campaigner for the preservation of the NHS. Occasionally it behaves like it has some kind of role in promoting Drs pay and working conditions but it does this half heartedly, and rarely follows anything through. It behaves like it has no hope of ever succeeding in anything, like it’s lost before it’s even started. The BMA bears significant responsibility for the mess the whole profession is currently in. It exists to protect us and yet it has spectacularly failed over many years. I feel almost as angry with the BMA as I do the government, indeed all the institutions involved in the regulation and guidance of medical practice in the U.K. , the RCGP and GMC too.
    They are all guilty and have all failed. What we have now is a product of all their work and it’s a steaming pile of shite.

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  • Macaque

    You can mock me for the audacity;

    If I ran BMA I would make a list of injustices happening to the doctors and publish them in the website so it is clear to the press and the government.

    examples of injustices:
    1. 28 doctors have killed them selves under GMC investigation.
    2. GMC is funded by the doctors whose priority is protecting the public. In that case the GMC should be funded by the public.
    3. Workload for some doctors are dangerous and this either should be stopped or compensated with higher pay.
    4. Huge brain drain of UK doctors due to terrible working conditions in the NHS
    5 etc.

    Members feedback to this system, and when there are emerging themes they are added to this list, just like the BBC rogue traders investigations!

    Then I would get the BMA top brass to brainstorm on how to address these injustices. And, I will take action after the members vote on the proposed actions.

    I will not looking for decorations like OBEs and Knighthoods in the hope of gaining confidence of the grass roots.


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  • @Macaque -Well said but please add: 'I will not be looking......'to see my face on TV or hear my lovely voice on the local radio' (as we have seen some BMA dudes who just can't get enough publicity and that feeling of being someone - probably need to see the Psychiatrist for untreatable narcissistic personality disorder !!

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  • Older GP's are just putting up with things, younger ones are leaving, locuming or looking for other work. No one wants to fight i.e. renegotiate contract to be paid for activity and freedom to close lists as needed which would actually save profession. Government wont do anything unless serious threat for us to all leave NHS and go private

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