The BMA is to consider a change of tack in the pensions dispute – with options including a possible boycott of GP commissioning – amid growing division among doctors' leaders after last week's industrial action.
A crunch meeting of BMA Council on Thursday, which will elect a new chair and decide what steps to take next, comes after outgoing chair Dr Hamish Meldrum called on the association at its Annual Representative Meeting in Bournemouth to ‘lower the temperature' and try and seek a resolution with the Government.
Just a quarter of GP practices in England and around 60% of those in Scotland took part in last week's day of action, considerably less than the 79% of GPs who voted in the BMA's ballot who backed action.
BMA Council members admitted that the turnout was less than hoped, with some arguing any future action must be targeted directly at the Government rather than inconveniencing patients.
Others told Pulse they would be arguing for a boycott of commissioning work or would consider a ‘bank holiday-style' strike, although both would be controversial.
BMA Council will discuss its response to the first day of action at Thursday's meeting, although Pulse understands a decision on further action may be postponed until a later date.
Dr Kailash Chand, a retired GP who will rejoin BMA Council this week, said he advocated action targeted at the NHS reforms, and would push for a boycott of the commissioning process.
He said: ‘It is the only way forward in my view. The day of action should not again be on the agenda.'
Dr Mark Porter, a consultant anaesthetist at University Hospitals Coventry and Warwickshire NHS Trust in Coventry, and a BMA Council member standing for chair, said there would be no ‘knee-jerk decision' to undertake a further day of industrial action, but a ‘bank holiday-style' strike was one possible option.
He said: ‘If we decide to do something like that, it is likely it will be more noticeable. But genuinely no behind-the-scenes decisions have been taken on that.'
Dr George Rae, a GP in Newcastle-upon-Tyne, and another BMA Council member running for chair, conceded the turnout during the first day of industrial action was ‘disappointing', and suggested any future action would have to ‘hit home at the Government and not at patients'.
‘We have to look at how we move it forward,' he said. ‘If we are going to do anything, the one thing we have to have is public opinion on our side.
‘If we want to get the public on board, the one thing we have got to do is not inconvenience them. We admitted that is what would happen [last] Thursday.'
Dr Dean Marshall, BMA Council member and chair of GPC Scotland, said: ‘From a Scottish perspective, there will be a push to have further days of action and we'll have to see how that feeds into the wider BMA.'
But outgoing BMA chair Dr Hamish Meldrum called for a period of reflection, and said doctors should not ‘rush to repeat or escalate' last week's day of action.
Speaking at the BMA's annual representative meeting yesterday, he warned: ‘In the long term it's in nobody's interests that this carries on any longer than it has to. I just really want not to raise the temperature, but to try and lower it. With a lower temperature you're more likely to get a solution.'
Health secretary Andrew Lansley said it would be 'even more peverse' if doctors opted to pursue further action that involved withdrawing their co-operation from clinical commissioning.
Speaking at last week's NHS Confederation conference in Manchester, Mr Lansley told Pulse: ‘Not engaging in clinical commissioning runs the risk of damaging services for patients for a long time to come.'