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The BMA Special Representative Meeting, as it happened

By Pulse news desk

Read Pulse's blow-by-blow account of the BMA Special Representative meeting, which saw GPs and doctors from across the country debate the Government's NHS reforms.

Which just about wraps up the first BMA Special Representative Meeting for 19 years. It's good news for Andrew Lansley, who survived a vote of no confidence and the threat of outright opposition to the health bill, and better news for Dr Hamish Meldrum, who has seen off quite a geniune challenge to his policy of 'critical engagement'.

Will the Government see today's meeting as an expression of the profession's concern, or will it see it more as a vote of confidence, albeit grudging confidence? And where now for pathfinders on the frontline of GP commissioning? Please leave your thoughts in the comments below, and thanks for reading.

17.36 It keeps getting better for the health secretary. Pulse political editor Ian Quinn has just filed this: Lansley survives BMA vote of no confidence

17.22 Delegates reject a motion condemning the BMA's policy of 'critical engagement', and also reject the key motion calling for the BMA to oppose the health bill 'in its entirety'. It's close though - the margin was 54% to 43% and 54% to 44%.

Relief for Dr Hamish Meldrum - and no doubt for Andrew Lansley too.

17.00 This vote looks like it's going to the wire. Is Andrew Lansley watching?

16.58 Strong applause for Dr Drage as she warns a vote to reject the bill in its entirety will see an exodus of GPs to the National Association of Primary Care, which she claims is 'sitting pretty' waiting to pick up 'disaffected GPs'.

She warns it could take the BMA 20 years to recover if it votes to reject the bill lock, stock and barrel.

16.56 Standing ovation for Dr Jacky Davis and deafening silence as Londonwide LMCs chief executive Dr Michelle Drage steps up to oppose the motion.

16.54 The key vote at the BMA's Special Representative Meeting WILL be taken by electronic vote, Pulse understands.

16.49 We're fast approaching the business end of the day. The BMA is about to start debating its 'Strategic response to the Health and Social Care Bill'. Rock star reception for self-confessed 'bad fairy' Dr Jacky Davis...

16.30 Foundation trusts are next up on the agenda, with a series of motions attacking Government plans as a recipe for privatisation.

16.06 The Department of Health's full statement on proceedings at the BMA Special Representative Meeting is now available here. Clue: they're not over the moon.

15:53 Motion 121, which calls for the prime duty of Monitor not to be the promotion of competition, but to 'maintain and extend a cooperative healtcare system', is passed.

15:46 Dr Steve Hajioff, head of the BMA's Representative Body, says the SRM is a 'wonderful exercise in democracy'. Watch his thoughts on the meeting here.

15:31 Huge support for a motion demanding that any changes to medical education are backed by evidence. Junior doctor Dr Benjamin Melyneax - resplendent in a checked shirt and borrowed shoes - uses his moment on the platform to say education and training is 'in peril' with plans to abolish deaneries. It is passed unanimously with a round of applause.

15.16 Essex LMCs chief Dr Brian Balmer, looking more and more like a slightly younger Robert de Niro, says the Government is holding GPs hostage over commissioning and he wants the BMA 'at the end of the phone' to negotiate on his behalf, rather than to withdraw from talks.

15:11 The Department of Health have released a statement saying the BMA vote for the health bill to be withdrawn is 'not representative of many of their members'. 'The reality is over 5,000 GP practices, covering two thirds of the country, have already signed up,' he said.

15.07 Motion is passed warning the doctor-patient relationship could be damaged by perceived conflict of interest, but the part of the motion calling on the BAM to oppose proposals to create GP consortia is defeated, despite quite a few hands in favour.

14.56 It's clearly getting late. Dr Hamish Meldrum has just asked representatives to 'please support this bill'. Don't panic... he meant 'motion'. Next up it's conflict of interest, a nest of vipers if ever there was one.

14.54 Dr Kevin O'Kane, chair of the BMA's London branch, tells representatives the Government has shown it will not listen to those who want to amend rather than kill off the bill, quoting the dismissive Downing Street response to the motion passed by the Lib Dems on Saturday.

Those representatives who want the BMA to vote for an all-out fight are becoming louder as the day goes on - but will their vocal cords last until this afternoon's crucial vote?

14.46 Back to that electronic voting story. Electronic voting has now been tested by the organisers, but BMA insiders are still refusing to confirm whether it will be used for the key vote later on. Debate on the crucial motion - considering outright opposition to the health bill and even possible industrial action - is scheduled to start at 5pm.

14.40 Motion passed calling on consortia commissioning roles to be open to GPs 'whatever their contractual arrangments'.

14.32 Salaried GP Dr Sarita Symon, from London, claims she and other salaried GPs have been snubbed in the formation of her local consortia.

'If consortia want to think that GPs are on board they must be seen to be inclusive of all GPs,' she said. 'It's not acceptable that entire sections of GPs are being excluded.'

14.25 The scrutiny of the Special Representative Meeting turns to the transparency of GP consortia, with a motion calling for consortia meetings to be held in public.

14.05 Motion 91, supporting the 'principle of GP-led commissioning', is carried with overwhelming majority, despite warnings from Dr Pamela Martin that passing the motion could open the door for privatisation.

13.53 GPC member Dr Helena McKeown - source of that story warning that delegates could be intimidated by a public show of hands on the crucial motion - clearly isn't intimidated herself. She proposes a controversial motion supporting the principle of GP-led commissioning, but opposing the need for further legislation. Mixed reaction from the floor.

13.52 Lunch is over, and tensions are clearly running high at the Special Representative Meeting. Pulse's political editor Ian Quinn has just filed this report from the conference floor: BMA delegates in plea for electronic vote on key motion amid 'intimidation' fears.

13.02 The full transcript of Dr Hamish Meldrum's keynote speech this morning is now up on the site.

13.00 Comment of the morning has to come from Twitter user and anaesthetist @sonyafdaniel, who tells us the 'BMA apears to have manned up and grown a pair'. Beautifully put...

12.52 The Special Representative Meeting has broken for a well-deserved lunch, a little earlier than planned.

While delegates head for the sandwiches, you can catch up on the morning's events on our dedicated Special Representative Meeting page.

12.42 Dr Tony Calland lets slip that the BMA is already seeking talks with ministers over possible amendments to the bill. He says, sarcastically: ‘In the unlikely event that it is not withdrawn, the BMA is seeking a meeting with Simon Burns to discuss amendments to the bill'. Clearly critical engagement is not yet dead.

12.40 Motion calling for complete transparency in financial dealings between the NHS and external consultants - including individual GPs - is backed with much gusto. Dr Hamish Meldrum calls for an 'era of full and open transparency'. Sorry Mr Fielden.

12.39 Sense of humour failure from BMA Consultant's Committee chair Dr Jonathan Fielden who, when arguing for confidentiality in dealings with private firms - such as those he admits he has been involved in, is asked from the floor: 'How much do you earn?' Answers on an FOI please...

12.32 Pulse's political editor Ian Quinn has filed the following story from the conference floor: BMA calls for health bill to be withdrawn

12.30 Members of HM press sternly reprimanded for somehow getting in the way of the BMA webcast. Obviously all of you will be reading this instead, so no need to worry...

12.25 Overwhelming vote against price competition. BMA chair Dr Hamish Meldrum says the policy may have been wounded by the Government's own amendments to the bill but adds 'I'm not sure its had a stake through its heart'.

Professor Van Helsing, aka Dr George Rae, proposing a motion calling for all price competition plans to end up as a pile of dust, warns of a 'price war' against the 'huge resources of the private sector' if the Government does not go further in its U-turn.

12.18 Dr Paul Roblin, a GP in the Thames Valley, risks his own health by calling for moves which will allow price to come into the equation, not just quality. Deafening silence...

12.05 Just one brave representative votes against a motion committing the BMA to lobby against the Government's any willing provider policy, with AWP seemingly even more unpopular in the room than Andrew Lansley.

The motion calls for the NHS to be the 'prefered provider', echoing the call from the Liberal Democrats' spring conference at the weekend.

Next up is price competition - equally popular with doctors of course...

11.52 GPC deputy chair Dr Richard Vautrey predicts the reforms will leave a damning epitaph for the coalition, in a motion attacking the Government for taking on such huge changes in a time of financial crisis.

He says the phrase 'it's the economy stupid' will be written on the coalition's tombstone.

11.45 And the meeting has passes the motion calling for the health secretary to withdraw the Health and Social Care Bill, and to 'call a halt to the proposed top down reorganisation of the NHS'.

11.42 Dr Ian Banks calls on representatives to give the Government a 'Glasgow Kiss' and a 'Liverpool Handshake' by rejecting the health bill outright. Delegates vote to urge the Government to withdraw the bill...big one.

11.30 Delegates are currently debating the 'pace and scale of proposed reforms', with Dr Jonathan Fielden, chair of the BMA's Central Consultants Specialists Committee, speaking.

10.57 The rest of the meeting gets underway with a typically impassioned speech from GPC negotiator and north London GP Dr Chaand Nagpaul. To see how the plan for the rest of the day, check out the BMA agenda here.

10.53 Dr Meldrum's speech concludes with a supportive, if not overwhelming, standing ovation. Has he done enough to win around the naysayers?

10.51 After the rabble-rousing, the realism. Dr Meldrum strikes a much more considered tone towards the end of his speech. 'There are huge dangers in putting all your negotiating eggs in one basket, however strongly you feel'.

10.43 Standing ovation for Dr Meldrum as he says to cheers: 'I do not support this bill. The profession does not support this bill. The BMA does not support this bill.'

10.41 Dr Meldrum is defending the BMA leadership's stance on the NHS reforms to date, calling Government claims of BMA support 'mischevious'.

'It's a funny kind of support that produces highly critical responses to the white paper consultations, setting out 77 pages of detailed concerns and risks,' he says.

10.37 BMA chair Dr Hamish Meldrum has begun his keynote speech. 'This is your opportunity to scrutinise the proposals, consider their impact and ultimately to decide how best to influence the direction of health policy in England,' he says.

10.34 Pulse reporter Gareth Iacobucci is on the conference floor, and reports that there's a smell of revolt in the air.

'The opulent surroundings of the grand auditorium make a strange juxtaposition to the hordes of protesters camped outside the venue,' he writes. 'Chants of 'Kill The Bill' ring through the air as hundreds of BMA members file into the hall. The stakes couldn't be higher today.'

10.30 The Special Representative Meeting is officially underway, and begins with SRM chair Dr Steve Hajioff asking delegates to respect a moment's silence.

09:40 BMA chair Dr Hamish Meldrum says it was the BMA leadership's idea to have an SRM meeting in an interview on the BBC website: 'We are always listening, and this is another way of ratcheting up our concerns about the Government's proposals.'

09:10 Health secretary Andrew Lansley looked most uncomfortable this morning when he was asked on BBC Breakfast whether he was planning any changes to the health bill in response to what happens at the SRM.

09:00 Welcome to this live blog from the SRM meeting in London, we will be keeping you up-to-date with all the developments from the concert floor.

Click here for all our coverage from the meeting SRM In pictures

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