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Would the one true voice of the BMA please speak up

Earlier this year, LMCs voted that the Health and Social Care Bill was the 'greatest threat to the NHS since its inception', but rejected a call for non-cooperation with the reforms and a ballot of all GPs in England asking whether they are happy to be in GP commissioning consortia.

At the following BMA annual conference, Dr Hamish Meldrum, did some backpatting on the amendments achieved for the health bill only for conference delegates to then pass a motion to scrap the health bill but to then reject a motion to oppose the bill in its entirety. Are we keeping up at the back?

Last week, Pulse reported BMA London had passed a vote of censure for how BMA chair Dr Hamish Meldrum had ‘failed' to campaign for the withdrawl of the bill.

Then yesterday we hear the BMA council had passed a vote of confidence in Dr Meldrum fully endorsing his handling of the health bill.

The BMA has got itself into a sticky mess on the health bill reforms for three reasons.

First it is tasked with representing all doctors- GPs and consultants - and if ever there was an issue to prompt a broad spectrum of views among doctors, it is the NHS reforms. The BMA not only claims to represent all doctors but on all issues, from ethics to pensions. Ah yes, pensions. This brings me on to the second reason. You don't have to be a rocket scientist to work out where the leverage on pensions might come from – concessions on the health bill? Say more commissioning functions being added to the GMS contract or GPs having greater ownership of local health outcomes?

The BMA is a negotiating organisation. It's stance on the bill has to be mindful of what else is on the horizon – pensions, out of hours, new GMS contract - and what it is prepared to give and take on.

Finally, the BMA has failed to set the agenda. It claims it wants to ‘save the NHS' but not defined how other than warding off the health bill it can do this.  Doctors are intensely loyal to the NHS – but  they know full well  the care their patients often receive is not what it should be.

In the last couple of years we've seen the Mid Staffs inquiry, £8 million wasted on the Independent Sector Treatment Centre contract, polyclinics opening only to become white elephants – events that GPs have to witness  happening to their NHS under their noses every day.

The BMA needs to move away from ‘save' the NHS, to ‘change' the NHS and come up with a 25 year plan that all doctors can sign up to.

Until now,  I've only been hearing about what the BMA doesn't want.

 The RCGP on the other hand, while  perceived as more opposed to the health bill, has called for a ‘major' profession-led NHS review.

BMA, I suggest you do the same.