All professional associations are broad churches and the BMA is no exception. The complex equations required in balancing the sometimes competing needs of different crafts can be tough, but are raised to another power in the BMA’s ethic of championing what is in our patients’ interests.
The BMA has often been described as Britain’s most effective trades union. Perhaps so, but to measure the BMA in this single dimension is to miss the point. Rarely do we see echoed in other sectors such overarching concern for the users of the service than among the nation’s doctors, and it is this fact that has made the formulation of effective action over pensions so tricky.
In the months before 21 June, many ideas and suggestions for action were considered in an attempt to force the Government to resume talks over their proposed pensions changes. There was widespread anger and dismay within the profession at this de facto tax on healthcare workers. Passions ran high, but BMA Council judged that a single day of industrial action short of a strike was the appropriate and sufficient next step in the campaign, having already exhausted other possible means of bringing the Government back to the table.
The effectiveness of the action can be gauged by the Government’s concerted media campaign in defence of their assault on a future-proof pensions scheme in rude financial health. What was more surprising to those of us involved in the BMA’s communications strategy was the widespread support on the ground from patients genuinely concerned at the prospect of elderly doctors being forced to work on the front line, making life and death decisions into their late 60s.
Most people understand the risks to patients inherent in putting economic pressure on doctors to perform well beyond their prime, and the day of action afforded the profession an opportunity to begin this dialogue with the public.
The profession emerged strengthened from the day of action, which was seen by all but the most strident commentators as proportionate, reflective and appropriate. The medical profession is naturally moderate and most doctors have sufficient insight to ask themselves what victory looks like.
In the context of 21 June it looks very much like the current situation, and to hold another similar day of action would have gained little and risked much. The BMA leadership recognised this and, like good strategists, changed their point of attack.
Further industrial action has not been ruled out, but rarely is a one-dimensional campaign a successful one and the story is far from over. The BMA, along with the other unions – very few of which are considering further industrial action – is taking part in discussions about the planned changes and is now part of the group reviewing the impact of working longer. Meanwhile, it is planning a step up in campaigning around the planned increase to the normal pension age, which I expect will see it advance the arguments that have already struck a chord with the public.
Of course, there will be a few individuals who regard this change in tactics as a sign of weakness and even a tiny handful who may consider resigning from the BMA in protest. The vast majority of the profession, however, recognise that skilled and authentic leadership requires flexibility, intelligence and tenacity. Inaccurate reports of a BMA capitulation are seen for what they are. My conversations with grassroots doctors underline this attitude and reinforce their support for the BMA in its campaign.
Industrial action has, for the moment, allowed us to show unity and demonstrate our anger at the attack on our pensions. Now it’s time to talk in defence of our profession and the patients we serve.
Dr Mark Sanford-Wood is the chair of Devon LMC and a GP in Barnstaple