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Will the day of action be the end of the BMA’s pensions protest – or the beginning?

Tomorrow thousands of GPs and other doctors will be downing tools for the first time since 1975.

While the BMA is insistent there will be no effect on patient safety, patients who are unable to see their GP or have to reschedule hospital appointments will most definitely notice. Wherever you stand on the pensions protest, there is no denying that industrial action has grabbed the headlines and moved the pension reforms up the political agenda in a way that months of earnest negotiating never could.

And yet, while thousands will be taking action tomorrow, many GPs - quite likely a majority - will not. Pulse revealed yesterday that just one in four practices have notified their primary care organisation they will be taking action, and while some may be yet to decide or inform managers, in some areas a majority have already ruled out action. For many practices, the day of action will be very much a day of business as normal.

It's far too soon, of course, to declare the BMA's day of action a damp squib. But while tomorrow will be fascinating - Pulse will be providing minute-by-minute coverage and is asking GPs to send in updates from around the country - already a crucial question is looming. Just what does the BMA do next?

We can take it as read that the day of action on its own is unlikely to make the Government budge on its reforms, as health minister Simon Burns made clear when he wrote for us a couple of weeks ago, and if only a minority of GPs take action, the BMA may well chalk up 21 June as a tactical defeat.

But will the BMA decide discretion is the better part of valour and declare that doctors have successfully registered their discontent? Or will it regroup and plan further action? Could there be a summer of stoppages of routine care? Or will it listen to the growing clamour for action directed at the bureaucracy of healthcare, perhaps commissioning, instead?

As yet, there are only questions, no answers, and BMA leaders are sensibly focusing their efforts on tomorrow.

Next week the BMA’s annual representative meeting convenes in Bournemouth, and the pensions action will inevitably dominate. BMA Council will then meet immediately after the ARM to decide on whether to take the campaign forwards. And at that meeting it will also elect a new chair to replace Dr Hamish Meldrum – a decision which will inevitably shape future action.

For now, all eyes are on the day of action tomorrow – the level of support from doctors, and the NHS’s response. But very shortly we should have an idea of whether the day's protests are a token expression of anger - or the start of a more sustained campaign.

Steve Nowottny is acting editor of Pulse. You can follow him on Twitter @stevenowottny, or email him at