27 June 2006Sarah Boseley
Doctors yesterday accused their leadership of failing patients, the profession and the country by putting up an inadequate fight against what they consider to be the government's destabilising NHS reforms. In a surprise vote, the annual representative meeting of the British Medical Association in Belfast passed a motion condemning the leadership's tactics and calling for a "policy of active opposition and proper scrutiny".
There was frustration and anger from doctors at the fast pace of change and what they see as creeping privatisation of the NHS, notably through the establishment of independent-sector treatment centres and the recent take-over by the American company United Health of a GP practice in Derbyshire.
"The BMA represents all of us here," said Natasha Arnold, a geriatrician from Islington who proposed the motion. "The BMA has been working with government over the entire period of reform, but has not succeeded in influencing how reforms have been implemented, despite the growing concerns in the profession."
Hamish Brown, a consultant surgeon from Birmingham, said: "The unchallenging nature of this opposition to government reforms has led to a great deal of feeling amongst consultants and doctors in general that we are implicitly supporting the reforms. The membership has been telling the BMA what the consequences of government reforms will be for years now - that these reforms will be bad for patients, for the taxpayer and for doctors." But the government, he said, now held the profession in contempt and would not listen to its advice.
James Johnson, chairman of the BMA council, said it was important for the leadership to keep on good enough terms with the government for dialogue to continue. The leadership had, he said, "spent the best part of the last two years telling government what is wrong with their policies".
"If you just go along and say 'the BMA doesn't want your policies and wants you to drop them all', it will be a very short conversation and you will not be asked back." But the leadership was defeated on an electronic vote by 58% to 42%.
Mr Johnson said later that the vote reflected how unhappy doctors were with the NHS reforms, but denied it was a resigning issue. The problem with negotiating with government is that "you can't put every discussion you have on the front page of newspapers", he said. But he conceded: "It is clear that the membership want us to be more robust and be seen to be more robust in the future."
Although the meeting rejected a call from obstetrician Wendy Savage to affiliate with the Keep Our NHS Public campaign, preferring to maintain its independence, there was clear distress from the floor about moves towards private sector involvement.
Mr Johnson, in his address earlier in the day, warned that the NHS was heading towards a supermarket model of care, with "plenty of choice, good quality and low prices", as they have in America. But in the US, this had led to prices being out of control, and more variability in quality of care than anywhere else in the world - "with mistakes common in some fields".
