The BMA doesn’t care about patients. It wants total power over a broken NHS

Members of the British Medical Association (BMA) on the picket line
Members of the British Medical Association (BMA) on the picket line

The health secretary’s anger with the British Medical Association was incandescent. Not only was the doctors’ body scaremongering, but it was “peddling untruths” and grossly misrepresenting the government’s position, he said. However, this was not Steve Barclay commenting today on the latest industrial action in the NHS but Alan Johnson, who held the post in the last Labour government.

Then again, it could have been Barbara Castle back in 1975, when consultants withdrew all non-emergency services and introduced a work-to-rule that closed entire hospitals and shut casualty departments. Their protest was against new contracts which they said would force them to abandon private practice. Later that same year, junior doctors also took industrial action over pay and conditions.

Or we can go back further to the post-war period to find another Labour health secretary, Aneurin Bevan, locked in a three-year battle with the BMA over the terms for establishing the NHS, settled only when he famously “stuffed their mouths with gold”. The key disagreement was over the continuation of contractor status for doctors and the capitation arrangement whereby GPs are paid per registered patient.

Without the deal, the BMA threatened to boycott the new NHS and kill it at birth. Looking at it now, perhaps it would have been better had they done so. We might have moved to a Continental-style, mixed-state and insurance-funded health service, which would have worked better than ours. The irony is that the BMA, an implacable foe of nationalised health care in 1948, is now the greatest obstacle to reforming it.

The row with Mr Johnson was over the Brown government’s plans to create large health centres, known as polyclinics, following a review by Ara Darzi, an esteemed surgeon and then health minister. This was a good idea and reflected the practice in other, more successful, systems such as Germany’s.

But the BMA fired up a campaign to stop it, launching a petition that attracted the signatures of more than one million people encouraged to believe these polyclinics would sound the death knell for general practice and family doctors (remember those?).

Laurence Buckman, then chairman of the BMA’s general practitioners committee, said: “My message to Gordon Brown is this: ignore at your peril the wishes of the most important people in the NHS, the patients.”

But the BMA does not really regard the patients as the most important people in the NHS. It appears to think doctors are. How otherwise can it possibly justify strikes that will mean the cancellation of thousands of appointments and operations? It is estimated that more than 800,000 procedures have already been postponed since this action began and, for all we know, many have never been rescheduled.

The people waiting for these treatments are anxious, quite likely in pain, possibly unable to work and in many cases desperate to be operated on or have their ailment diagnosed. To hear BMA spokesmen saying that their action is being carried out for the greater good of the nation is risible.

The Government says the union is vetoing local agreements to exempt certain hospitals and departments from the strike, which is why ministers now want to impose a minimum service requirement on them.

The BMA responded with a weaselly worded statement, declaring: “This week’s industrial action comes as a result of this Government failing to address the unprecedented staffing crisis that is engulfing our NHS, and betraying the doctors who they applauded through the pandemic, by failing to value the work they now do to help the NHS back onto its feet.”

How would a pay rise – even the ludicrous demand of 35 per cent – make any difference? It would not end the backlog – which is likely to be growing because of the strikes – and it would not reduce the workload of burnt-out doctors. The reason that the lives of GPs and hospital doctors are so difficult is because the NHS is in a mess and the reason for that is the way it is structured and funded. Yet any attempt to change either would be resisted by the BMA.

It suits the union to have a monopolistic, nationalised healthcare system because it gives them total power; yet its members would be paid better in a hybrid healthcare market of the sort that operates in places like Australia, where many of them are now heading. Depressingly, in seeking to retain the existing broken NHS structure, it is supported by the main political parties.

The BMA is behaving like the National Union of Mineworkers in the 1980s, run by militants, resistant to change and prepared to wreak any amount of damage on the country in pursuit of its aims. At least the miners were trying to stop their livelihoods being closed down, which is not the case for doctors who are, in addition, paid well even if they think it’s not enough. I have yet to meet a destitute GP, let alone an indigent consultant.

Indeed, they can earn so much that the Chancellor removed the cap on the pension lifetime allowance in his March Budget to address concerns that they were being taxed on savings over £1 million and to incentivise them to stay in practice. For most of the people forced to find a new date for their knee replacement or cancer treatment, this is a retirement sum beyond their wildest dreams.

How on earth can they go on strike without compunction? More to the point, why are so many prepared to go along with the wrecking tactics of their union as the ballots on industrial action suggest they do? Of course, the BMA fulfils its function by getting the best deals for its members, including massively beneficial contracts which pusillanimous governments have agreed over the years in order to secure its goodwill.

But the union never reciprocates. Every health secretary since Bevan should have learnt that to deal with the BMA it is necessary to sup with a long spoon. Mr Barclay thinks that, if he refuses to negotiate on its demand for full pay restoration to 2008 levels, the action will eventually fizzle out. He shouldn’t bank on it. The BMA has forced governments to their knees before and looks determined to carry on until it gets its way, whatever misery it inflicts in the process.

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