The BMA must now lead from the front

The next month is going to be critical for the future of the BMA, and the future of the medical profession. Following the resignation of Jim Johnson as chairman, who is going to lead the association? More importantly, how is the association going to lead the profession?

The first question will be answered at the BMA's annual representative meeting in June, when those present will vote for a new person to take the helm. We already know they will be a GP because the previous incumbent was a hospital consultant and these things rotate in a gentlemanly manner.

The second question is more difficult to answer. But what is clear is that the BMA has failed to provide the leadership that the profession has so badly needed of late.

GP complained last year that Patricia Hewitt seemed to be swinging around the NHS on a wrecking ball: she had to be stopped. But the BMA has appeared reluctant to commit itself to a forceful challenge. We saw the march of private providers continue, NHS services slashed to Save Pat's Job, and the relentless bashing of doctors in the media.

The profession feels under attack and Mr Johnson found out the hard way that this is not the time to express solidarity with the enemy.

Resignation was the only way out if the BMA was to retain any credibility with its membership and it is, at least, heartening that the mood of the council was such that his position quickly became untenable. Maybe there is some fight left in the old dog yet?

Let's hope so because the attack continues apace. In the past week we have seen the National Audit Office bizarrely criticising GPs' generic prescribing rates, Gordon Brown wanting to reform out-of-hours care, and a replacement formula for the global sum that has even had the RCGP spitting feathers.

The BMA needs a chairman, or chairwoman, who will take the fight to the government. This means an aggressive new media strategy to match Whitehall's spin doctors and a more cold-blooded approach to negotiations. It also means leading from the front while not losing touch with the troops.

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