While some LMCs are implementing measures to improve gender diversity and overhauling rules to reflect recommendations from the review, in others reform is being blocked - and in some cases staff have been prevented from speaking publicly about poor behaviour with measures such as confidentiality agreements, GPonline understands.
The whistleblower - a GP who until recently worked in a senior LMC role - experienced and formally reported bullying and aggressive behaviour by a senior colleague.
The senior colleague whose behaviour was challenged by the whistleblower sought to undermine work to implement a code of conduct that incorporated lessons from the Romney review, while at the same time exhibiting unacceptable behaviours specifically identified in the review, the whistleblower said.
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> Key recommendations from the Romney review
This included shouting, withholding information required by colleagues to do their jobs, taking on additional roles without first consulting colleagues, and behaving in a way that left others feeling belittled and undermined.
BMA gender diversity champion and chair of Devon LMC Dr Rachel Ali told GPonline she was ‘enormously saddened but not surprised’ to hear of ongoing problems with sexism and bullying within LMCs.
She said that ‘a lot of positive work’ was happening in many LMCs where recommendations from the Romney review were being taken ‘really seriously’ - but that there were others where this work was not happening. Dr Ali said there were ‘pockets of poor behaviour’ within LMCs - and that this could only be tackled by being exposed.
An internal report commissioned by the whistleblower’s LMC into the senior colleague’s behaviour was not published or shared with either the complainant or others who gave evidence.
Cultural change
The whistleblower said their sense that the LMC was not ‘prepared to address its culture by openly recognising and learning from these events’ had made their position untenable.
The GP told GPonline that at least one other LMC had carried out a similar internal review into allegations of bullying or sexism recently - but that again it had not been made public so that lessons could be learned.
The BMA accepted recommendations in full from the 2019 Romney review, launched after senior GPs spoke out via GPonline about experiences of harassment, bullying and sexism within the association's GP committee.
LMCs have also formally welcomed the review's findings at national conferences - and called for regular reports from the GP committee on work to stamp out the sexist and bullying culture identified by the Romney review.
GPonline reporting on BMA sexism
> Harassment, exclusion, innuendo: women frozen out by sexist BMA culture
> 'Sexism at the BMA has cost general practice a generation of leaders'
> Two of GPC's longest-serving women speak out on sexism
But the whistleblower's account of their experiences within the past year suggest that these behaviours have not only continued within LMCs, but have also not been handled with openness and transparency.
Dr Ali added that it was difficult to enforce change on LMCs because of their independence - but that her role as gender diversity champion ‘specifically mandates me to be reaching out to LMCs and trying to help them to improve their culture and governance around diversity issues’.
She said there was ‘a lot of positive work going on in LMC land’ - with some bringing in their own diversity champions, reviewing their constitutions and carrying out gender audits. But she added: ‘It is going to be slow to get global buy-in I think, for lots of reasons. Among them are time and finance - LMCs are different sizes and have different resources available.’
The BMA gender diversity champion said she was in the process of building a ‘repository’ of good practice drawn from work LMCs are already doing around gender diversity and inclusion so that others could learn from it and adopt the best approaches.
Seeking advice
She added that she was happy to be approached for advice by any doctor experiencing poor behaviour. ‘People still need to go down the right routes to make official complaints and to get support for addressing inappropriate behavior. But I'm really happy for people to come to me to discuss what those routes are and to offer support if they need it.’
Of a dozen LMCs approached by GPonline with questions about how they were implementing recommendations from the Romney review, just two replied. The responses came from two of England's largest LMCs.
Londonwide LMCs chief executive Dr Michelle Drage said: ‘Londonwide LMCs and our constituent LMCs have a proud history of championing and supporting diversity, and robust policies to manage and support staff and LMC officers in the event of concerns being raised regarding sexism, bullying, harassment or other behaviours.
‘Although the recommendations of the Romney review are specific to the BMA, they do serve as a reminder that fostering equality is an ongoing job, and we continue to work towards an equal and inclusive culture in London practices and across our representative committees.'
Acting chief executive of Wessex LMCs Dr Gareth Bryant said: ‘Wessex LMCs took the Romney review very seriously. In response to the review we set up a subgroup to review the recommendations within the report and determine which were relevant to our LMCs and determine what steps we needed to take.' He said the LMC developed a charter and a confidential reporting mechanism, and held training sessions for staff.
A BMA spokesperson said: 'LMCs are wholly independent of the BMA but we would hope they would encourage their members to behave in a manner that is fair, supportive and does not result in colleagues feeling bullied and harassed in any way.
'The BMA has worked hard to implement the recommendations of the Romney review and this includes rolling out active bystander and valuing difference training for BMA staff and elected members, establishing a committee mentoring programme help support new committee members and the setting up of an independent 24-hour support telephone line as well as a new independent complaint investigation process that has been established.'
