Chris Lancelot on... The BMA's impotence

At a time when the NHS seems to be falling apart you might expect the BMA to be in the forefront of the debate, monitoring the collapse of health services across the country and vociferously leading opposition to the government's ill-thought-out plans.

This is not the case. Although widely regarded outside the profession as one of the strongest unions, this strength only relates to individual cases — skirmishes rather than strategy. The global viewpoint is sadly missing.

In part this is a legacy of the 1990s, when the BMA went on a strident campaign against Kenneth Clarke’s NHS reforms and nearly split its membership in the process. It is instructive to compare the BMA’s fierce opposition to the Conservatives’ 1989 plans with its effete response to Labour’s intrusive proposals of 1997 onwards.

Historically, the BMA has always had a left-wing lean and for many years has taken the view that the NHS is the only way to provide comprehensive healthcare and that any privatisation is to be deplored. A moment’s thought shows how imprudent this attitude is: almost all GP practices are small private providers and without doubt the most efficient part of the NHS. Privatisation itself is not the problem: the rot sets in when private organisations are treated preferentially by the DoH.

Because of this rigid doctrine and its failure to achieve true consensus among its members the BMA is paralysed. Its lack of clear overall strategy means it is unable to mount consistent, reasoned and above all powerful opposition to the Labour government’s inept plans.

As a result, the government continues to dismantle the NHS virtually unopposed. To counter this the BMA needs to wake up and acquire a workable long-term vision — and then tackle the government head-on. But will it get its act together in time? I doubt it. History is not on its side.

So we all need a Plan B — and no, this doesn’t involve setting up an alternative to the BMA. That has been tried in the past and failed miserably. To halt this wilful destruction of our precious health service we need to bypass the effete BMA, get the patients involved and raise public awareness of what is about to happen to the NHS. I’ll suggest some new ways of doing this next week.

- Dr Lancelot is a GP from Lancashire. Email him at

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