A total of 82 people gave evidence as part of an independent investigation launched by the BMA after GPonline reported earlier this year on senior women within its GP committee speaking out over belittling, crude and sexist comments, being frozen out of meetings or ignored and facing sexual harassment.
A hard-hitting 32-page report by top barrister Daphne Romney QC, who led the investigation, repeats many of the concerns highlighted in reporting by GPonline - and makes clear that the problems with unacceptable behaviour are not limited to the BMA's GP committee, but 'arise across the BMA' - and go beyond sexual discrimination and harassment into bullying and other poor behaviour.
The report is damning about the failure at all levels of the BMA - and of senior leaders in particular - to put a stop to unacceptable behaviour. It warns: 'There has been a failure of leadership for too long throughout the BMA in calling out bad behaviour, including sex discrimination, sexual harassment, rudeness and bullying of all kinds.
Sexual harassment
'Chief officers, committee chairs, members, and senior management, must all take responsibility for not doing more to condemn it, and to intervene to stop it; in the case of the BMA leadership, the buck stops with them.'
It highlights poor behaviour including shouting, demeaning women, sexual harassment, and bullying, and makes clear that women in the organisation are 'consistently made to feel that they are of less importance and are less capable, than a man'.
Sessionals GPs - who are predominantly female - have also been made to 'feel that they are not "real doctors" because they work part-time' and have encountered hostility, the report says.
It points out that the BMA has never had a woman chair of council in its 187-year history, and that women continue to be underrepresented on committees.
Speaking out
Older women who gave evidence as part of the investigation said they now felt 'ashamed' they had not spoken out earlier. The report says sexual harassment was 'rife' in the NHS thirty years ago, with many women in training at the time facing 'pressure to sleep with a more senior doctor'.
Although this culture has changed, the report says - 'there does seem to be a lingering feeling of entitlement amongst some doctors, particularly towards younger women doctors and female members of staff, which tends to emerge during drunken events, namely conferences and dinners'.
The report highlighted cases of sexual harassment reported by people who gave evidence 'particularly at [the BMA's annual representative meeting] and other conferences, after excessive consumption of alcohol'.
The report says that 'sex discrimination and sexual harassment are but two aspects of the problematic culture at the BMA', highlighting a wider culture of 'intolerance of other views'.
Bullying
It says: 'This is seen in some committees, and on listservers, and it stems from an inability on the part of some doctors to concede that there is a point of view other than their own. Some doctors continue to bully and to harass other doctors and staff for reasons other than sex – sometimes it is ‘otherism,’ sometimes it is just bullying and harassment, and sometimes it is a mixture of the two.
'Whatever it is, it is intolerable, but it has been tolerated and it is poisonous.'
The report sets out a 31-point list of recommendations for reform within the BMA, calling for policy changes such as limits on how long individual doctors can hold committee posts changes to human resources policies, better protection for staff and immediate action on complaints - and makes clear that 'shouting is never acceptable in the workplace'.
Former GPC member Dr Zoe Norris - who along with Dr Katie Bramall-Stainer wrote an article for GPonline in April setting out how sexism had cost the BMA a generation of leaders - said the findings were a huge relief.
She said: 'Those of us who spoke out and gave evidence to the inquiry feel vindicated and enormously relieved by the publication of Daphne Romney’s report today.
Relief
'The last few months have been extremely difficult - we have been subjected to abuse and accusations about our motivations in speaking out. We have been treated shockingly.
'Feeling at first you are not going to be believed, and now this feeling that it is not just you, it is not just in your head - they believe us - is an enormous relief. There is now an opportunity for real change to happen within the BMA. Tom Grinyer, the new CEO struck me as very sincere about his desire to change things.
'There will, however, be people within the BMA who knew what was going on - and if they have any shred of decency they should be willing to reflect on their position with in the organisation.'
Another former GPC member who spoke out about sexism within the BMA, Dr Stephanie de Giorgio, said: 'Learning of the contents of this report this morning was intensely emotional. Hearing that Zoe, Katie, Amy [Small] and myself were not alone in the experiences we had, and that we have been believed has left me feeling both relieved and deeply angry.
'Relieved because the new BMA chief executive has absolutely taken on board the findings of the report and I believe that he will change behaviours in the organisation. Relief also because the appointed QC, Daphne Romney, has compiled an expert and non biased report into bullying and sexist behaviour.
'I am angry however that this behaviour has been allowed to go on for so long, unchecked and indeed perpetrated by those in positions of authority. Others stood by and watched it happen. It has meant good people, women and men, doctors and staff, have left the organisation and that the BMA has not been the credible force speaking on behalf of our profession that it should be due to stifling and silencing of talented individuals. This simply should never have been allowed to happen.'
Dr Amy Small said she had shed 'tears of relief' on reading the report and now felt optimism for the future. She said: 'It's been a tough few months of snide comments, difficult emails - but also lots of praise from other colleagues who were too afraid to come forward before but felt empowered now to speak out.'
In a video statement, BMA chair Dr Chaand Nagpaul said: 'When reports came to light this year that BMA members and staff were being subject to sexist behaviour we were appalled. On behalf of the association I want to offer my heartfelt apologies to all of those affected by these behaviours.'
NHS England director of primary care Dr Nikita Kanani said: 'The findings of the independent investigation into the claims of sexism and sexual harassment within the BMA are appalling. This sort of behaviour is unacceptable in any walk of life, and people who treat women in this way have no place in our profession and no place in our leadership.'
