Meldrum leads the charge

In his third opening address to the LMCs conference as chairman of GPC and, he must be hoping his last, Dr Hamish Meldrum set out his conditions for Gordon Brown as incoming prime minister.

GPC chairman Dr Hamish Meldrum
GPC chairman Dr Hamish Meldrum

Government attacks on the profession must stop, he said, just as attacks from the press must stop. Gordon Brown must learn to work with doctors, not snipe at them.

'The message is clear, the doctors are prepared to crew your flagship Gordon but only if you work with us, get the minesweepers out and remove the obstacles in our way,' he said to warm assent.

This was a tricky address for Dr Meldrum. It has been a difficult year for the organisation he chairs, the GPC, and for the organisation he hopes to chair, the BMA. Yet the profession is still riding high on the achievements of the new contract - less work, more money, evidence-based care - so the underlying mood remains buoyant.

Looking forward
For 2007/8, Dr Meldrum had little good news to report. To say it was a difficult year is an understatement, he said - 'with the ongoing dispute over pensions, difficult with the failure to reach agreement with NHS Employers, difficult with the zero award from the Doctors and Dentists Review Body, difficult with an NHS that staggers from one crisis to another, difficult with the continuing attacks on GPs.'

There was no news on the judicial review being mounted by the BMA against the government on pensions. And there was only the old, bad news on pay - that GPs won nothing in the 2007/8 round.

But in an adroit twist, he turned what by any standards was a failure by the GPC negotiators into a rallying call: ' award is not just about paying GPs. It's about paying our staff, paying for our premises, resourcing the very nature of the work that we do.'

Government failure
Dr Meldrum recited his litany of failures and nailed scapegoats for each one, singling out the government, the Secretary of State for Health, and the press. He doubtless knew in advance that Jenny Hope, the Daily Mail's omnipresent health editor would be representing the national media when he composed his speech: GPs, he told conference, are now among the best paid in Europe, a position they deserve as they also top the good-care list of English speaking countries, according to the Commonwealth Fund, a US health policy think-tank.

'That didn't happen by accident. It happened as a result of the massive endeavours of GPs and their practice staff. It happened by GPs working harder than ever before. It happened despite a chorus of morale-sapping carping and criticism. It happened in a climate of boom and bust, crisis-management-ridden NHS. It would be refreshing if the Daily Mail printed that for a change.' 28 seconds of applause followed that rallying cry.

Candidate for chairman
Looking tanned and trim, with his beard only gently whitening and his monk's cowl only marginally larger than last year, Dr Hamish Meldrum sought out the positives.

He needed to get the troops behind him. After all, he is in the middle of a bid to replace Jim Johnson as BMA chairman as part of the fall-out from the juniors doctors' training fiasco. By convention the job goes to a GP this time round but the BMA has another strong alternative candidate in east London GP Sam Everington. Will Hamish Meldrum, one day a week GP and inheritor of the new contract negotiated by Drs John Chisholm and Simon Fradd, be the lucky man?

Dr Meldrum used his address to his constituents as part of his personal campaign. After admitting the year's failures, he moved on to a rousing visionary section ('a face-to-face consultation with a GP still costs less than a call to NHS Direct'; 'this happened as a result of the massive endeavours of GPs'; 'the values that we hold dear, that are the essence of general practice, remain constant and unchanging. The registered list, person-centred, holistic care, the ability to innovate, to be flexible, the deliver high-quality, family medicine to our patients - do not and must not change' ... 'the values of general practice will survive and flourish').

Then came his five pledges - to fight for the under-pinning values of UK general practice, to fight for 'a GPC and a BMA that fiercely and honestly respresents the UK's doctors', for a fair, universal and quality-driven NHS, to resist those who try to destroy it and finally to 'continue to fight with every fibre of my being for a profession that I love and am proud to represent.'

Most of the pundits loved it. Led by the bank of loyal negotiators who spattered the address with 'Hear, hear's and 'Shame's, the hall rose to its feet, as is custom, and applauded their leader for 33 seconds.

How many stayed in their seats? A handful perhaps. The non-conformist dissenters who will spell trouble and excitement at this conference.

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