QC's report lifts lid on scale of GP dissatisfaction with BMA representation

GP representation in the BMA is 'dysfunctional', run by an old boys' network and disconnected from LMCs and grassroots doctors, according to views set out in a report that reveals deep-rooted dissatisfaction with the profession's leadership.

BMA House
BMA House (Photo: Malcolm Case-Green)

A report by QC Ijeoma Omambala - commissioned by the GP Defence Fund to lead an 'independent review of the current representative structures of general practitioners in the UK' following a motion passed at the 2021 UK LMCs conference - identified dissatisfaction in all UK nations among GPs with their representation.

However, the report found greater dissatisfaction in England than in Scotland and Wales - and 'a strong feeling of disconnect between LMCs and GPC England specifically'.

Among more than 700 GPs in England polled for the report, the average satisfaction score with GPC England was 'particularly low, at just 3.9 out of 10'. It also found 'very real tensions' between partners and sessional GPs across the UK, but particularly in England.

GP representation

The report highlights concerns among GPs that elections to GPC England are 'run by an old boys' network', that its executive team is too 'secretive' - and found that some cultural problems identified in the 2019 review by Daphne Romney persist.

The report highlights 'sometimes abusive, disrespectful and/or unpleasant language used by some GPs to speak to one another' on the 'listservers' used by LMCs and BMA committee members to communicate.

It adds: 'This was an issue highlighted in the Romney Report. Rude, bullying and disrespectful communication on the listservers clearly acts as a disincentive to participation in LMCs in general. In addition, it has the potential to contribute to the marginalisation of women, BAME and other minority voices within LMCs and GPCs.'

The report by Ms Omambala comes as a debate at the 2022 UK LMCs conference this week on plans to create a national association of LMCs highlighted anger among some delegates at representation by the BMA. One former GP committee member for England told the conference: 'The BMA GP committee in my opinion is not representing our needs and I don't believe it ever can.'

Grassroots GPs

Concerns around the link between LMCs and GPC England centred around GPs reporting that GPC England, its executive team and the BMA overall failed to give sufficient weight to motions passed at annual conferences - and that there was 'no effective mechanism for ensuring that the views of grass roots GPs were heard and taken into account in developing policy and devising negotiating strategies'.

GPs also felt that GPC England representatives sometimes had no effective connection to an LMC, that communication between LMCs and and GPC England was poor, that LMC members did not always engage with the process for electing people to GPC - and that 'many' GPC representatives simply represent themselves and their own interests.

The report found 'greater dissatisfaction in England than in Scotland and Wales' but identified concerns in all nations with national representation, contracts, engagement with the NHS, engagement with governments, and representation by their national GPC.

Dissatisfaction was at a similar level among all types of GP - and was particularly pronounced among rural GPs generally, but particularly those in Scotland.

BMA culture

BMA UK GP committee chair Dr Phil White said: 'We take extremely seriously any allegations of bullying or reports of bad behaviour, and have an independent process in place to investigate such occurrences. In recent years we have made great strides in representation, and made considerable progress since the 2019 Romney Review, including the introduction of training for members and staff and activities to improve culture. Across the BMA we have increased the representation of ethnic minorities, women and other groups but still have more to do.

'GPC and the wider BMA is constantly seeking to learn and improve and regularly reviews how it is working. This report will be a valuable contribution to that process. We will need time to digest its contents, but we take seriously the claims made and are committed to working alongside GPDF to address the issues raised and discuss the ideas proposed.

'GPC is dedicated to representing, defending, and advocating for all GPs, whatever their background, both through its work as a committee and through the BMA’s wider function as a professional association. As the trade union for doctors, we negotiate with health services and governments across the UK, and strive to secure the best deal for all GPs, not just BMA members.'

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