Is the BMA a 21st century organisation?
http://www.100md.com
《英国医生杂志》
1 Guy's Hospital, London SE1 9RT nizam.mamode@gstt.sthames.nhs.uk
The BMA is out of touch with its members and in urgent need of reform, according to a former senior member. In an accompanying article the BMA's chairman of council argues that change is well under way
Introduction
Until I made the fact public, probably fewer than 50 of the BMA's 125 000 members were aware that it recompenses senior members for loss of private practice while working for the association. The reason so few people knew this is that the committee which decides the payments does not publish its minutes; although the sums paid are published, the reasons for these awards are not. In 2003, the BMA spent ￡478 459 (720 000, $870 000) compensating 25 council members,1 54% more than the amount paid out the previous year, but nobody officially knows what the money is paid for. This lack of transparency is unacceptable in a modern trade union, and clearly transparency is essential to prevent corruption. The amount that members can claim is not capped, although a cap is to be introduced eventually as part of an ongoing review by the compensation committee. Over the past three years, the highest single compensation payment was ￡55 670.
The BMA in full flow: debating the establishment of the NHS in 1948
Compensating members of a professional organisation for money foregone is unusual. The Law Society, for example, pays compensation only to the president, the vice president, and deputy vice president, with the money going direct to those individuals' firms. Other council members have to be satisfied with out of pocket expenses. Similar rules apply at the Royal College of Nursing, while the Royal College of Surgeons and Royal College of Psychiatrists reimburse only expenses.
Representation
As Macpherson made clear, the first step towards change is recognition that there is a problem.7 Many of us are waiting to hear that recognition. The BMA urgently needs to reform. To do this it first needs to acknowledge the problems. An alternative to the current compensation system needs to be introduced quickly. Radical steps to reconnect with the membership and revitalise the political process are necessary. A more active role in leading opinion and fighting for change is essential. The BMA needs to take steps to attract and recruit ethnic minority doctors, to fight their causes, and to be seen as an inclusive and democratic organisation. Without these steps it will fail.
Summary points
The BMA is serving its members poorly
Large and increasing sums are spent compensating council members for loss of private earnings
Poor voting turnout and a lack of candidates for council elections are symptomatic of members' disenchantment
The BMA denies the existence of institutional racism but represents doctors from ethnic minorities poorly
Competing interests: NM has received a payment from the compensation committee while working part time.
References
BMA Annual report of council, 2003. London: BMA, 2003. www.bma.org.uk/ap.nsf/Content/AnnRepCoun03 (accessed 24 June 2004).
BMA Health Policy and Economic Research Unit. Healthcare funding review. London: BMA, 2002. www.bma.org.uk/ap.nsf/650f3eec0dfb990fca25692100069854/80256b140033ce0780256b50004e1cf4/$FILE/healthcare%20funding.pdf (accessed 24 June 2004).
BMA. Learning the lessons (unpublished).
BMA returns fire over allegations. Hospital Doctor 2004 Feb 12: 28-9.
Scarman, Lord. The Brixton disorders 10-12 April 1981. London: HMSO, 1981.
Gould M. Report accuses NHS of institutional racism. BMJ 2004;328: 367.
Macpherson W. The Stephen Lawrence inquiry. London: Stationery Office, 1999.
Dosani S, Schroter S, Macdonald R, Connor J. Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers. BMJ 2003;327: 961-4.
BMA. The future of our doctors: a conference on racial equality in the NHS. London: BMA, 1998: 9.(Nizam Mamode, consultant )
The BMA is out of touch with its members and in urgent need of reform, according to a former senior member. In an accompanying article the BMA's chairman of council argues that change is well under way
Introduction
Until I made the fact public, probably fewer than 50 of the BMA's 125 000 members were aware that it recompenses senior members for loss of private practice while working for the association. The reason so few people knew this is that the committee which decides the payments does not publish its minutes; although the sums paid are published, the reasons for these awards are not. In 2003, the BMA spent ￡478 459 (720 000, $870 000) compensating 25 council members,1 54% more than the amount paid out the previous year, but nobody officially knows what the money is paid for. This lack of transparency is unacceptable in a modern trade union, and clearly transparency is essential to prevent corruption. The amount that members can claim is not capped, although a cap is to be introduced eventually as part of an ongoing review by the compensation committee. Over the past three years, the highest single compensation payment was ￡55 670.
The BMA in full flow: debating the establishment of the NHS in 1948
Compensating members of a professional organisation for money foregone is unusual. The Law Society, for example, pays compensation only to the president, the vice president, and deputy vice president, with the money going direct to those individuals' firms. Other council members have to be satisfied with out of pocket expenses. Similar rules apply at the Royal College of Nursing, while the Royal College of Surgeons and Royal College of Psychiatrists reimburse only expenses.
Representation
As Macpherson made clear, the first step towards change is recognition that there is a problem.7 Many of us are waiting to hear that recognition. The BMA urgently needs to reform. To do this it first needs to acknowledge the problems. An alternative to the current compensation system needs to be introduced quickly. Radical steps to reconnect with the membership and revitalise the political process are necessary. A more active role in leading opinion and fighting for change is essential. The BMA needs to take steps to attract and recruit ethnic minority doctors, to fight their causes, and to be seen as an inclusive and democratic organisation. Without these steps it will fail.
Summary points
The BMA is serving its members poorly
Large and increasing sums are spent compensating council members for loss of private earnings
Poor voting turnout and a lack of candidates for council elections are symptomatic of members' disenchantment
The BMA denies the existence of institutional racism but represents doctors from ethnic minorities poorly
Competing interests: NM has received a payment from the compensation committee while working part time.
References
BMA Annual report of council, 2003. London: BMA, 2003. www.bma.org.uk/ap.nsf/Content/AnnRepCoun03 (accessed 24 June 2004).
BMA Health Policy and Economic Research Unit. Healthcare funding review. London: BMA, 2002. www.bma.org.uk/ap.nsf/650f3eec0dfb990fca25692100069854/80256b140033ce0780256b50004e1cf4/$FILE/healthcare%20funding.pdf (accessed 24 June 2004).
BMA. Learning the lessons (unpublished).
BMA returns fire over allegations. Hospital Doctor 2004 Feb 12: 28-9.
Scarman, Lord. The Brixton disorders 10-12 April 1981. London: HMSO, 1981.
Gould M. Report accuses NHS of institutional racism. BMJ 2004;328: 367.
Macpherson W. The Stephen Lawrence inquiry. London: Stationery Office, 1999.
Dosani S, Schroter S, Macdonald R, Connor J. Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers. BMJ 2003;327: 961-4.
BMA. The future of our doctors: a conference on racial equality in the NHS. London: BMA, 1998: 9.(Nizam Mamode, consultant )