The
British Medical Association (
BMA) is the professional association and registered
trade unionA trade union, trades union or labor union is an organization of workers that have banded together to achieve common goals such as better working conditions. The trade union, through its leadership, bargains with the employer on behalf of union members and negotiates labour contracts with...
for
doctorsA physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
in the
United KingdomThe United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
. The association does not regulate or certify doctors, a responsibility which lies with the
General Medical CouncilThe General Medical Council registers and regulates doctors practising in the United Kingdom. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise...
. The association’s headquarters are located in BMA House,
Tavistock SquareTavistock Square is a public square in Bloomsbury, in the London Borough of Camden with a fine garden.-Public art:The centre-piece of the gardens is a statue of Mahatma Gandhi, which was installed in 1968....
,
LondonLondon is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
. Additionally, the Association has national offices in
CardiffCardiff is the capital, largest city and most populous county of Wales and the 10th largest city in the United Kingdom. The city is Wales' chief commercial centre, the base for most national cultural and sporting institutions, the Welsh national media, and the seat of the National Assembly for...
,
BelfastBelfast is the capital of and largest city in Northern Ireland. By population, it is the 14th biggest city in the United Kingdom and second biggest on the island of Ireland . It is the seat of the devolved government and legislative Northern Ireland Assembly...
, and
EdinburghEdinburgh is the capital city of Scotland, the second largest city in Scotland, and the eighth most populous in the United Kingdom. The City of Edinburgh Council governs one of Scotland's 32 local government council areas. The council area includes urban Edinburgh and a rural area...
, a European office in
BrusselsBrussels , officially the Brussels Region or Brussels-Capital Region , is the capital of Belgium and the de facto capital of the European Union...
and a number of offices in English regions. The BMA has a range of representative and scientific committees and is recognised by
National Health ServiceThe National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
employers as sole contract negotiators for doctors. The aim for the BMA is
"to promote the medical and allied sciences, and to maintain the honour and interests of the medical profession".
About BMA membership
Currently 141,000 doctors and medical students are members of the association. It is officially recognised by Government and by the Review Body on Doctors' and Dentists' Remuneration as the only organisation representing all NHS doctors in the hospital and community services employed under national agreements. The BMA has sole bargaining rights for these doctors.
Members of the BMA have access to expert employment advice. Advisors can help with a range of employment related issues, from answering a simple question to advising on more complex problems including contract checking, job planning, pay disputes and relationship issues.
BMA Committees
As part of the representative remit of the BMA it has a number of representative committees formed from members elected at the Annual Representatives Meeting (ARM) and via other election processes. The most senior of these is Council. It meets five times a year to implement policy as decided at the ARM and to take relevant decisions during the year. Council has 34 voting members, led by the Chairman who is elected by council for an initial term of three years and to a maximum of five.
The Board of Professional Activities reports to Council and considers ethical, scientific, research, and educational matters whilst The Board of Representative and Political Activities considers reports from the following committees which represent doctors across the seven branches of practice which are:
- Central Consultants and Specialists Committee (CCSC) – representing senior hospital doctors
- General Practitioners Committee (GPC) – representing NHS General Practitioners (GPs)
- Junior Doctors Committee (JDC) – representing junior hospital doctors, including GP registrars in the hospital part of their training
- Medical Academic Staff Committee (MASC) – representing academic and research staff
- Medical Students Committee (MSC) – representing medical students
- Public Health Medicine Committee (PHMC) – representing public and community health doctors
- Staff and Associate Specialists Committee(SASC) – for doctors in the non consultant career grades.
Branch of Practice committees have a majority of BMA members but may also include non-members. All members are elected. These UK committees are mirrored across the devolved nations of
ScotlandScotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
,
WalesWales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
, and
Northern IrelandNorthern Ireland is one of the four countries of the United Kingdom. Situated in the north-east of the island of Ireland, it shares a border with the Republic of Ireland to the south and west...
.
Other committees
The BMA also has a number of committees which represent other specialities and interests which affect its members, including:
- Medical Ethics
- Board of Medical Education
- Pensions
- Armed Forces
- Civil and Public Services Committee
- International Committee
- Medico-Legal
- Occupational Health
Medical Ethics Committee
The Medical Ethics Committee provides guidance to the Association on current and developing issues in medical ethics. It is widely seen as one of the foremost authorities on ethical issues in the UK and international medical field. The committee debates issues of principle including those touching on:
- Medical ethics
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...
- Medical law
Medical law is the branch of law which concerns the prerogatives and responsibilities of medical professionals and the rights of the patient. It should not be confused with medical jurisprudence, which is a branch of medicine, rather than a branch of law....
- Ethical matters concerning the relationship between the medical profession, the public, and the state.
Issues considered by the committee include
abortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
,
organ donationOrgan donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. Transplantable organs and tissues are removed in a surgical procedure following a determination, based on the donor's medical and...
and presumed consent, patient confidentiality, and the
Mental Capacity ActThe Mental Capacity Act 2005 is an Act of the Parliament of the United Kingdom. Its primary purpose is to provide a legal framework for acting and making decisions on behalf of adults who lack the capacity to make particular decisions for themselves....
.
The committee has eighteen members, composed of both doctors and expert lay members. Seven doctors who are members of the BMA are elected at the BMA's Annual Representatives Meeting (ARM) each year and three are elected by the BMA’s governing committee, BMA Council, which also appoints four external members "drawn from disciplines such as moral philosophy, natural sciences or law." The Committee itself co-opts an additional four expert members, drawn from similar disciplines. The co-opted members do not have voting rights. The Committee cannot by itself set BMA policy, although it develops its own policy which has advisory status.
The Medical Ethics Department, which provides support to the Committee, answers individual ethical enquiries from doctors who are members of the BMA and produces guidelines and other publications. The bulk of the Department’s guidance is freely available on the open access part of the BMA’s website.
Armed Forces Committee
The BMA supports armed forces doctors through its Armed Forces Committee (AFC) which represents clinicians in all parts of the armed forces, whether they are deployed to war zones, acting as reservists or civilian doctors employed by the Ministry of Defence. A large part of the AFC’s work is the production of evidence to the Armed Forces Pay Review Body (AFPRB). The AFPRB advises on remuneration for members of the naval, military, and air forces. Further to this work, the AFC negotiates with the Ministry of Defence on the terms and conditions for civilian doctors. The committee holds two conferences a year; an Armed Forces Committee conference usually in May and a Civilian Doctors’ conference usually in October.
Private Practice Committee
The BMA supports doctors that undertake private practice outside the NHS through its Private Practice Committee. This body considers topics facing both private consultants and general practitioners. The committee meets three times a year and holds conferences in relation to private practice. The main issues currently being dealt with by the committee include looking at the implementation of revalidation in the independent sector and addressing difficulties that doctors experience in relation to new ways of working by the private medical insurers.
History
The British Medical Association was founded as the Provincial Medical and Surgical Association (PMSA) by Sir Charles Hastings on 19 July 1832 at a meeting in the Board Room of the Worcester Infirmary. This is now the site of the
University of WorcesterThe University of Worcester is a British university, based in Worcester, Worcestershire, England. It was granted university status in September 2005.-History:...
's City Campus. An audience of 50 doctors was present to hear Hastings propose the inauguration of an Association both friendly and scientific for the sharing of knowledge between doctors. Ten years after its initial meeting the Association’s membership had grown to 1350 and it had begun to publish a weekly journal,
The Provincial Medical and Surgical Journal, known from 1857 as the
British Medical JournalBMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...
or
BMJ. The Association’s membership grew rapidly and in 1853 the Provincial Medical and Surgical Association extended its membership to London doctors and became the British Medical Association in 1856. Medical students have been admitted from the late 1970s onwards.
Although not initially formed with the aim of initiating medical reform, the BMA played a key role in the drafting and passing of the
Medical Act 1858The Medical Act 1858 was a British Act of Parliament which created the General Medical Council to regulate doctors in the UK.Describing its purpose, the act notes that "it is expedient that Persons requiring Medical Aid should be enabled to distinguish qualified from unqualified Practitioners".The...
, which established the
General Medical CouncilThe General Medical Council registers and regulates doctors practising in the United Kingdom. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise...
and set a standard for qualified and unqualified doctors and established a system of professional regulation. Prior to this anyone, qualified or not, could practice as a doctor. This also positioned the BMA to play a major role in future medical politics, campaigning on issues such as
Poor LawThe English Poor Laws were a system of poor relief which existed in England and Wales that developed out of late-medieval and Tudor-era laws before being codified in 1587–98...
Medicine,
quackeryQuackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...
,
public healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
,
alternativeAlternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
and military medicine, and contract practice. During this time one of the most active and influential of the Association’s bodies was the Parliamentary Bills Committee, formed in 1863 to take a leading role in influencing legislation on public health matters.
Headquarters
BMA House has been the headquarters of the BMA since 1925, the Association being originally housed at 429 The
Strand, LondonStrand is a street in the City of Westminster, London, England. The street is just over three-quarters of a mile long. It currently starts at Trafalgar Square and runs east to join Fleet Street at Temple Bar, which marks the boundary of the City of London at this point, though its historical length...
since its move to London. The building, now grade II listed, was originally designed for the
Theosophical SocietyThe Theosophical Society is an organization formed in 1875 to advance the spiritual principles and search for Truth known as Theosophy. The original organization, after splits and realignments has several successors...
by Sir
Edwin LutyensSir Edwin Landseer Lutyens, OM, KCIE, PRA, FRIBA was a British architect who is known for imaginatively adapting traditional architectural styles to the requirements of his era...
with work commencing on 3 September 1911. However the start of
World War IWorld War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...
interrupted construction and the Army Pay Office took over the uncompleted building. After the war the Theosophical Society could not afford to finish the building, and it was sold to the BMA for £50,000, with the association later purchasing the freehold of the site from the Bedford Estates in 1962.
After purchasing the building, the BMA commissioned Lutyens to complete the building to its specifications. The building was officially opened by
King George VGeorge V was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 through the First World War until his death in 1936....
and
Queen MaryMary of Teck was the queen consort of the United Kingdom and the British Dominions, and Empress of India, as the wife of King-Emperor George V....
on 13 May 1925. However, plans were soon commissioned from Cyril Wontner Smith to extend the building to overlook
Tavistock SquareTavistock Square is a public square in Bloomsbury, in the London Borough of Camden with a fine garden.-Public art:The centre-piece of the gardens is a statue of Mahatma Gandhi, which was installed in 1968....
. The Association later commissioned
Douglas WoodDouglas Wood , is an Australian construction engineer who had worked with the American military, and was held hostage in Iraq for six weeks between May and June 2005, before being rescued.-Early life:...
to design two more extensions on either side of Wontner Smith’s front entrance (build 1938-1950) and one at the back of the building (build 1959–1960).
The BMA in the early 20th century
In May 1911 the Government introduced the National Health Insurance Bill which presented the BMA with new challenges. This bill introduced the idea that for a maximum contribution of four pence a week every employed person in the country could be insured against treatment costs for sickness. The BMA supported the principle but had a number of reservations about the scheme including the lack of doctor involvement in delivering the medical benefits, which were instead being delivered by friendly societies and trade unions. In response the BMA produced "Six Cardinal Points" which it felt should be included in any legislation.
At the BMA's general meeting in July 1912, incoming president Sir James Barr condemned the National Health Insurance Bill as "the most gigantic fraud which had ever been perpetrated on the public since the South Sea Bubble." Addressing "a large and distinguished audience," Barr "spoke eloquently and forcibly in favour of the improvement of the race by attention to eugenics, and pointed out the necessity of preventing disease as well of curing it. No serious attempt, he said, had yet been made to prevent the race from being carried on by its least worthy citizens." Barr explained that: "If such an attempt was to be successful we must begin with the unborn. The race must be renewed from the mentally and physically fit, and moral and physical degenerates should not be allowed to take any part in adding to it".
Ultimately the final bill was passed in 1913 in which four of the six points had been included. This resulted in an income limit of £2 per week being set to join the scheme, there was to be free choice of doctor by patient, the payment to the doctor should be adequate, and finally there should be adequate medical representation among the various bodies working on the Act.
With the start of World War I, the BMA formed a Central Medical War Committee (CMWC), and was given responsibility by the government for managing the demand for doctors in the armed forces whilst maintaining a full medical service for civilians. The BMA repeated this role during
World War IIWorld War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
. During this time the BMA also campaigned on issues such as the production and marketing of "secret remedies",
nutritionNutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....
and
physical fitnessPhysical fitness comprises two related concepts: general fitness , and specific fitness...
, the relationship of
alcoholIn chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
to road accidents, and the medical aspects of
abortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
.
Early in the Second World War, the BMA became aware of the need for a change in the provision of medical care to the public after the end of the war and during peace time, so shortly after the war, the BMA had produced its own plan for a "general medical service for the nation". The plan had a number of revisions incorporating the latest BMA policy on various aspects of health care and in 1942 the Annual Representatives meeting approved a proposal for a state system "for the whole community" as suggested by the BMA’s Medical Planning Commission. Later in 1942 the
Beveridge ReportThe Report of the Inter-Departmental Committee on Social Insurance and Allied Services, known commonly as the Beveridge Report was an influential document in the founding of the Welfare State in the United Kingdom...
announced a comprehensive national health service was to be established. The White paper "A National Health Service" was published on 17 February 1944.
The BMA and the NHS
Although the BMA agreed in principle with the establishment of the NHS, the BMA objected to the administration methods and the lack of consultation and negotiation with doctors regarding the scheme and the effects that the NHS would have on doctors' lives.
By 1945 a negotiating committee was set up and by 15 December 1945 it had announced seven principles with which the proposed service should comply if it were to be supported by the profession. The seven principles were;
- No salaried service
- Clinical freedom
- Free choice of doctor for patients
- Free choice for doctors of form and place of work
- Freedom of every registered practitioner to join the public service
- A hospital service centred on universities
- Adequate professional representation on all administrative bodies
Having gained a number of concessions from the government, the National Health Services Bill was published on 20 March 1946 and became law on 6 November 1946. The BMA conducted a referendum of its members to consider the Act. After 3 votes and a Special Representatives Meeting, the BMA Council recommended that the profession cooperate in the new health service and the NHS came into operation in 5 July 1948. The BMA has continued to play an important role in the NHS, specially in the negotiation of doctor’s terms and conditions. The association also made a number of significant contributions to high profile government reports during the 1950s and 60s, such as The Royal Commission on Marriage and Divorce (1951) and The Wolfenden Committee (1955).
NHS Reform and the Current Role of the BMA
The BMA continued to play an ongoing role in the reform of the NHS by contributing to a number of reports since the founding of the NHS. The Royal Commission on Doctors’ and Dentists’ Remuneration (1956) had important implications for general practitioners' pay, and was followed by a second inquiry – The Medical Services Review Committee. The report from this committee, known as the Porritt report was published in 1962 and included important recommendations for reforming the NHS administration, in particular the formation of area health boards. The third committee on General Practice was set up in 1961 under Annis Gillie and was charged with examining the future of General Practice. Its report was published in 1963. In 1965 the BMA published its General Medical Services Committee paper "A Charter for the Family Doctor Service".
The BMA continued to actively contribute to public health issues. The BMA's "Policy in Relation to Smoking" was published in 1971. In response to the perceived threat of nuclear war in the early 1980s, the Association reported on the possible medical and environmental effects of global conflict. The BMA’s first statement on
AIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
was published in 1985 following the worldwide spread of the disease.
In 1989 the Association rejected Kenneth Clarke's reforms of the NHS based on internal market. Led by its chairman John Marks it mounted a powerful public relations campaign involving newspaper advertising, a poster campaign, the issue of 11 million pamphlets for distribution by general practitioners, and radio and television broadcasts in an attempt to educate the public about the dangers of the governments proposals. Even Kenneth Clarke admitted that the Association won the public relations exercise, but predictably the government imposed the internal market.
In 1992, the genetic engineering working party culminated in the publication "Our Genetic Future", which considered the scientific and ethical implications of genetic engineering.
By the late 1980s, the BMA continued to negotiate contracts on behalf of doctors, some of them controversial. It has voiced concerns over the impact of
European UnionThe European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...
directives on the profession, devolution in the UK, new technological sources for medical advice, and many other aspects of issues affecting patients and the working lives of doctors.
BMA Policy and the Representative Body
As a democratic organisation, members decide BMA policy through the major policy making body, the Representative Body, which meets annually at the Annual Representatives Meeting (ARM). Membership of this body is approximately 600 and is elected both geographically and by branch of practice. Motions debated at the ARM come largely from BMA divisions (local bodies representing doctors) however they may also come from Branch of Practice or national committees.
Logo
The logo of the BMA includes a stylised version of the
rod of AsclepiusThe rod of Asclepius , also known as the asklepian, is an ancient symbol associated with astrology, the Greek god Asclepius, and with medicine and healing. It consists of a serpent entwined around a staff. The name of the symbol derives from its early and widespread association with Asclepius, the...
, associated with
AsclepiusAsclepius is the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia , Iaso , Aceso , Aglæa/Ægle , and Panacea...
, the Greek god of healing.
External links