Electoral reform of GMSCBMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6984.938a (Published 08 April 1995) Cite this as: BMJ 1995;310:938
EDITOR,—As a member of the General Medical Services Committee of many years' standing who may have to answer to an electorate of ordinary general practitioners, J David Watts has one view of the need for changes in the method of election to the committee.1 I, as one of those ordinary doctors, have another view.2 It is perhaps understandable that they differ considerably. I am grateful to Watts, however, for telling us why Leicestershire's motion at the BMA's annual representative meeting last year was deliberately placed low on the order paper.
What Watts seems not to understand is that the current, somewhat archaic system, unchanged in “its constitution and procedures” in any major way for over 80 years,3 4 has finally given way under the pressures of the late 20th century. A committee that represents doctors and directly negotiates with the government on behalf of doctors should be directly answerable to those doctors for its performance. I find it intriguing and revealing that Watts calls my argument in favour of democracy “spurious.”
Watts's argument that the local medical committees raise the quota for the defence fund is weakened by the fact that they raise it from general practitioners and that it is the general practitioners who are expressing their dissatisfaction with the present system by encouraging me in my efforts to reform the voting procedures of the GMSC. These doctors feel remote and unable to influence events on a national scale. Direct elections would give them that influence, would keep GMSC members' eyes more closely on the ball, and would allow a greater range of candidates for seats on the committee.
Under my proposed procedure, local medical committees would remain untouched and would still be able to exert an influence on the GMSC. Members of local medical committees would be able to stand, with other general practitioners, for election from the larger GMSC constituencies. The difference is that all general practitioners would be able to express their vote for them. Is this suggestion “spurious democracy”? I maintain that it is far better that the GMSC carries out the “collective will” of all general practitioners rather than just that of local medical committees.
For the GMSC to resist the first step on this road to democracy—a referendum of all general practitioners carried out by the Electoral Reform Society—is to show either a Luddite mentality or electoral cowardice. In the meantime, general practitioners' morale remains low, recruitment is minimal, and retirements are increasing, and the government remains supreme. The GMSC cannot absolve itself from some responsibility for this.
Finally, it is perhaps as well for the future of general practice that neither Watts nor the GMSC can influence any requisition for an extraordinary general meeting of the BMA. A referendum would be preferable, but, one way or the other, ordinary general practitioners will speak.
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