The BMA's annual representative meeting

Why are doctors leaving the NHS?

One of the liveliest debates was on why doctors were leaving the profession. Dr Conrad Guerrier (Somerset) implored the council to set up a working party on the subject. Dr Mark Porter (JDC) supported the call. He said that reliable statistics were needed now before the flow of doctors out of Britain and out of clinical medicine became a haemorrhage. Dr Helen Davison (JDC) added her own plea. She had started working as a junior doctor at the time of the reforms, had become increasingly ground down, and had had to leave medicine for health reasons. At first she had felt guilty but now realised that it was the system that had let her down.

Dr Brian Keighley (LMC conference) thought that the government should be investigating the haemorrhaging of its own staff, not the BMA, and the reasons were clear: rising workload, insensitive management, inflexible training, the internal market, juniors' long hours, and GPs' night visits.

The chairman of council pointed out that Isobel Allen's study had provided some data: a half of a cohort of 229 doctors had thought of leaving the profession, 2% actually had done so, and a further 8% thought it likely they would do so. The BMA's health policy unit had set up a cohort study of doctors qualifying in 1995 and planned to follow them up annually. This would, he said, provide reliable information, but unfortunately not yet. The motion was passed as a reference.

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The meeting …

• Reaffirmed the commitment of the BMA to a national health service

• Believed that rationing in a health service with finite resources was inevitable and that the government should involve the public in decisions on priorities

• Urged the government to maintain accident and emergency services and other emergency hospital services so that clinically appropriate access by the …