The BMA and the NHSBMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7150.45 (Published 04 July 1998) Cite this as: BMJ 1998;317:45
- Charles Webster, senior research fellow.
- All Souls College, University of Oxford, Oxford OX1 4AL
Charles Webster is official historian of the NHS. We invited him to look at the relationship between the BMA and the NHS since the NHS's beginnings
The inauguration of the National Health Service and its main anniversaries have been marked by solemn declarations of commitment by the main parties, but these figure less prominently in the collective memory than episodes of dramatic confrontation and interminable negotiations. Still fresh in the memory are the rows with Kenneth Clarke over the 1990 contract and the internal market reforms. Klein called these events “the biggest explosion of political anger and professional fury in the history of the NHS.”1 This was certainly the biggest of the many skirmishes that took place during the recent, eventful 18 years of Conservative government.
The radicalism and controversial character of the government's policies undoubtedly merited strong reaction, but it would be dangerous to conclude that the tangles with Kenneth Clarke were on an unprecedented scale. Indeed, it is arguable that the BMA possesses an unenviable record for assaults against the government of the day on matters great and small. Even periodic pay disputes, such as the one in the mid-1950s that led to the Pilkington commission on doctors' and dentists' pay, or the one resulting in the 1966 contract, were associated with menacing demonstrations of force on the part of the BMA.
Taking the past 50 years as a whole, it is arguable that the most concerted attack by the BMA occurred during the term of office of Barbara Castle, who in 1975 was embroiled in confrontations over pay, both the consultants' and junior doctors' contracts, and, most potent of all, the phasing out of pay beds. On one occasion the secretary of state was kept at the negotiating table from 4 pm to 7 am the …