This year marks the 175th anniversary of the BMA. The association has been centrally involved in the evolution and stewardship of the medical profession and has made contributions to national and international health that go far beyond its role as a representative and negotiating body. It has had an important role in debates on abortion, euthanasia, global conflict and the proliferation of nuclear weapons, AIDS, genetics in medicine, and human rights. It must also take a good deal of the credit for the present ban on smoking1 and, of course, for this journal.

The BMA took a highly conservative and aggressive stance against Bevin's plans for the National Health Service (NHS) in the 1940s, but 50 years later found itself almost in step with the health departments after the abolition of the internal market. However, this sense of common purpose is now much more difficult to discern.

The BMA has …