Dirty Dancing at the BMA?

“Cause I’ve had the time of my life, and I owe it all to you” – from “(I’ve had) The Time Of My Life”, Theme to “Dirty Dancing”

This week we learnt that senior officers of The British Medical Association (BMA), a doctors’ trade union, have been repeatedly using members’ money to pay for their spouses’ travel on expenses.

The news came in a manicured report in the British Medical Journal (a magazine linked to the BMA), published at the height of the nation’s distraction with Brexit. However, the Parliamentary expenses scandal shows how initial reports can belie much bigger problems. MPs fought hard to avoid their individual expenses becoming public. A leak to the press, detailing those expenses, removed MPs’ power to obstruct. The leak had far-reaching consequences. Some MPs were convicted. Several more, though notionally acting within the rules, were forced to repay large sums and / or step down.  Given that context, the BMJ report begs more questions than it answers.

First, the BMJ report fails to give basic facts like how much was claimed and by whom. It’s rumoured separately that spouses’ first class air travel and five star accommodation have been paid for out of members’ subscriptions. If correct, it means the sums involved may be in the tens of thousands. Without transparency, there’s no way to rule out a scandal involving larger sums still.

Second, the report suggests that claiming expenses for spouses was seen as custom and practice i.e. par for the course. This begs further questions. We need to know how long this has been going on, and how widespread has been the rot. If governance has been so weak, how are members to know that many more junior officials haven’t submitted similarly questionable claims?

Third, the report’s content would indicate that some form of internal investigation has already been done. The BMA needs to disclose any such investigation in full, so as not to heap further contempt on its members. In particular, the BMA has judged that the officers involved in the expenses scandal, in fact, broke no rules. The full reasoning behind this internal judgment needs to be disclosed, so members can make up their own minds. The BMA has proved adept at exploiting loopholes to pursue critics, so it’s surprising that it meekly accepts such expenses abuse. Members need to see for themselves whether the BMA has erred by giving discretionary protection to senior officials who could instead be held to account.

Fourth, the report suggests there will be an independent review of BMA governance, but says nothing of accountability for those who were already in oversight roles. The BMA should list those who should have been keeping an eye on such matters, and publish their answers as to what went wrong.

Fifth, the senior officers and their spouses were reportedly the beneficiaries of funds for hospitality and travel. We need to see a register of interests (for BMA officers and spouses alike) to determine any conflicts of interest. Otherwise one cannot rule out e.g. that payment for spouses influenced official BMA business.

Sixth, this spending on senior BMA officers (and their spouses) came during a period when the BMA failed to support a single doctor to full trial in defence of their employment rights. Instead, the BMA brokered pay offs and non-disclosure agreements with NHS trusts. The BMA needs to review its spending decisions, not just on travel, but on the (non-)defence of whistleblowing members like Dr Chris Day and others.

Seventh, it’s been reported separately that the BMJ story came to light only after a leak to the press. This raises concerns over the welfare of the person or people who dared to expose the BMA. The BMA has not protected whistleblowing doctors and has harassed me for years after I went to the press as a last resort, with concerns about patient safety.

Sir Ken Clarke MP (former Secretary of State for Health, and current Father of the House) has voiced his own concerns about the BMA’s methods:

They were certainly the worst trade union I ever dealt with. I had perfectly reasonable relationships with all the more traditional militant trade unions and I dealt with most of them, but the BMA were completely ruthless and unscrupulous. And they do have a tradition of personalising attacks…

A leak about BMA expenses raises a fundamental concern as to why the BMA did not come clean on this issue in the first place. Instead, it appears that the truth is having to be dragged from the BMA.

Eighth, the report indicates that the officials who claimed expenses for their spouses have now left the BMA. But Gateleys, the BMA’s main law firm, has admitted gagging is “common” – even in whistleblowing cases. The BMA should disclose whether its senior officers left with non-disclosure agreements (as occurred with a previous Head of Legal). If so, wrongdoing may have been covered up at members’ expense but without their knowledge.

Conclusion

A disclosure to the press appears to have forced the BMA into a limited exposé of its expenses scandal. Those behind the leak need protection, as the BMA is unlikely to be happy with being exposed in this way.

Beyond that, it’s a real concern that the BMA hasn’t yet come clean on the full details of the expenses claims. It’s also a concern that BMA representatives (still in post) reportedly voted against efforts to come clean on these matters. Many MPs acted similarly – until the full and egregious details of their expenses claims were examined publicly in the press.