BMA chairman resigns over MTAS letter to the Times
From Mmc
BMJ 2007;334:1074-1075 (26 May), doi:10.1136/bmj.39223.767870.DB
BMA chairman resigns over MTAS letter to the Times
Lynn Eaton London
In an unexpected move, the BMA's chairman, Jim Johnson, has resigned after protests at a letter he wrote to the Times newspaper published on 17 May (www.timesonline.co.uk/tol/comment/debate/letters/article1800798.ece). His letter supported the government's reforms of medical education and stated that continuing to use the flawed medical training application service (MTAS) system for appointing round 1 candidates was the "best available solution."
His letter, written with Carol Black, chairwoman of the Academy of Medical Royal Colleges, upset BMA members over last weekend and led to Mr Johnson's decision to resign last Sunday.
Jonathan Fielden, chairman of the BMA's Central Consultants and Specialists Committee, was one of the council members who called for Mr Johnson's resignation.
"The history of this goes back to the last annual representative meeting," he said. "There was a considerable amount of concern that Jim was not expressing the views of membership. In his acceptance speech [of his fourth year as chairman] there was a great deal of acceptance that he would change and reflect more what members wanted. When Jim welcomed the [government's] reforms, that jarred with a lot of people.
"Over the MTAS issue it was clear that his views, particularly around the chief medical officer, don't reflect the huge amount of anger and distress that the profession, in particular junior doctors, are feeling," said Dr Fielden.
Mr Johnson fiercely denied Dr Fielden's allegations, however, describing them as "absolute nonsense." "I have reflected entirely what members think throughout the year," he said. "And I have never welcomed the government's reforms."
Dr Fielden's allegations were "not borne out by the comments I have been making," said Mr Johnson.
Several motions are put down for debate at the annual representative meeting next month calling for the chief medical officer to resign, said Dr Fielden.
Many junior doctors were furious that the BMA representatives on the MTAS review group had gone along with the proposal to continue with existing interviews despite them being based on the flawed MTAS computer system.
Mr Johnson claims his letter to the Times was merely reiterating existing BMA policy. He says that what seems to have most annoyed BMA members was the paragraph in which he and Carol Black said that they "restated their support for the chief medical officer and his role in improving junior doctors' training."
"The chief medical officer seems to be a bit of a hate figure within the BMA at the moment," Mr Johnson said. "I think it is my job to support any member who is being got at and isn't in a position to support himself," he added.
He defended the comments he made about MTAS, arguing that what he wrote was in line with the BMA's policy: "MTAS may not be a very good system, but we've got to be pragmatic."
He added that the BMA had accepted that the current round of interviews should go ahead, albeit on a flawed application system, because "doctors have to be in training posts by August."
The suggestion originally made by Remedy UK, a group of junior doctors that has taken the government to judicial review, that the interviews held so far should be scrapped, was not accepted by the BMA, Mr Johnson said. "The rather flawed system has got to go ahead," he added.
Eventually, before launching an application for judicial review which, as the BMJ went to press, was yet to be determined, Remedy UK changed its stance, calling instead for the appointments to be made on a temporary basis only.
Mr Johnson told the BMJ that he had not thought it necessary to consult the BMA before writing to the Times. "The BMA policy is that we support Modernising Medical Careers," he said. "We can't have a policy we are ashamed of. I don't have to consult every time I write a letter."
Mr Johnson said it was "completely untrue" that he wasn't angry about what had happened over MTAS. "But I don't regret coming to the aid of a colleague."
Mr Johnson was going to stand down from the BMA next month in any case, after being at the helm for four years. "I was feeling for a long time that four years was enough," he said. "But I wouldn't have chosen to end it in this way.
"It's got to the stage where it is actually damaging the association. There have been a few resignations, and if your own council members are being critical of you, that is a situation where I am no longer helping."
He defended his decision to support the chief medical officer, although many members feel this put the BMA too close to government. "The BMA is always seen as a bit of the establishment. There will always be members who say the BMA isn't doing enough."
David Pickersgill, treasurer of the BMA, said that the letter reflected the association's agreed position of working towards a pragmatic solution for this year. But its tone failed to reflect the anger being expressed by members, particularly junior doctors.
"It was felt to be insufficiently sensitive and has led to a loss of confidence in the chairman," he said. "The BMA continues to be the robust voice of doctors, with renewed determination to engage with its grass roots. We remain resolved over the next days and weeks to get junior doctors' training right—for their sakes and those of their patients."
The BMA will now consider the process for electing a new chairman and the interim arrangements that need to be put in place.
Commenting on the news, Conservative health secretary, Andrew Lansley, said, "I'm sorry that Jim Johnson has felt he has to resign. This shows the depth of anger there is in the medical profession over the shambles made of medical training, but the prime responsibility lies with the Department of Health. That is why last week I called on Patricia Hewitt to resign. We have to rebuild confidence in medical education and training."
Gill Morgan, chief executive of the NHS Confederation, said Mr Johnson had been a real leader at the BMA.
"His approach was to make the BMA part of the solution, not the problem. His resignation is a loss to the BMA. It is a great pity that its membership does not recognise and appreciate his style of working and many talents."
