Meldrum urges doctors to take leading role in reform

Hamish Meldrum told the BMA's annual conference this week that doctors could keep their principles pure and "cavil and criticise from the sidelines", but that would get them nowhere.

He said: "Alternatively, we can get talking, get involved, get engaged, take a leading role, not with some blind and unquestioning acceptance, but with eyes wide open."

As doctors gathered in Edinburgh, relations with government appeared to be at a low. GPs were still smarting from health minister Ben Bradshaw's comments that practices were operating "gentlemen's agreements" to prevent patient choice.

Against such a background, Dr Meldrum's words on getting involved could be considered conciliatory.

However, the rest of his speech was more critical, particularly of private sector involvement in the NHS. "The BMA wants to see an NHS untarnished by a market economy, true to its beginnings, giving the public a fair, caring, equitable and cost-effective health service," he said. "Not a service run like a shoddy supermarket war."

GP committee chairman Laurence Buckman talked about government "untrustworthiness" over extended hours, pensions and changes to the GP contract.

Independent sector treatment centres were decried for being costly, risking the stability of NHS services and damaging continuity of care.

In a meeting where all manifestations of a marketised health service were voted down, David Wrede, a consultant in Somerset, was practically the sole voice of dissent.

A member of the steering committee of pressure group Doctors for Reform, he said the English NHS was achieving better outcomes in terms of access than the devolved health service in Scotland, which has rejected the market model.

He called for European social insurance models of health service funding to be considered.