On the way home from the BMA annual representative meeting in 2019 where I was elected deputy representative body chair, I was approached by a BMA rep at Belfast Airport. 

‘I voted for you,’ he said. But he swiftly went on to add he had immediately begun wondering, ‘Oh gosh, what am I putting this poor person through? What am I putting this junior doctor through? Is this the right thing for her?’

It stuck with me. My election had been a bit of a shock. I stood at the last minute because I felt I was the best candidate – the most qualified from an ARM perspective having been involved with the agenda committee for years and knowing the processes and the conference very well.

I thought I could do a good job and it wasn’t lost on me that I was in a number of under-represented minority groups in the BMA and across medical leadership. I was a woman, from an ethnic-minority background, and I was a junior doctor. It surprised me that I was elected but it clearly worried the kind colleague who voted for me. 

It was a tumultuous experience – and has remained so. In 2021, in the midst of a global pandemic, my predecessor and the RB chair stepped down unexpectedly. I was in a position where our articles and bye-laws offered no provision other than for me to step up and do both jobs. So I did. 

It was a worry for me, though. This hadn’t been a career goal for me. But, as a colleague from the GMC where I was working in 2019 told me: ‘Sometimes the best leaders are those who don’t aspire to power.’ On my part, I saw inequalities in medical school, in the NHS and in society and I wanted to make a difference. At that time – and still now – the BMA was the best tool to do that. 

But, the person who approached me at Belfast Airport was right to be worried. This job can be brutal. And in recent weeks and months I have found myself increasingly at the centre of dispute, on the receiving end of judgement or poor behaviour.

When I was elected I stood, as I have repeated in this column for clarity, on a manifesto of challenge, change and communication. I’ve delivered on those things. I’ve made significant, consistent improvement to the ARM for the benefit of the association and members. I’ve constantly challenged and been challenged by individual grassroots members. And I’ve done my best to communicate and be visible. I try to reach out to people, I write this regular blog and I respond to people wherever I possibly can.

But the role has become increasingly challenging as views become more polarised, members’ positions become more entrenched and discourse becomes more difficult. I have been pulled in many directions at the same time and it is not easy. Often, policy gives a structure and a backbone that governs my work but when issues outside policy come up my remit is governed by BMA articles and bye-laws. 

These rules and processes often lead to questions about fairness, and to criticism. Sometimes it ends in people questioning me and my role. But fairness is so often subjective and I cannot campaign for one member’s fairness over another’s. With more than 192,000 members, representation on an individual level isn’t possible.  My role is neutral. Sometimes, unfortunately, members won’t get the answer they want even though I truly am listening.

On most days this role has been a pleasure and a privilege – on fewer days, however, it has been difficult and unpleasant. I always welcome challenges – I’m happy for people to ask me to do things differently and better – but I have had increasingly unpleasant experiences and I would ask people who are challenging to be mindful of the way they are doing that, especially if your request is not a possible one. To leaders – what do you do when you can’t meet expectations?

If you have any views on my reflections about leadership, or want to speak or challenge, you can contact me on [email protected] or @DrLatifaPatel

Dr Latifa Patel is chair of the BMA representative body