We are your voice - in continual contact with ministers, government departments, members of both Parliaments, the National Assemblies and many other influential bodies.
Through these contacts and the media we promote the profession's collected views and have a long history of providing ethical guidance and of campaigning on health and related issues. And we have always represented our members' interests in developing and maintaining their terms and conditions of employment.
In 1971, we were registered as an independent trade union and are currently included on the list of trade unions maintained by the Certification Officer in accordance with the Trade Union and Labour Relations (Consolidation) Act 1992.
Since the inception of the NHS, we have been formally recognised for collective bargaining purposes within national negotiating machinery and by individual employers at local level.
This status enables us, and our representatives, to benefit from rights under the legislation, including those relating to:
- the provision of information
- the right to be consulted on proposed changes
- involvement in collective bargaining
- representation of members individually and collectively
- facilities and time off work for its representatives
National pay scales for medical staff employed within the NHS are determined by ministers in the light of recommendations of the Doctors' and Dentists' Review Body. Each year we submit evidence to the Review Body.
Other NHS conditions of service are agreed between the Departments of Health and the BMA. We have bargaining rights in respect of all employed doctors in the NHS, whether or not they are members. Members and officers of our branch of practice committees sit on Joint Negotiating Committees and also produce information and guidance on the implementation of the national agreements.
Until 1991 when NHS Trusts were established, all NHS-employed medical staff were subject to national terms and conditions of service. Most NHS employers, however, are now able to determine the pay and conditions of service for all their staff, except doctors in training who remain subject to nationally-negotiated terms and conditions. As a response to this local freedom, we introduced local negotiating committees (LNCs) and these are now established in almost all NHS organisations that employ doctors.
LNCs consist of local representatives of doctors (and dentists) employed by the organisation. They will meet regularly to identify issues for negotiation with local management and to agree their objectives. They also meet with management representatives in the Joint Negotiating Committee to conclude and monitor the application of local agreements and agree and monitor arrangements for the implementation of national agreements within the organisation.
The LNC will also usually nominate BMA representatives for other joint committees (eg Joint Medical Consultative Council, Health and Safety Committee) and work with other trade unions in areas of common interest.
The constitution should be agreed locally by the medical staff to whom the LNC should be accountable. Membership of the committee must be open to representatives of all branches of practice employed by the organisation(s) concerned and equality of opportunity will be ensured. The LNC will, therefore, potentially include:
- staff and associate specialist doctors
- doctors in training
- salaried GPs
- dental staff representatives
- medical academics
- public health doctors
- community health doctors.
A BMA industrial relations officer (IRO) will also be a member of the committee and, where salaried GPs are represented, the Local Medical Committee (LMC) will be entitled to send a representative. Members of the committee who are BMA members will be accredited as local representatives (see below).
The committee should itself meet regularly and meet with management at least every two or three months. Minutes of meetings should be taken and the LNC will ensure that it communicates effectively with medical staff and that regular reports are made to the Medical Staff Committee.
Provided that the majority of LNC members are BMA members and the constitution complies with the above guidance, we will accredit the LNC as a representative committee. This will ensure entitlement to the benefits of being a recognised trade union set out in the legislation and any national and local agreements. It will also ensure that the committee receives our support.
We provide training and information for chairmen and members of accredited LNCs and will establish an LNC forum in each region and devolved nation. LNCs will nominate a representative (normally the chairman) to the forum, which will provide a focus for the exchange of information and development of a consistent approach to issues where this is important. Regional Services staff will also maintain a database of local agreements.
Individual and collective representation in the workplace
While initial advice is available from our advisers, support and representation for members in the workplace is provided by Regional Services staff. Industrial relations officers (IROs) or assistant secretaries (ASs), senior employment advisers and employment advisers are expert in employment law and NHS working arrangements and are based throughout the UK. They will be familiar with local agreements in their area and will seek to establish sound working relationships with local NHS managers, particularly those with medical staffing responsibilities.
In common with other trade unions, we also accredit members to act as local representatives within employing organisations. Local representatives are appointed from the members they will represent, so their role is confined to a particular geographical location and/or branch of practice group.
Employment legislation provides some significant rights for local representatives of recognised trade unions. Most significantly, they are entitled to paid time off work to undertake their industrial relations duties and undergo training. They may take further time off for other union activities and also have additional rights under local agreements on trade union recognition and facilities for local representatives.
Employers are obliged to consult with and provide information to recognised trade unions and this will often be through the local representative. Such representatives are also protected against victimisation arising out of their trade union role.
Local representatives will be required to act in accordance with BMA policy and their responsibilities will include:
- acting as a channel of communication between members and Member relations staff
- providing a first point of contact for members with an individual query and 'signposting' them to the appropriate resource
- accompanying and supporting members in their dealings with local management
- coordinating group discussions with local management that are not appropriate to the LNC
- attending LNC meetings
- representing the BMA on other local committees, eg Joint Consultative Committee, Health and Safety Committee as required
- promoting the interests of the BMA, the members represented and recruiting new members.
It is important that local representatives have the confidence and support of their constituency. While a formal election might not always be necessary, their proposed appointment will be widely publicised amongst the constituency.
Appointment arrangements will be overseen by the IRO or AS and where one or more alternative nomination(s) is received, a ballot will be organised and only those members in the constituency will be eligible to vote. The period of appointment will parallel that of the LNC Chairman (ie normally two years, renewable) and the IRO or AS will arrange to notify the appointment to the employer.
Such accreditation will be withdrawn:
- on resigning the position or leaving the employer or the constituency
- at the request of a majority of the members represented
- on the expiry of the period of appointment, unless re-appointed
- on ceasing to be a member of the BMA
- exceptionally, at the discretion of the Regional Manager or Deputy National Secretary following consultation with the Chairman of the LNC and or the Chairman of the relevant branch of practice committee.
We will provide induction and updating for local representatives and they will be eligible to attend negotiating skills courses and other relevant training events that we organise.
Trade union influence
The ultimate sanction available to employees in dispute with their employer is to take industrial action. To comply with industrial relations legislation and protect our position, certain important requirements, eg in relation to ballots, have to be met and the BMA's bye-laws carefully and clearly set out the manner in which such procedures might be authorised.
The idea of taking such action is a difficult one for many doctors and it is not easy to envisage circumstances in which we would encourage it. Nevertheless, experience shows that medical staff, acting together in the best tradition of trade unionism, remain a powerful and influential force through which a great deal can be achieved at both national and local level.