I spoke directly to both groups to gather an understanding of whether the experiences of internationally trained, black and minority ethnic members can help improve the BMA’s support provision.

I engaged with current, former members and those who've never been members, plus the BMA staff who provide services and engage with membership. I also explored the support provided by external legal advisors and met with Council members to hear both their reflections on the past and their hopes, aspirations, and intentions for the future, as well as reaching out to focus and interest groups who have a vested interest in the review.

After analysing all my findings, my overall view is that the employment services the BMA provides, specifically the support services, although not perfect, are of high quality, particularly in comparison to a range of trade unions I work with who also provide legal services.

This doesn't mean the quality of the advice and representation which the BMA provides always meets the requirements of its members, but even those I spoke to that reported negative or inadequate interactions recognised elements of good practise. They identified individual members of staff who provided valuable support, both legal, and emotional, signposting members to groups, individuals, and services that can help in difficult times. One thing I was impressed by when I spoke to BMA advisors was that they were acutely aware that when Members reach out for advice and support, they are often vulnerable and need to be listened to, supported, and where possible, reassured.

I did however note an inconsistency in the levels of service that is provided across the BMA. In some regions, members have the benefit of high quality of advice and support whilst in other regions they experience greater challenges. All these doctors were united in their view that the BMA could and should do better.

What I think is a real challenge is that levels of trust and confidence amongst minority ethnic membership is low. Many perceive the BMA as an organisation that is not interested in minority ethnic doctors, feeling that the membership fee is not worth paying unless and until they face a problem that impacts their professional life.

The BMA should be aiming higher: confirming what kind of organisation it wants to be and agreeing on how it’s going to get there. It should be responding to the needs of all UK doctors and ensuring that the richness and the diversity of the whole of the medical profession is properly reflected in its structures.

The recommendations present a real opportunity for the BMA, in terms of our culture and structure, and we recognise that more work is needed to continue to improve the BMA experience for our minority ethnic members.

To highlight some areas for improvement, Ms Omambala KC notes “whilst process improvements have been made it is not clear that they are sufficiently far-reaching to breakdown the somewhat siloed ways of working in this part of the BMA. Members are best served when an organisation is working in an open and collaborative way.” Although there is much good work that takes place every day within the BMA, it is acknowledged that there can be siloed ways of working which are more focused on litigating or ameliorating poor treatment than addressing its underlying causes.

Although areas of improvement have been rightly highlighted, it is important to acknowledge that the expertise and services provided by BMA staff were generally considered as being of high standard, particularly when compared to that of other Unions. This is shown in Ms Omambala KC's conclusion that "Anecdotal evidence from contributors to this Review indicate that the escalation process in respect of standard cases is working well. Although the available monitoring data is limited, there is no indication of a race disparity in the escalation of standard cases brought by minority ethnic members.(para 166)" and that "....the consensus amongst the information provider LSPs is that the quality of the referrals that are escalated to them by BMA advisors is generally significantly better than those from other trade unions (para 155)".

We would like to thank colleagues working in these challenging roles for all the support they provide to members across the UK. This does not, however, mean that we are complacent and will continue to build on good practice to maintain and improve our service provision to minority ethnic members.

Whilst implementing change brings its challenges, the issues and recommendations raised in this report come at an opportune moment for key staff teams who are about to commence a series of changes aimed at bringing the BMA closer to members.

In Member Relations, this will include improving how we interact with membership locally and establishing a holistic view of the workplace environment to address the root cause of problems faced by members. First point of Contact (FPC) will be brought in house, with closer integration into regional and devolved nation staff. We are building a BMA that addresses structural discrimination at work. Ultimately, this will improve things not only for minority ethnic members, but for everyone receiving services from the BMA.

With accountability ultimately sitting with the BMA Board of Directors, I want to assure our membership of our determination to make positive change and build a BMA that our minority ethnic members will be proud to be a part of.