Women in leadership positions and elected roles are seen differently to men in similar positions. I know this is an issue that is important to our members. It is important to your BMA too – to me.
I have always seen my role at the BMA – as your representative body chair – as an opportunity to ensure the voice of the membership is amplified as loudly and clearly as possible and also to give members clarity and transparency about their association, to encourage involvement and engagement and to ensure we are advocating for doctors as powerfully as we can. Specifically, I want to represent underrepresented groups better.
This column has often been an opportunity to do each and all of these things. And in this column, I would like to share my experiences as a woman in a senior elected role at the BMA – an ethnic minority, a junior doctor, the first to be pregnant in this role and a new parent, to discuss the BMA’s commitment in ensuring representation is fair and diverse, and to ask you to work with us.
Your BMA is not a building. It is not a board. It is not a council. It is our entire membership – all 195,000 members but we also have thousands of elected members in structures across the UK, whether those are in hospital local negotiating committees, divisions and regional council or the council and branch of practice committees, the list goes on.
We know that our NHS has a culture where discrimination is allowed to flourish – sexism, racism, homophobia, ableism, grade-ism, to name a few. It is unavoidable that some of those behaviours are apparent in the BMA. We are, after all, some of the same people.
When I stood for election as RB chair, I heard lots of comments about me being a woman, a junior doctor, and that I will of course have to resign to start a family and go on maternity leave. I couldn’t possibly be a good candidate for a leadership role – some people concluded: too young – too woman. And they were happy to make these comments out loud.
None of that surprised me because I knew sexism in medicine was rife. And perhaps these people were good at predicting the future, because I am still a junior doctor, and I did indeed become a parent.
However, I hope the membership would agree that I have given this role my absolute best – and I have worked to my best to ensure members are represented. I stepped up 3.5 months into my maternity leave, during a pandemic, during lockdown, when my predecessor stepped down unexpectedly. I took my responsibility incredibly seriously.
On reflection – I made a sacrifice which affected my whole family. My daughter lived in a sling whilst I performed BMA duties. She attended all my meetings with me – I breastfed, I changed nappies, I paced, I lulled her to sleep. I did this not only because of my elected responsibilities – I did this because I knew that any decision I made would affect every woman, or junior doctor, who stood for my position in the future. You see – women are held to higher standards.
However, BMA colleagues were the most supportive of any people I came across. I was actively supported to do my job whilst being a new mum. This went all the way from everyday meetings to the annual representatives meeting where I was supported to breastfeed and have caring responsibilities. I don’t know any other organisation where I could have done this level of job with my daughter with me.
And we now have a specific implementation group – CIIG, chaired by Alex Freeman; a GP, council member and board director, which is dedicated entirely to increasing the representation of women in the BMA.
There has clearly been progress in the culture of the BMA. But we know there is still work to do.
Elected BMA roles are very different to employees. BMA elected roles are akin to our elected MPs though our terms and contingency plans are better. That distinction is important though. There are rights to maternity pay and arrangements in BMA leadership roles. I was made aware of them when I stepped up.
All members are also entitled to support which childcare while attending BMA work. All BMA meetings are hybrid, and we have clear policies on inclusivity and accessibility – every reasonable adjustment is valid and considered. When an elected person in a BMA role steps back, be it owing to sick leave or maternity leave, the contingency plan is for their deputy to take over.
The RB chair, my role, has an elected deputy which means there is someone to step in. This can be a positive, but it also comes with issues. When I stepped up as deputy, I was essentially doing two roles – the deputy and the acting chair role for a whole year, because our articles and bye-laws did not allow for the role to be elected outside of the normal election cycle. Safe to say, some of our governance is outdated.
However, in other roles there are appointed deputies and not necessarily an elected representative to step in. These deputies are appointed by the chair. There are questions about whether appointees have the same delegated authority as an elected representative.
The issue therefore becomes what happens when a committee does not agree with the appointed leadership in place while the elected leadership is on leave. Currently – our standing orders specify that the elected leadership’s confidence is voted on and not the appointees.
And our archaic structures which assume elected members never require leave, never get sick, never go on maternity leave, never need time off – are equally discriminatory to underrepresented members with disabilities and long-term conditions or those with caring responsibilities – a group more likely to need time off. We have asked that our governance considers absence cover and the committee standing orders be reviewed to take account of the possibility of a no confidence vote during a leave of absence.
Ultimately, however, elected members make and vote on changes to our articles and bye-laws and standing orders, so it is within your gift to change them if necessary
I have always been committed to being open, honest, and transparent as your RB chair. There is lots of good work going on at your BMA, but I know that there is a long way to go – and I don’t think we can ever stop trying to address these issues.
If you are concerned about these issues, or any others regarding the BMA, you should ask questions, you should get in touch and, if you can, you should get involved. We are trying to make these changes, but progress always needs fresh impetus.
My advice to you is – get involved, stand, get elected, and help make our BMA, better.
Latifa Patel is representative body chair of the BMA