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Hamish, take a bow

Hamish Meldrum talks about his five eventful years as BMA council chairman, and swapping Lansley and Johnson for Gilbert and Sullivan

When Hamish Meldrum took up the post of BMA council chairman, the medical profession was facing some tough challenges.

Training shake-up MMC (Modernising Medical Careers), the associated debacle that was MTAS (medical training application service), ongoing concerns about privatisation, and attacks on terms and conditions were among the issues in his in-tray.

Little did anyone realise that many of these — although still ongoing — would be eclipsed by other worries. At that time, the infamous Health and Social Care Act reforms were but a twinkle in the eye of the then opposition health secretary Andrew Lansley, while no one imagined that attacks on doctors’ pensions would lead to the profession voting to take industrial action for the first time in almost 40 years.

‘I became chairman of council the day after Gordon Brown became prime minister, the same day as Alan Johnson became health secretary,’ Dr Meldrum says. ‘I remember when he — Alan Johnson — rang me. He asked if we should have a bet on which of us would last longest in the post. I said “I hope I last longer than you”.’

Perhaps he should have taken that bet; Mr Johnson served less than two years as health secretary, whereas Dr Meldrum has just completed the maximum five years as BMA council chairman. Aged 64 (two months older than the NHS itself, he jokes), last year he also retired from the general practice in Bridlington in east Yorkshire where he had been based for most of his working life.

Chance decisions

Given that Dr Meldrum’s devoted so many years to medicine, it’s surprising to find he entered the profession almost by chance.

‘I’m not one of these people with an overwhelming burning desire that said “I must go and heal the sick”,’ he says. ‘But I had an older brother doing medicine, and there was nothing else I wanted to do more.’

Nevertheless, he enjoyed his six years studying in Edinburgh (among his other achievements, he represented the university at athletics), and probably would have stayed there had circumstances not intervened.

In the event, after completing his junior house jobs, he moved to Torquay.

‘It was fortuitous, because that’s where I met my wife,’ he laughs.

It also brought his first brush with medico-politics. He was mess president in 1975, when juniors took industrial action over pay and conditions — although his hospital voted not to join the action.

Political engagement

At around that time, Dr Meldrum decided to leave hospital medicine and become a GP.

‘There were a couple of reasons: I was struggling to get my Royal College of Physicians membership, and had a young family [he now has three children and three grandchildren]. And general practice looked very attractive; these were the “golden years”.’

The family packed up and moved to the seaside town of Bridlington, where Dr Meldrum joined a practice with a broad remit, including providing maternity care and minor surgery. The year after he arrived, he joined the local medical committee.

It was really the reforms of former Tory health secretary Kenneth Clarke (under prime minister Margaret Thatcher) that engaged him more deeply.

‘I didn’t like the idea of fundholding, and felt that I could carry on whingeing about it, or I could try to do something about it,’ he says. ‘So I stood for what was then called GMSC [now the BMA GPs committee] in 1991, and have been a member ever since.’

Tumultuous time

After becoming GPC joint deputy chairman in 1999, he was elected chairman in 2004, before taking on the council chairmanship in 2007. And it has, he admits, been a tumultuous few years.

‘I suppose juggling your commitments between home, practice and the BMA is one of the toughest challenges,’ he says. ‘I also became chairman at quite a difficult time.

My predecessor had resigned, and the problems with MMC and MTAS meant that some juniors were losing confidence in the BMA. It was a low point; my job was to build bridges and rebuild confidence.’

Membership of the organisation has risen again under his tenure, and he can also point to other achievements — such as BMA success in the judicial review over GP pensions in 2008, rising profits in the BMJ group, and, he laughs, ‘the new BMA website — that really was a challenge’.

There is, however, no getting away from the fact that much of the emphasis in the past few years has been on England’s health reforms and the pensions battle.

Harder stance

The two issues have caused heated debate (to put it mildly) in the profession. Leading the organisation when members are holding widely divergent views could at times be tough.

Dr Meldrum faced particular criticism from those who felt the BMA should have taken a harder stance over the Health and Social Care Act and opposed it outright from the start.

‘There were those who thought we should just say absolutely no,’ he says. ‘But I think that the stepwise way we built up opposition — from being critically engaged, to suggesting amendments, to outright opposition — was the right thing to do; the timing was right.’

There was a danger, he adds, that the BMA would have been sidelined had it not engaged with the white paper — a document which, he says, took everyone by surprise in terms of the sheer scale of the proposed reforms. We knew that Andrew Lansley wanted to give budgets to GPs but thought it would be fundholding mark two.

We didn’t think it would involve such wholesale reorganisation,’ he says.

The bill that followed was ‘even more mad’, he adds.

Unenviable position

This, of course, was quickly followed by the ongoing pensions dispute, which led to doctors voting to take industrial action. Dr Meldrum found that particularly hard, he says.

‘It was always going to be difficult for doctors to take action, because if they take action which has an impact on the government, it will have an impact on patients,’ he says.

‘It was certainly one of the hardest things I’ve faced. I don’t think anyone wants to go down in history as the person who led doctors out on [industrial action] for the first time in 40 years.

‘It was difficult for me personally as well. The Daily Mail came and took pictures of [my] house to make it look like I was living in this big detached place; they didn’t write that it’s split in two and we only have the ground floor.’

Enjoyable challenge

Dr Meldrum says it took him a long time to admit to himself that he enjoys a challenging life. And although he has retired officially, it’s not likely that he’ll be giving up work altogether.

‘I have various ideas,’ he says mysteriously. ‘But I’m not going to be involved in the BMA. I don’t want to be a ghostly figure saying “I’d have done it that way”.’

He and his wife hope to spend more time travelling, particularly in France, and enjoying their new life in Edinburgh, close to their youngest grandchild, Jacob, who was born seven weeks ago.

And, just to make sure he doesn’t get bored, Dr Meldrum is hoping to join a choir, ideally one which sings Gilbert and Sullivan. As a bass baritone, he modestly hopes he might find a place in the chorus. On being pressed about which parts he might like, however, he points out diffidently that the Mikado is bass baritone.

Hmm, a daring tale of political machinations, unpopular legislation and threatened executions. Surely for a former BMA council chairman, accustomed to dealing with governments of all hues, nothing could possibly be more satisfactory.