It is a welcome change to hear common sense emanating from the British Medical Association (BMA). I should declare that I cancelled my BMA membership shortly after qualifying as a doctor. To my mind at the time, the organisation had rountinely failed to do what it should, i.e. stand up for doctors’ best interests. Not only that, their regular pronouncements on the state of the NHS appeared wedded to the original, out-dated, Socialist ideal. More importantly, by being both left wing and a poor advocate for the medical profession, I believed that the BMA was not serving patients’ best interests.

Recently, with the MTAS debacle, there has been more evidence of their ineffectual performance. It took doctors themselves to whip up support for resistance to the government’s imposition of the disastrous system before the BMA came belatedly on side. So today, I was very surprised to read that the BMA, having vocally supported doctors’ militancy, have now advocated a policy on NHS provision in this country that I can honestly support. To date, the BMA and its numerous committees, had a left wing ‘air’. Not anymore. For they have announced that they would support a slimming down of services offered under the NHS, i.e. rationing of care. For the BMA to be advocating such a radical move illustrates how acute the problems are in the NHS.

Britain has an ageing population and an increasing appetite for medical intervention. We all expect more from our health service than did our grandparents. That stoical generation are now few in number, and have been replaced by people who want and expect more. Ask any doctor about patient demands and you will get the same response: “increasing greatly”. The likely consequence of this justifiable expectation is a rationing of services provided by the NHS. In effect, it will become an acute service combined with specialist treatment of ‘major’ conditions.

The trouble with this conclusion are the political ramifications. Try being an MP in a constituency where only ‘necessary’ services are being provided by the local hospitals. Not many votes to be had there I suspect! And that is the problem. It is easy for the BMA to call for a slimming down of the NHS healthcare provision for their leaders are not elected on the basis of NHS performance. Unfortunately, politicians of all persuasions still are affected by health issues. Until healthcare provision in this country is depoliticised (by, say, creating the independent health board that the BMA suggests), the changes necessary to maintain an acute health service that benefits all in this country will not be made. The NHS needs tough medicine to cure its ills. If it does not take it soon, I fear its life expectancy will shorten.