The trade union role of the BMA in the National Health Service
- Introduction
- National negotiations
- Local negotiations
- Individual and collective representation in the workplace
- Local representatives
- Trade Union influence
The BMA is a voluntary association of doctors founded in 1832 'To promote the medical and allied sciences and to maintain the honour and interests of the medical profession'.
Today the BMA is the voice of the profession in continual contact with ministers, government departments, members of both Parliaments, the National Assemblies and many other influential bodies. Through these contacts and through the media the profession’s collected views and policies are promoted. The Association has a long history of providing ethical guidance and of campaigning on health and related issues.
In addition, the Association has always represented its members’ interests in developing and maintaining their terms and conditions of employment. In 1971, the Association was registered as an independent Trade Union and is 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, the Association has been formally recognised for collective bargaining purposes within national negotiating machinery and by individual employers at local level. This status enables the Association and its 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 the Association submits evidence to the Review Body.
Other NHS conditions of service are agreed between the Departments of Health and the Association, which has sole bargaining rights in respect of all employed doctors in the NHS, whether or not they are members of the BMA. Members and officers of the BMA central craft committees sit on Joint Negotiating Committees for the different groups of doctors and the central craft committees also produce information and guidance on the implementation of the national agreements.
Local negotiations
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 themselves 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, the Association introduced Local Negotiating Committees (LNCs) and these are now established in almost all NHS organisations which employ doctors.
LNCs consist of local representatives of doctors (and dentists) employed by the organisation who will meet regularly to identify issues for negotiation with local management and agree their objectives. They will meet with management representatives in the Joint Negotiating Committee in order 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 (e.g. Joint Consultative Committee, Health and Safety Committee) and work with other trade unions in areas of common interest within the organisation.
.
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 crafts employed by the organisation(s) concerned and equality of opportunity will be ensured. The LNC will, therefore, potentially include:-
- Consultants
- Staff and Associate Specialist doctors
- Doctors in training
- Salaried GPs
- Dental staff representatives
- Medical Academics
- Public Health doctors
- Community Health doctors.
Members of the Committee who are BMA members will be accredited as local representatives by the Association (see below)The Committee will appoint a chairman and vice-chairman and may appoint a secretary. These appointments should also be for a fixed (renewable) period of not more than two years.
The Committee should itself meet regularly and should meet with management normally at least every two or three months. Minutes of meetings should be taken and the LNC will ensure that it communicates effectively with the medical staff and that, in particular, regular reports are made to the Medical Staff Committee.
Provided that the majority of members are BMA members and the constitution complies with the above guidance, the Association will accredit the LNC as a representative Committee. That will ensure the 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 support from the Association.
The Association will 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
Whilst initial advice is increasingly available from the askBMA helpline, support and representation for BMA (and in certain instances, BDA) members in the workplace is provided by Regional Services staff. Industrial Relations Officers or Assistant Secretaries, Senior Employment Advisers and Employment Advisers are expert in employment law and NHS working arrangements and work from a network of offices in England, Scotland, Northern Ireland and Wales. 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. IROs and Assistant Secretaries in particular will play a key role with Local Negotiating Committees.
In common with other Trade Unions, the Association also accredits members to act as local representatives within employing organisations. Local representatives are appointed from amongst the members they will represent, so their role is confined to a particular geographical location and/or craft 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 may 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
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 regional services staff.
- Providing a first point of contact for members with an individual query and ‘sign posting’ them to the appropriate resource.
- Accompanying and supporting members in their dealings with local management.
- Co-ordinating group discussions with local management which are not appropriate to the LNC.
- Attending Local Negotiating Committee meetings.
- Representing the Association on other local committees eg. Joint Consultative Committee, Health & Safety Committee as required.
- Promoting the interests of the Association and the members represented and recruiting members to the Association.
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 Association.
- Exceptionally, at the discretion of the Regional Manager/Deputy National Secretary following consultation with the Chairman of the LNC and/or the Chairman of the relevant Craft Committee
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 the position of the organisation, certain important requirements, e.g. in relation to ballots, have to be met and the Association’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 the Association 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 much can be achieved at both national and local level.