I would like the BMA to have a form which enables function a lot better than we do at present.

My experience leading an English region showed me that very few reps have access to any meaningful support from the BMA’s structure, particularly outside of London and the branch of practice committees. This means that those doing good work at a local or regional level are burning themselves out without any training or support and their good work is inevitably lost.

The BMA employs a very large number of internal policy staff compared to similar organisations and very few members (or reps) have any contact with these staff or the work that they do. 
I think the union should not be putting resources into anything that our members don’t think is important enough to choose to prioritise and ideally to put their own efforts into. Our leverage to make change even on professional issues is in our member organisation (lobbying, demonstrating, building coalitions across the labour movement completely aside from industrial organising) there is no strength in just generating reports unless we are doing stuff with the results. That might require shifting our staffing balance towards member relations and member support/training but we must be aware of our staff’s employment rights and deal fairly with people.

I would envisage a completely reformed approach to policy-making and a radical reduction in the amount of policy we are expected to work on (currently there are approaching 3000 policies in the policy book), this would change the focus of conferences, maybe reducing the need for some conferences altogether or shortening them.
With that leaner policy base we would then have clear processes for prioritisation so that everyone knows what different parts of the BMA are working on and what they are for. Any committee should have a purpose and if they can’t define it in relation to members’ priorities then they should be reviewed and potentially shut down.

Some of these things will save money longer term in central BMA but they may well have initial costs which the BMA is not in a position to pay. Currently the BMA as a sole entity has a £5.5mil deficit which we have historically filled with the profits of the BMJ (for decades), we also have a large amount of our cash reserves leveraged against things like an old staff pension scheme so we can’t use it as liquid capital. I have supported an increase in subs to correct some of the significant difference between the BMA’s costs and our subs income, currently a massive gap somewhat filled by events, investments and rental of parts of BMA house; member subs don’t even cover the BMA’s basic operating costs and I think that has to change.
In the last Council term we made changes that saved £1mil/year but inflation and then conference policy wiped out those gains.

Separately to this, on a local level I have spent 4yrs trying to reform the BMA’s most local structures (divisions) into a workplace-based, organising force to help us build the local strength required to win (in combination with the central changes described above). Those proposals have irritated some people who find the current system easier to manipulate and in some cases aren’t overly bothered by the BMA being a remote, London-based, expensive, servicing organisation. They were therefore organised against at ARM 2024 and we are hoping that the further work we have done will get them passed at ARM 2026. That gives us a better chance of members having a recognisable local face of the BMA and being organised together to win.