Cuttings

Abstract

It is now surely time for the BMJ to enter the pungent arena of public debate about the National Health Service (NHS) and its institutions. During the summer the rank and file of the British Medical Association (BMA) surprised its sleepy leadership (aka the ever affable Jim Johnson, chairman of the BMA's Council). The medical proletariat rapped their masters' knuckles for ineptitude. They were frustrated that their team had become too cosy with Patricia Hewitt. They called for a “policy of active opposition” to Labour's anti-NHS regime. Johnson advanced the response of one with an eye on the possibility of a knighthood. Listen folks, he intimated, you can't just go along and tell government to drop what it's doing. “You will not be asked back”, he said. Power—so the BMA's leaders believe—depends on access. No access means impotence. Nonsense. Power and influence do not depend on access. They depend on the message and how you put across that message. Do the right research, marshal your arguments effectively, and use the media to make what you have to say understood. That is the way to change policy. You don't need to share a biscuit with Patricia in order to shift government thinking. Disintermediate. Go straight to the people. Which is where the BMJ comes in. The house magazine of British medicine has built up an impressive reputation as an entertaining read. Richard Smith's conflict of interest statements about his pet rabbit were rather wonderful. We enjoyed the strong political polemic about the demise of the NHS, the General Medical Council (GMC), and so on. Exuberant writing. Maverick commissioning. The BMJ was known as a pot-pourri of eccentricity. Although some doctors and academics thought the journal was guilty of whimsy or worse, the BMJ had an undeniable personality. It was bizarre and belligerent all at the same time. Since Smith left, the BMJ has smartened itself up. Doctors in suits will like its reconstituted sobriety. Has something been lost? Edge perhaps. The BMJ has a unique part to play in British medical life. It is the only credible tool we have to hold leaders of the claret-soaked medical establishment to account for their feeble meanderings through the corridors of the Athenaeum. The BMJ should pick up its pen and start doing what BMA members have taken it upon themselves to do—rebel. The BMJ should take apart the BMA, the GMC, and the Royal Colleges. Your readers are on the march. Start catching them up!