In the meantime, the association itself had been undergoing huge change. When the era of cooperation began in 1949, the profession was still represented by a loose confederation of basically autonomous branches of a British organisation. The powers and responsibilities of each level of the organisation in Australia were defined, limited and accepted only in a kind of gentleman’s agreement. Over the preceding 40 or 50 years, the association and the profession at large had faced huge change in health policy in Australia and, most importantly, with the way in which government structures had developed in Australia to put this change into place. More change was on the way. From time to time since the 1890s, events such as the parent body’s handling of matters in Australia had set off much talk among branches and members about whether or not a professional medical organisation was needed that could act and react more flexibly, more independently, than one that was but one branch among others of a parent body on the other side of the planet. By 1936, the ties between the parent BMA and its Australian branches were still close enough that the parent in London was putting £1,000 a year towards the secretariat and other expenses of the Federal Council in Australia.
In its eighth meeting in August 1937, a decision by the Council to reappoint Dr Hunter as General Secretary led to a general discussion about the organisation of the medical profession in Australia. This in turn led to the Council’s deciding that Dr Newman-Morris, one of the two Victorian delegates, form a committee with Dr Hunter that would “draw up a proposal, for submission to the Branches, for the formation of an Australian Medical Association”. In a draft proposal for the committee, the Council said that it had become increasingly apparent that the organisation of the profession in Australia “is impeded rather than assisted by reason of the fact that the work is carried on under the Memorandum and Articles of Association of the British Medical Association. This involves frequent reference of important matters for decision to London, and the transference of large funds which are required in Australia. The Federal Council therefore is of the opinion that the time has arrived to explore the possibility and desirability of forming an Australian Medical Association affiliated to the British Medical Association, and refers the matter to the Branch Councils for consideration.” The Council resolved that Drs Morris and Hunter should outline a draft constitution of an AMA for a later meeting.
The next meeting of the Council was in February 1938. Delegates discussed the committee’s report (which had also been circulated to all the branches). They decided that the Federal Council – “realising by experience the need of complete autonomy and powers for regulating the actions and promoting the interests of the organised profession in the Commonwealth”– should urge the BMA Central (parent) Council to consider amending the BMA’s Memorandum and Articles of Association and by-laws “so as to give the organised profession in Australia full autonomy”. They also resolved to authorise Dr Victor Hurley (who was going to the UK as a representative of the Victorian Branch to the 1938 BMA Annual Representative Meeting) to discuss the issue with officials of the parent body. His report on his discussions was tabled at the Council’s meeting in December 1938. At that meeting, it was decided to ask the views of the branch councils about the desirability and extent of altering the Federal Council’s Articles of Association “with a view to obtaining greater autonomy (for it), than at present possessed”. The Council also resolved that it was “of opinion that, in order effectively to organise the BMA in Australia, the fullest possible executive powers be given to the Federal Council, and that the Branch Councils be requested to indicate if such executive power be desirable”.
Finally, at a meeting in September 1959, the Council decided that “the time is now opportune to proceed with the formation of an Australian Medical Association, independent of but affiliated with the British Medical Association” and that its opinion “be forwarded with a request that the views of members be obtained”. Its decision was circulated to the branches with a statement on five pros and two cons in forming such an autonomous body.
Under the heading “Advantages”, the statement listed that:
“Complete autonomy of the medical profession in Australia would result; decisions of procedure and action deemed advisable for the organised profession in Australia would lie with a body composed of Australian elements, fully equipped with the knowledge of local conditions and problems;
On the financial side, the present BMA overseas subscription would no longer need to be paid to the Parent Body, ie, an amount of approximately £25,000 would be retained in Australia. However, it is impossible to forecast at this stage the probable saving, if any, likely to accrue from this to the individual member, as undoubtedly in the setting up of a new association there are bound to be some initial and unforeseen expenses;
In the field of medico-political negotiations, it is believed that the importance of such negotiations in future will increase and although in the past the name of the British Medical Association has always carried with it the great prestige and high esteem it so rightly deserves, it is nevertheless felt that a purely Australian association, with the full representation of the Australian medical profession, would have an even stronger and greater part to play.”
The disadvantages were that:
“The effect of disruption of the close and traditional ties which have existed with the British Medical Association for such a long period, and the very real sentiment attached thereto, needs to be carefully considered. However, as has been evidenced in the case of other medical associations of Commonwealth countries, particularly Canada and South Africa, close affinity and affiliation with the BMA has been shown to be possible and, in fact, none of the existing attachments of friendship and cooperation with the Parent Body needs to be lost;
Members of a Medical Association of Australia would no longer routinely receive the British Medical Journal but for those members in Australia still wishing to receive this Journal, a separate annual subscription of two guineas would provide same.”
Dr Ross-Smith has pointed out that the idea of a national association caught on with remarkable speed. The MJA reported in a November 1959 issue that it was “hastened by a rather more rapid (even startlingly sudden) appreciation of the fact that leaders of the Association in England had no objection to such a move and indeed considered it overdue”. In fact, the Canadian Medical Association had been born as far back as 1867, the Medical Association of South Africa in 1947 and the associations in India and Pakistan in 1950.
With the branches’ unanimous agreement, the Council decided in February 1960 to start straight away drawing up a constitution for the new national association. “A steering committee, composed of the four NSW representatives on the Council, was duly appointed for this purpose,” Dr Ross-Smith says, “and the committee was directed by the Council, in formulating the constitution, to make every effort to maintain unity in all branches of the profession in Australia. This concept of unity of the profession was actively pursued, and not only the six BMA branches but, in addition, all nationally organised medical societies and organisations, totalling 30 in all, were consulted about the constitution. The splendid work of the steering committee culminated in a National Convention of representatives of branches, the Royal Colleges and other nationally organised medical bodies in Sydney, on November 26 and 27 1960 for the purpose of discussing a Draft Constitution.
“The Federal Council, having virtually received a vote of confidence at the Convention, proceeded immediately to finalise the Memorandum and Articles of Association, which was adopted in final form on June 10 1961,” Dr Ross-Smith reports. The Australian Medical Association was then duly registered in Canberra, ACT, on October 25 1961 and, from January 1 1962, it commenced to function, with the six former State BMA Branches becoming Branches of the Australian Medical Association.”
Dr Ross-Smith says that a close link was retained between the AMA and the BMA, “as evidenced by the signing of an affiliation agreement, designed to work to the mutual advantage of members of both Associations”, and that a large number of AMA members had shown their desire to keep in touch with the British colleagues and British medicine by continuing as overseas members of the BMA. The first AGM of the new organisation took place in May 1962 at The University of Adelaide – fittingly, in the State that had played such a significant part in the history of medical organisation in Australia. Prime Minister Menzies opened the meeting, having been made the first honorary life member of the AMA. Sir Henry Newland, President of the old Federal Council, installed Dr Cecil Colville as the AMA’s first President. Sir Douglas Robb, President of the parent BMA, presented Dr Colville with a gavel made from a mulberry tree in the garden of the BMA’s then national office in London (in what had once been the home of Charles Dickens). The other first office bearers in the new AMA were: Vice-President Dr Angus Murray (NSW), Chair of the new Federal Assembly Dr LR Mallen (SA) and Treasurer Dr WF Simmons (NSW). The AGM concluded with a standing ovation for Dr John Hunter, who was retiring at the end of 1962 after 20 years as General Secretary of the Federal Council. Dr Hunter, Dr Colville said, “more than any single person, was responsible for the success of the fight . . . against the Chifley Government in its attempt to place a galling yoke of subservience on the necks of the members of the medical profession”.