David Ernest Bolt
Authors: T. Grabham
Journal: BMJ (2002)

Former BMA president and negotiator who saved private practice within the NHS

David Bolt was, without doubt, one of the best loved and most effective medical politicians of his generation. He trained in surgery and in 1960 was appointed consultant to the West Middlesex Hospital, where he rapidly developed a reputation as a kind, caring, and competent general surgeon. He also consulted privately for some time from his rooms in Harley Street, but was never as comfortable in this scene as he was in his beloved “West Mid.”

A keen supporter of the BMA, he joined the central committee for hospital medical services (CCHMS) in 1970. His character and style were not those of the typical medical politician, in that he always exuded an aura of genuine sincerity and intellectual honesty. He also appeared to have a complete absence of personal ambition.

In politics one meets many that are effective political performers and many that are good, kind, and sincere men. But David combined all these qualities, day in and day out. His ability led to his rapid elevation to the deputy chairmanship of the CCHMS, where he became part of the then notorious negotiating team of Grabham and Bolt, often called “the hard man and the soft man.”


At that time the consultant body was becoming increasingly dissatisfied with its terms and conditions of service. There was widespread demand for a new contract that was more work sensitive and more rewarding. In 1974 the Wilson government came to power bringing with it proposals to change the consultant contract to favour full timers over those part timers who did private work. In 1975 it published proposals to phase out private beds within NHS hospitals. This was vigorously rejected by the CCHMS as it was seen to challenge the original compact between Aneurin Bevan and the profession at the inception of the NHS. 




The battle lines were drawn and neither side was prepared to give way.

It was David Bolt who provided a simple but effective compromise. If, in any district, there were adequate private facilities outside the NHS, then the NHS private beds would be phased out. If, however, the private facilities outside the NHS were inadequate, then private beds within the NHS would remain.

Lord Goodman, acting as mediator, fastened on to David's suggestion, and envisaged how the private facilities might be preserved in a small town such as Cullompton in Devon, which incidentally did not actually have a hospital. Nevertheless he developed David's proposals into what was called the “Cullompton principle,” which subsequently became the heart of the Medical Act of 1976.

David's typically reasonable approach had produced a compromise that both greatly favoured the profession and also saved private practice within the NHS.

David subsequently became a successful chairman of the CCHMS and the conduct committee of the General Medical Council—where he only rarely gave the impression of being asleep during the long afternoon sessions. He was honoured by the BMA and became its vice president in 1983, and its president in 1987.

It has become customary for obituaries to reveal something of the subject's weaknesses. If David had a darker side, it was never seen in all his years at the BMA. The only possible flaw that he ever revealed, and for which he was teased, was a propensity to split infinitives. He also relished the smoke filled rooms of BMA house, occasionally contributing more than his fair share from his ever present and well loved pipe.

By an extraordinary coincidence David died at the Castle Valley Centre in Cullompton. Predeceased by his first wife he leaves two daughters, Caroline and Angela; and his second wife, Joan.

David Ernest Bolt, former consultant surgeon; b 1921; q Bristol 1945; FRCS; died after a long illness on 21 March 2002.