O’Donnell saw the imposition of the ARF as an opportunity to reform an institution which he claimed was undemocratic and unrepresentative. Only 11 of the GMC’s 46 members were elected. The others were appointed by the Universities, Royal Colleges and the Privy Council. All were white and only one was a woman. The council, he wrote, often gave the impression that it represented 'a medical establishment uninfluenced by or accountable to workaday doctors.' And the arbitrary way it instituted disciplinary proceedings led 'some doctors — not all of them paranoid — to wonder whether the decision to prosecute is sometimes less arbitrary than selective … more indulgent to patricians than to proles.' O’Donnell suggested doctors should not pay the new fee until the GMC was reformed. The campaign for reform was taken up by the Junior Hospital Doctors Association (JHDA) a breakaway group from the BMA formed by hospital doctors below the rank of consultant.