BMA calls for major amendments to Health Bill
pharmafile | May 26, 2011 | News story | | Health and Social Care Bill, NHS reforms
The BMA says the government should withdraw its plans for health reform completely and go back to the drawing board.
The doctors’ association has responded to a consultation by saying that if this is not possible, the Health and Social Care Bill should at least undergo major changes.
The BMA says the latest feedback from its members in the English NHS indicates very high levels of concern.
In its formal submission to the NHS Future Forum, the body leading the government’s listening exercise on the reforms, the BMA says the legislation represents “an enormous risk” during a time of huge financial pressure for the NHS.
Instead, it recommends changes which would encourage the development of more integrated services, arguing that greater collaboration is more likely to improve quality and efficiency than the current proposals to increase and enforce competition.
It says NHS staff are worried because change is still going ahead, despite the announcement of a ‘pause’ in the legislation. Over 80% of just under 1,000 BMA members who completed a feedback form on the BMA website in May said their attitude to the reforms was either mostly or very unwelcoming. Just over half identified the proposal for Monitor to promote NHS competition as being potentially the most damaging.
The BMA submission to the Future Forum calls for “a more mature form of commissioning”, based on clinical networks of specialists and primary care professionals working together across traditional boundaries, alongside commissioning consortia. The BMA is also today publishing new guidance putting forward examples of possible models for the governance of consortia and advising that, as a minimum, specialists should be involved in the design of patient pathways.
The key recommendations in the BMA’s response to the Future Forum are that:
• The primary role of the economic regulator, Monitor, should be amended to protecting and promoting high quality, comprehensive, integrated services, not promoting competition
• There should be an explicit duty on commissioning consortia to fully involve all relevant clinical staff in commissioning
• National and regional oversight of doctors’ education and training should be maintained, with UK-level workforce planning, and regional quality management continuing to be undertaken by deaneries (the BMA today also publishes a letter to the Future Forum from its Junior Doctors Committee detailing its concerns with the Bill’s impact on doctors education and training)
• There should not be an artificially rigid timetable for all NHS trusts to achieve foundation status, as the current deadline of April 2014 could compromise patient safety
• The Secretary of State’s duty to secure the provision of comprehensive healthcare services for the people of England should be reinstated. Meanwhile his or her powers over the NHS Commissioning Board on appointments, further regulations and its mandate should be subject to explicit safeguards and transparency requirements to avoid unnecessary political interference
• The NHS Commissioning Board should be required to consult with consortia, where changes affect them, before making use of its powers to ensure an appropriate level of freedom
• The independence of directors of public health should be explicitly protected by bringing together all public health staff under a single NHS agency
• Patient consent should continue to be required for the disclosure of confidential patient information
Dr Hamish Meldrum, Chairman of Council at the BMA, said: “The message from doctors is clear and simple – the Bill must be changed significantly, if not withdrawn altogether, if the NHS is to continue to improve.
Dr Meldrum said that while change is necessary, major upheaval was not. He added that more competition would not help the NHS become more efficient, improve public health or tackle chronic illness.
“Increasing and enforcing competition is not the answer – competition is not an end in itself. Instead, we are putting forward recommendations that aim to maximise the potential for positive change in the proposals, by genuinely giving more say to patients and to clinicians at the front line.”
Andrew McConaghie
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