Doctors express serious doubts about health reforms
pharmafile | October 1, 2010 | News story | Sales and Marketing | BMA, NHS, healthcare reform, reform
The government’s plans for radical reform of the NHS has come under attack from doctors’ association the BMA, which says many proposals could be damaging to the health service.
The criticism is contained in the BMA’s formal response to a consultation on the White Paper ‘Equity and Excellence: Liberating the NHS’ which was unveiled in July. The response is a clear shift away from the BMA’s initial response, which broadly welcomed the reforms.
The BMA says it supports the devolving of control to patients and frontline clinicians, and a stronger focus on public health, but warns these would be undermined by changes which would accelerate a market-based approach.
At the heart of the White Paper are plans for GPs to take charge of deciding how budgets are spent through commissioning. The BMA says this will only be a success if other clinicians, such as hospital consultants, are also brought into the process, and if there is meaningful engagement with the public and patients. It also says consortia must have sufficient management and administrative support to take on the additional responsibilities.
But it warns that plans to encourage further competition in the NHS – such as extending choice to “any willing provider” and giving the foundation trust regulator Monitor a duty to promote competition – would risk shifting the focus onto cost rather than quality, and would undermine opportunities to work more collaboratively across primary and secondary care.
“There are proposals in the White Paper that doctors can support and want to work with. But there is also much that would be potentially damaging,” says Dr Hamish Meldrum, Chairman of Council at the BMA. “The BMA has consistently argued that clinicians should have more autonomy to shape services for their patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency.
Meldrum said doctors wanted to build on the founding principles of the NHS, and to improve services despite the financial squeeze, but said they could only succeed if they were permitted to work “in partnership with others in a co-operative environment.”
The BMA also suggests the scale and speed of the reforms do not take into consideration the size of the task, and the financial squeeze already facing the health service. It says it questions whether the aims of reducing bureaucracy and empowering clinicians could have been achieved through “less disruptive structural change.”
The BMA response also:
-
- says protection of national terms and conditions is essential to ensure an equitable spread of staff across the UK
- supports the reduction in top-down NHS targets, but calls for greater clinical input into the proposed new outcomes framework
- expresses serious concerns about the determination for all trusts to have foundation status by 2013-14
- questions whether there is any evidence that significant numbers of staff wish to work in social enterprises, and urges caution in changing the ethos of NHS provision
- expresses support for the elimination of unnecessary bureaucracy but says it would be wasteful to delegate inappropriate management tasks to clinicians
- insists on a national approach to education and training
Related Content
Digital mental health technologies – a valuable tool in supporting people with depression and anxiety
The potential benefits of digital mental health technology for managing depression, anxiety and stress, together …
A community-first future: which pathways will get us there?
In the final Gateway to Local Adoption article of 2025, Visions4Health caught up with Julian …
The Pharma Files: with Dr Ewen Cameron, Chief Executive of West Suffolk NHS Foundation Trust
Pharmafile chats with Dr Ewen Cameron, Chief Executive of West Suffolk NHS Foundation Trust, about …
