Doctors’ leaders hit out at hospital funding proposals
pharmafile | September 21, 2009 | News story | |Â Â NHS, hcÂ
The British Medical Association has hit out at health secretary Andy Burnham's ideas to link hospital funding to measures of patient satisfaction.
The health secretary last week gave a speech to the King's Fund thinktank setting out plans for the NHS over the next ten years.
"It will, of course, be a very different decade than the last. In 1999, the big challenge was to get more people through the door; today, it is all about the quality of what they get once inside," he said.
One initiative to address this challenge will see new financial framework will be put in place that links payments to levels of patient satisfaction.
But doctors' leaders were critical of how this will be implemented.
"The overall benefits of treatment on a patient's health are more important than factors such as the distance of the car park from the ward," said BMA chairman Hamish Meldrum.
While rewarding quality is a "laudable aim", he is worried that hospitals and their staff may be penalised for things beyond their control.
Steve Barnett, chief executive of the NHS Confederation, was also concerned, saying that greater clarity was needed about what the idea means in practice.
Like Meldrum, he pointed out that payment structures are only one element of any solution on care quality.
"Commissioners of services may be limited in their ability to move services swiftly to alternative providers where there is clear benefit to patient care and value for money for taxpayers," he added.
But Barnett welcomed the broad idea that healthcare providers' payments "should better reflect patient experience and staff satisfaction".
King's Fund chief executive Niall Dickson warned that any measure "does not, for instance, hamper poorer performing hospitals' ability to progress".
GP allocation rules to change
Burnham also signaled that the rules on GP allocation would change, meaning patients would no longer have to use the GP near where they live.
The BMA foresees massive problems with this.
"Abolishing practice boundaries would mean a major change in the way GPs and other healthcare staff provide their services," said Meldrum.
Home visits would be more difficult and expensive for the NHS in future, he warned, while rural and suburban practices could close if too many patients opt for practices in urban areas where they work.
But Dickson said the restriction on where patients can register "is an anachronism and the government is right to sweep it away".
"There are details to be worked out, but it should not be impossible," he added.
Burnham also wants a multi-year tariff for the NHS, to "give the NHS certainty and a longer run at the challenge" of finding cost-savings over the next few years, he said.
Clinical quality, patient safety and patient satisfaction would be the key measures of success for the NHS going forward, he concluded.
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