GPs launch scathing attack on health service reforms
pharmafile | June 16, 2006 | News story | |Â Â Â
Government reforms and targets for the health service have come under a scathing and comprehensive attack from general practitioners, who say much of the NHS's problems stem from political meddling.
Hamish Meldrum, leader of the BMA's general practice committee has lashed out in a speech to the doctors' annual conference, rebutting accusations that GPs are overpaid and attacking the government's continuous reform programme.
"We've had re-organisation in the past, but this government must win the prize for the fastest about-turn in the history of the health service," he said, pointing out that three structural reforms of the NHS since Labour came to power has brought it full circle, with the newly announced system very similar to that it inherited in 1997.
Meldrum took aim at a number of other reforms, including the twin reforms of Practice Based Commissioning (PBC) and Payments by Results.
Practice Based Commissioning allows general practices to have the power to decide how and where patients are treated, giving them the chance to make services more patient-friendly, cut waiting times and potentially save the NHS money at the same time.
The government wants to see all practices involved in PBC by the end of December, but the lack of clear budgets and incentives means many doctors are not taking part.
"While it [PBC] might be fine in principle, in practice in too many areas there are too many barriers to the effective participation of practices. Deficits, a crude inflexible system of Payments by Results, lack of PCT co-operation or an insistence that practices take on so-called referral management schemes that are basically rationing by any other name – it's no wonder that in many areas it just isn't happening."
He warned NHS chief executive Sir Ian Carruthers: "Unless PCTs pull their socks up and start incentivising and co-operating with GPs, they haven't a snowball's chance in hell of meeting the target of universal coverage of PBC by December. Dream on."
Other doctors at the conference criticised reforms, including those that emerged from the White Paper on public health.
Dr Peter Boffa, a GP from Croydon, south London, attacked plans to give health MOTs – check-ups at key times in a patient's life, saying it was merely a vote catching policy.
He said there was no evidence the idea would improve health and that the check-ups could be exploited by people from wealthier backgrounds.
Health Minister Lord Warner replied to the criticism by saying: "I begin to wonder if the BMA read our recent White Paper, which asked GPs to play a central role in achieving our goal of providing patients with more treatment closer to home. "
He added: "We make no apology for pressing ahead with these reforms, as they will bring huge benefits to NHS patients, as well as more satisfaction to the practices which participate."
Meanwhile, Gill Morgan, leader of the NHS Confederation, which represents health service managers, warned of turbulent times ahead.
"It has been a tough year for the NHS. And the next two years will be among the most challenging we have ever had to face," said Dr Morgan.
"Nurses and doctors are not buying into the reform agenda and are worried about deficits and job losses. We cannot ignore the anger and frustration expressed. People don't know where the reform agenda is taking us because we haven't told a compelling story and set out a vision of the health service we want to see," she added.
She said while greater clarity was needed from politicians, NHS managers also needed to contribute by making it clear to patients how services would change.
