Take NHS away from politicians, say doctors
pharmafile | May 9, 2007 | News story | |Â Â Â
Doctors have put together a list of radical reforms they say will stop the government undermining the NHS in England and fragmenting the care it provides.
They propose appointing an independent board of governors to oversee a written constitution and holding a public debate on what the health service can afford to provide.
BMA chairman James Johnson said: "As the ultimate guardians of the public purse, politicians and parliament should decide the high-order questions around setting priorities and funding. When it comes to the day-to-day running of the NHS, the role of national politics should be significantly reduced."
More independence is needed to give health economies greater flexibility and to increase local accountability he added.
Under the BMA plans, parliament would establish and appoint the NHS Board of Governors who would, in turn, appoint an executive management board to guide the NHS performance and national operation.
An NHS constitution would then enshrine its core values and incorporate new ones, such as support for world-class research and education. It would also contain arrangements to determine what services are nationally available on the health service.
BMA chairman James Johnson said:"If we are going to retain an equitable, universal approach within limited resources, then priority setting is inevitable.
"Politicians need to acknowledge this, and that it happens already, but in a non-transparent and piecemeal fashion."
NHS managers support tackling the issue and say society needs to address how choices are made in a health service with limited funds.
The NHS Confederation represents more than 90% of NHS organisations and its director of policy, Nigel Edwards, said: "The NHS exists in a cash-limited system and has a multitude of competing priorities. It is extremely difficult to reach a consensus on expensive drugs and treatments that pleases everyone.
"We need to confront the reality that if the public do not want cost to be a factor in NHS decisions, then they may have to prepared to pay more in order to have every treatment funded."
The BMA proposes drawing up a very substantial core list of services available on the NHS after a public debate on the process for doing so.
Other recommendations in the BMAs discussion document A rational way forward for the NHS in England include:
* Shifting the focus of the Department of Health towards public health and reducing health inequalities
* Commissioning services from the private sector only when they cant come from the NHS
* Engaging with healthcare professionals earlier on new health policies
The full report can be found online at http://www.bma.or.uk/rationalwayforward and its proposals will be open to comment from those within and outside the medical profession.
Comments on the recommendations should be sent to caringfortheNHS@bma.org.uk by 7 September, 2007.
