NHS makeover not welcomed by the BMA

By Dr. Ananya Mandal, MDOct 1 2010

The British Medical Association (BMA) has expressed doubts about the radical makeover of the NHS and how it would affect patient care. The reorganization of the NHS in England was unveiled in health secretary Andrew Lansley's white paper in July. The BMA says that the plans are potentially damaging, risk setting groups of clinicians against each other and are not a good use of public money when the NHS has to save £15 to £20 billion.

BMA in its statement said, “There are aspects of the white paper's proposals which have the potential to undermine the stability and long-term future of the NHS.” It said that the new plans that force all hospital trusts to become semi-independent foundation trusts will prove damaging. It said, “Changing the status of existing NHS providers to foundation trust status has already threatened the character and ethos of NHS provision. Further moves towards the deployment of corporate entities would threaten the stability of the NHS and the security of its employees and their terms and conditions of service.” About half the hospital trusts in England have become foundation trusts, which are free of most Whitehall control.

BMA in its warning also added, “We urge the government and NHS organisations to focus on those areas where they can truly eliminate waste and achieve genuine efficiency savings rather than adopt a slash-and-burn approach to health care, with arbitrary cuts and poorly considered policies.” For Lansley this is big trouble. He had sought to win the profession's backing by stressing that family doctors will gain unprecedented autonomy, extra influence over their patients' treatment and control of £80 billion of the NHS budget through a switch to GP-led commissioning of healthcare.

According to Dr Hamish Meldrum, the BMA chairman doctors approved of some measures, such as patients having more say and a greater focus on outcomes. “But there is also much that would be potentially damaging. 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,” he added.

The health secretary said he welcomed the BMA's response. Andy Burnham, the shadow health secretary however said, “This is a humiliating blow for Mr Lansley and his plans. Doctors are telling him in no uncertain terms that his proposals will damage the NHS.” He added that these changes would “unpick the very fabric of our NHS and turn order into chaos”.

Dr Richard Vautrey, deputy chairman of the BMA's GPs committee, agreed that the majority of family doctors had “concerns”. And Jennifer Dixon, chief executive of the Nuffield Trust, also said that the BMA was right to highlight some of the issues. “The reforms are substantial and will require significant management expertise to implement smoothly. A real concern is whether this level of reform can be implemented without risk of major failure,” she said.

In retaliation to these criticisms Health Secretary Andrew Lansley said, “There are many GPs across the country who are keen to make the transition quickly, others want to know more about how it's going to work before they implement it…This is what the consultation process is about, everyone coming forward to say how can we make this work.” He added that the plans were aimed at making care better for patients.