According to the British Medical Association (BMA) the Coalition government’s plans to reward GPs for enforcing budgetary controls could fundamentally damage trust with their patients.
Dr Hamish Meldrum, the chairman of the British Medical Association, said the suggestion under revamped plans from the health secretary, Andrew Lansley, might lead to allegations that doctors were withholding patient treatments and referrals to increase their pay. These warnings came at the eve of the BMA's annual meeting in Cardiff. David Cameron has already been accused by Labor of being forced into a dramatic U-turn after ditching his original reform plans for the NHS in England.
Meldrum said the BMA has “great reservations” about government plans to reward GPs for the high-quality commissioning of services. He said, “If patients even suspected that their GPs might be rewarded for how well they do, and particularly how well they do financially in terms of commissioning – giving way to suggestions such as 'You may not be referring me, you may not be investigating me, you may not be prescribing for me because that actually means money in your pocket' – well, that would seriously damage the trust. While we have always argued that doctors must be a part of the decision-making process, it has to be in partnership with patients and done in a way that doesn't undermine that trust.”
He said that the relationship between patients and their GPs would be a theme throughout the BMA's negotiations with the government over the future role that its members would play in a changed NHS. He added, “At times of crisis, trust is more important than ever. There is a danger that this may be put at risk by some of the government's plans. The public is not prepared to gamble with the future of the NHS, and doctors are not prepared to see this trust abused by government policies that could undermine the value of doctor-patient relationships.”
The editors of the British Medical Journal (BMJ) said, “It would be better for the NHS, the Government, and the people of England to sweep [the amended Health and Social Care Bill's] mangled remains into an unmarked grave and move on.” In an editorial published today, Dr Tony Delamothe and Dr Fiona Godlee, said they were concerned the Future Forum recommendations would leave “the NHS with a similar proportion of bureaucrats to the Austro-Hungarian empire on the eve of the First World War – and about as flat footed”.
According to a latest Ipsos Mori survey released by the association to coincide with the conference claims, doctors are the most trusted profession, with 88% of the public generally believing they tell the truth. The figure compares with 81% of teachers, 68% of clergy, 29% of bankers and 19% of journalists. Government ministers, on 17%, and politicians, on 14%, occupied the bottom two places. More than 1,000 members of the public were asked to say whether they trusted people who worked in 21 different professions.
Dr Brian Keighley, chair of BMA Scotland, said, “As we move into difficult scenarios in public finance with patients and the government looking for the evidence-based advice about how to configure services, if we have that level of trust it reinforces our view that government should be using doctors to look at the evidence and give them advice about what can safely be done to smooth the patient's path within available resources.”
The BMA annual meeting runs in Cardiff until Thursday. On Monday, they debate spending cuts within the NHS. The health and social care bill will be debated on Tuesday.
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