NO TO NHS PRIVATISATION – BMA consultants vote to defend District General Hospitals

BMA Consultants Conference delegates in London on Wednesday voted to reject NHS privatisation
BMA Consultants Conference delegates in London on Wednesday voted to reject NHS privatisation

The British Medical Association (BMA) Consultants Conference in London on Wednesday voted to reject NHS privatisation and to call on the BMA to launch a campaign to defend District General Hospitals.

In his keynote speech, to the 150-strong conference, the chairman of the BMA consultants committee, Dr Jonathan Fielden attacked the ‘wasted millions’ spent on private treatment centres, PFI for ‘saddling NHS hospitals with expensive long-term debt’ and for ‘mortgaging the future’ and involving the private sector in commissioning and plans for ‘private management to sort out “failing” NHS trusts.’

He warned that the government is ‘apparently fixated on a drive to allow the private sector to take over the NHS.

‘We will not let this government privatise the NHS,’ he pledged to applause.

The conference went on to vote overwhelmingly for motion 9 rejecting polyclinics, which read:

‘That this conference:

‘(i) rejects an imposed model of privately-owned polyclinics across the English Health Service as an unproven, crude and expensive structural solution to a fundamentally functional problem

‘(ii) insists that the roll out of polyclinics should be halted until they have been piloted and appraised in line with the advice from the Secretary of State in other areas.’

Mover Dr David Wrede said: ‘This is an expensive and wasteful idea.

‘Why do GPs have to be crammed into new buildings to carry out services that are already available in surgeries?

‘This is really about political control, giving it to big corporate bodies, and is totally against the interest of patients.’

In the debate, Anna Athow from NE London opposed clause (ii), saying ‘polyclinics should be halted immediately. They must not be promoted.

‘Polyclinics would not only see the end of general practices but destroy district general hospitals.

‘They are such a danger they should not even be piloted.’

Consultants committee chair Fielden advised conference: ‘The centrally enforced polyclinic plan holds no water, has no benefit and no financial gain.’

But he added that ‘we have said show us the evidence, so we should not oppose pilot schemes’ for the government ‘to dump the polyclinic plan.’

Dr Anne Thorpe, NW London, won a unanimous vote for her motion 20 on private treatment centres, stating: ‘That this conference believes the evidence that ISTCs have proved poor value for money is now overwhelming. The DH should acknowledge that the policy was mistaken and waste no more taxpayers’ money on it.’

Prioritised motion 52 from London North-East RCSC was overwhelmingly passed.

The motion stated: ‘That this conference believes that hospitals throughout England have lost significant numbers of beds and staff in the 2005/6/7 turnaround cuts, which are continuing in 2008.

‘Hospitals have lost maternity, paediatric and A&E departments. DH policy in “Our health, our care, our say’’ instructs PCTs to shift funds out of secondary care and into polyclinics.

‘This meeting opposes the closure of hospitals and their departments, which provide consultant-led hospital care and train junior doctors.

‘It calls on CCSC and the BMA to mount an active campaign in support of our hospitals.’

Mover Anna Athow said: ‘32,000 hospital beds have been closed in the last 10 years, 8,400 in the last year.

‘This government is disintegrating excellent DGH services.

‘The real motives for these changes are political and economic.

‘This is not about improving patients’ care, but about handing over a giant share of PCT money to PFI consortia and corporate, for profit healthcare companies, like polyclinics.

‘There’s a huge threat here to consultants’ jobs and juniors’ training posts.

‘We should take a leaf out of the General Practitioners Committee’s book and start a national campaign, and we should officially support the campaigns of local people, staff and residents to keep our District General Hospitals (DGHs) open with all departments.’

Earlier, there was controversy over motion 48 in the section headed ‘service reconfiguration’.

The motion from the anaesthetics subcommittee stated: ‘That this conference, whilst noting concerns over the direction of the Darzi health reforms across London and England, believes that any move towards further centralisation or “hub and spoke” provision of services will increase the imperative that England develops a robust inter-hospital transfer system for adults and children, and patient care will suffer dramatically should such a system not be developed urgently.’

Mover Dr Stephen Millar said: ‘Staff are being taken away from other duties to do emergency transfer.

We need a better organised system with quality control.’

SE London acute medicine consultant Dr Kevin O’Kane opposed the motion saying: ‘I support the sentiment in proposing the motion but it is fundamentally flawed and must be voted down.

‘This motion implies that Darzi is inevitable and that we should get on with implementing it.

‘What does Darzi mean? In London it means reducing our acute hospitals from 33 to between 8 and 16, i.e. up to 75% of A&Es will be closed.

‘Chase Farm Hospital’s 24 hour A&E to close, replaced by an 8am to 8pm walk-in centre staffed by GPs and nurses.’

He warned that ‘the Darzi system will destroy our hospitals.’

He added: ‘This motion implies a fait accompli, of closing DGHs and shipping patients around the country to the nearest available bed in a real hospital.

‘Under such a system patient care will suffer drastically and we should not endorse it.

‘We must fight to keep our A&Es and DGHs rather than offering patients a second rate taxi service.

‘Please support your DGHs. Vote against this motion.’

Anna Athow also opposed the motion saying ‘ “reconfiguration” is about the wholesale closure of hospitals.

‘We cannot accept Darzi is an inevitability. Of course patients will suffer if half our A&Es are closed down.

‘We should be developing a strategy to oppose closures of DGHs instead of meekly accepting Darzi “reconfiguration”,’ she concluded to applause.

Motion mover Dr Millar urged a vote for insisting ‘this is nothing to do with Darzi’.

Consultants committee deputy chairman Dr Ian Wilson advised conference: ‘I do oppose Darzi but we must have a safe transfer system it is vital your support for this motion is overwhelming.’

Millar added: ‘This motion is not approval or acceptance of the Darzi report. But if reforms happen, Darzi will make things worse, we need a system now.’

The motion split the conference and was narrowly passed on a show of hands.

In other motions, consultants voted to reject ‘flawed’ government targets, to reject a planned new ‘sub-consultant’ grade to call for an expansion of the consultant workforce, for shorter working hours and for no political interference in patient referrals.