Reforms Threaten NHS – Bma

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BMA Council Chairman, Dr Hamish Meldrum, yesterday wrote to all MPs warning them that the government’s health reforms still present an ‘unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably, now and in the future’.

He reiterates that BMA policy is that the Bill must be withdrawn.

The report stage and third reading of the Health and Social Care Bill for England takes place in the House of Commons next Tuesday and Wednesday (September 6th & 7th), after which the Bill moves to the House of Lords.

Meldrum warns there ‘continues to be an inappropriate and misguided reliance on “market forces” to shape services’.

He adds: ‘The risks are high, not least because the long-term effects of the legislation are likely to be extensive.’

Specific areas of concern on the Bill include:

• The removal of the cap on how much income Foundation Trusts (FTs) can generate from private patients, which, the BMA says, could lead to reduced access for NHS patients as FTs seek to increase their income by focusing more on private care.

• The proposed ‘Quality Premium’ for commissioners, which the BMA insists must be judged against well-defined quality measures not financial performance, must remain separate from GP practice income and only be used to improve patient care.

• Forcing all NHS Trusts to become FTs, with the financial stringency this requires, the BMA believes could compromise patient safety and quality of care.

Meldrum warns that ‘the general direction of policy travel, such as widening patient choice to “Any Qualified Provider” (AQP) across a much larger range of services, has the potential to destabilise local health economies if not carefully managed.’

He adds that there must be a robust and transparent process which has the full confidence of the profession when it comes to how ‘failing’ FTs are dealt with, in order to protect the interests of patients and the public.

He points to the lack of satisfactory assurances that the Secretary of State will have ultimate responsibility for the provision of a comprehensive health service whilst also allowing other bodies, like the new NHS Board and clinical commissioning groups, day-to-day operational independence.

In his concluding remarks, Meldrum says: ‘The risks are high, not least because the long-term effects of the legislation are likely to be extensive. Meaningful, sustainable reform needs to have the full confidence of patients and those working in the health service.’