Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, wrote to all GPs in England yesterday setting out why the Committee wants the Health and Social Care Bill withdrawn.
Buckman warns GPs that ‘over time, it has become clear that this is the most top-down reorganisation the NHS has seen since its inception’ and that, despite what the government says, ‘the ability for ordinary GPs to change things will diminish’ under the Bill.
Buckman writes that ordinary GPs within Clinical Commissioning Groups (CCGs) will not have the ability to improve the health service – a key plank of the original proposals – as CCGs are forced to develop into ever larger and more remote units in order to be approved.
He also writes that GPs will be pressured into making hasty decisions to adhere to an unrealistic timetable for approval of local service organisation.
CCGs will become the vehicles for turning the NHS into a competitive marketplace where services have to compete for their business and where patient care becomes increasingly fragmented.
Commissioning may end up being controlled not by clinicians but by private organisations, operating outside of the NHS. These could end up taking over CCGs, not just doing their admin.
Proposals for a ‘quality reward’ – an incentive for CCGs if they are deemed to have commissioned ‘well’ – could cause irreparable damage to the relationship GPs have with their patients, on top of which GPs will be blamed by their patients for having to make health cuts.
Buckman urges the government ‘to listen and act on the concerns of GPs in the interests of the future of the NHS and what is best for patients – there is a sensible alternative to proceeding with this Bill’.
He says this includes returning to the principle of allowing commissioning to be truly clinically led; for decision making to be devolved to local groups far more than is happening under the current plans; increasing co-operation between providers, including local authorities; and allowing the employment of more staff in primary care so more care can be delivered properly in the community.
The GPs Committee earlier this week passed a motion calling for the government to withdraw the Bill.
