NHS white paper, Equity and Excellence, has set doctors on edge

NHS reforms ‘potentially damaging’

NHS reforms ‘potentially damaging’

By Alex Stevenson

Doctors have warned plans to shake up the NHS could create waste, bureaucracy and inefficiency.

The influential British Medical Association’s (BMA) response to the white paper on NHS reform launched this summer doubts whether efforts to boost competition will lead to improvements.

Health secretary Andrew Lansley has argued encouraging competition in the NHS, like extending choice to “any willing provider” and giving foundation trust watchdog Monitor a duty to promote competition.

The BMA says this shift risks encouraging an emphasis on cost rather than quality.

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It argues this could undermine opportunities to achieve its main aim – getting other clinicians brought into the new management processes, to be headed by the proposed GP consortia.

“There are proposals in the white paper that doctors can support and want to work with. But there is also much that would be potentially damaging,” the BMA’s chairman Hamish Meldrum said.

“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.

“Doctors want to build on the founding principles of the NHS, and to maintain and improve services despite the hugely challenging financial climate. However, they can only succeed if they can work in partnership with others in a cooperative environment.”

Mr Lansley responded by welcoming doctors’ acknowledgement that GP-led commissioning is the “best place” to manage patient care.

He did not address the BMA’s competition concerns but instead argued that those doing the referral and prescribing needed to be the same as those making the decisions on managing resources.

“We need a healthcare system where the management of the care of patients is combined with an understanding of how resources are used,” the health secretary argued.

“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.”