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Darzi Review: latest reaction to the proposals

By Lilian Anekwe

The BMA has warned that the reforms proposed in Lord Darzi's review will only succeed if doctors and other NHS stuff are engaged and fully consulted on their implementation.

As responses to Lord Darzi's long-anticipated review of the NHS flooded in, Dr Hamish Meldrum, Chairman of BMA Council, said: ‘There is much here that could bring about improvement – if it can be delivered. That will depend on the details, and on the true engagement of NHS staff in implementing change.

‘If they are sidelined, these are little more than fine words and we won't see the improvements the NHS desperately needs. In some areas there was insufficient consultation with the public or staff on changes to local NHS services during the review process and we don't want to see that repeated in the future.

‘There will clearly be a lot of detail to examine and many practical issues to consider, and we look forward to working with the government as part of the consultation process.'

On the proposed changes to way primary care is currently delivered, Dr Nick Goodwin, King's Fund Senior Fellow said: ‘The call for comprehensive wellbeing and prevention services with local authorities suggest a direction of travel in primary care providers towards managing health rather than treating illness.

‘This will require significant changes in the way primary care is managed and organised with greater multi-disciplinary working and tailored support for patients in a way that has not previously been seen.'

The Conservatives said the proposals demonstrated the Labour Government's ‘complete lack of vision'.

Shadow health secretary Andrew Lansley said: ‘The complete lack of vision in these proposals means that, sadly, the Government has missed its ‘once-in-a-generation opportunity' to enact the real reform that our NHS needs.

‘Instead of scrapping the targets which distract doctors from delivering the best possible health care, Labour have opted for more of the same. It's no good talking about focusing more on health outcomes if doctors and nurses continue to be micro-managed by bureaucrats in Whitehall and their local strategic health authorities.

‘What health professionals want and need is for politicians to stop interfering and to allow them to do the job they were trained to do. At the beginning of this process Gordon Brown said he would listen to patients and staff and act on their concerns – unfortunately he has clearly done neither.'

Alastair Henderson and Sian Thomas, acting directors of NHS Employers said:

‘Much of what is outlined in today's report will be welcomed by employers and supports the direction of existing work programmes which seek a fit-for- purpose workforce delivering high quality patient care.'

Steve Barnett, acting chief executive of the NHS Confederation said: ‘The proposals appear to be highly permissive and could mark a shift in the NHS towards local control if embedded. The Department of Health will need to resist the temptation to prescribe nationally and local staff will need to avoid looking upwards for direction. Local delivery requires local leadership and local really must mean local.'

GMC president Professor Sir Graeme Catto said: ‘Lord Darzi has conducted an important and wide-ranging review of the NHS in England at a time when we are rightly celebrating its 60th anniversary. We particularly welcome the strong emphasis on the importance of education and training in helping to deliver quality healthcare for the benefit of patients. We look forward to playing a key role in taking forward the quality agenda.'

Dr Neil Bentley, director of public services at the Confederation of British Industry (CBI), said: ‘These bold and overdue reforms must not be allowed to founder on the rocks of trade union opposition. The government must stand firm in its dealings with the BMA and other opponents of reform in the weeks ahead if the NHS is to provide better healthcare.

Planned changes to the GP service will help cut the burden of millions of working hours lost to time spent in the doctor's surgery, and will mean patients will have access to a wider range of treatments at times far more convenient to them.'

Sir Ian Kennedy, chair of the Healthcare Commission, said: 'This has a real chance of helping to improve the quality of care that patients receive. The proposals should be given a fair wind – they deserve one.

He added: 'While we welcome the objectives of this review, it is essential to have an independent assessment of progress. The document is somewhat short on how this will come about and the role of regulation. We will be raising this with the Government.'

Dr Hamish Meldrum: fine words mean nothing without consultation Dr Hamish Meldrum: fine words mean nothing without consultation

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