Divided BMA votes to attack white paper as ‘smokescreen for privatisation’

By Ian Quinn

Exclusive: The BMA is to launch an attack on core elements of the Government's health white paper, which it will warn opens the door to further privatisation of the NHS and could lead to services being provided on the basis of cost rather than quality.

After nearly two days of often fiery talks, which exposed major divisions in opinion among the leadership, the BMA Council has finalised its response to the consultation over health secretary Andrew Lansley's plans and will issue a strong warning over the impact of commercialisation.

Pulse has learned that the BMA Council passed a motion at its meeting earlier this week which reads: ‘The Council has significant concern about the direction of travel of the NHS reforms with respect to commercialisation of the NHS as provided in the white paper.'

The BMA response will support in principle the Government's move to give GPs more power over commissioning, but will also express fears that the white paper could lead to a lottery of service provision by allowing decisions at local level rather setting central public health needs.

The document will also warn that many GPs are far from ready to take on commissioning, with council members expressing concern at the decision to axe PCTs.

GPC member Dr Helena McKeown told Pulse after the meeting: ‘We want to make clear that we have major concerns over the policy of any willing provider.'

‘There is a fear that GPs and clinicians could design entire services and then have their decisions overruled by Monitor on the basis of cost which could throw whole hospitals into chaos and open the door to private firms. The analogy I used is it's like the game Jenga - you could take one brick out and the whole thing could fall down.'

Some council members also expressed fears that the Government's plans could worsen health inequalities, she added.

'The White Paper could open up a postcode lottery. Laurence [Buckman, GPC chair] told the meeting that the response must all be about preserving quality.'

Dr Andrew Dearden, chair of the BMA's Welsh Council, said: ‘There was a general concern at the meeting about the increasing privatisation in the NHS which the white paper seems to be laying the ground for. There is a widespread concern about the direction of travel of the white paper.'

‘At this stage they are still proposals. There is nothing to fight about at the moment. But the BMA has been very accurate in its previous predictions about the private sector. We warned that PFI, for example, would be the albatross around the NHS's neck it's become. I'm always puzzled that each successive Government seems not to recognise our tendency to be right.'

Dr Dearden said the response of the Government to the BMA's concerns would determine whether it could yet win the support of doctors or be faced with trying to impose its revolution of the NHS.

‘When the actual proposals come as a result of this consultation, the BMA has a decision to make - is it something it can work with or is it something it will have to fight?'

‘If the Government presses ahead with what is basically a smokescreen for privatisation, which will lead to always having the cheapest service, rather than the best we can afford, which are two entirely different things, then it becomes a blatant attempt to privatise and I think it's something we will fight.'

But another senior BMA member at the meeting, who asked not to be named, dismissed the fears over privatisation which he said had come from a 'core group of die-hards'.

‘They said this was all about commercialisation of the NHS, and that this was the hidden agenda. But they were always going to be suspicious of anything that came out of a Tory government,' the source told Pulse.

‘One person who spoke summed up the mood – that it's not a question of whether, it's a question of how. There's an acceptance it's going to happen and that the BMA's role is to support doctors in its implementation. That's what Laurence [Buckman] and Fay [Wilson] said was the mood among GPs around the country.'

The Department of Health's consultation on the white paper closes on 11 October.

To answer three short questions on the Government's plans for commissioning and help us build up a picture of grassroots GP opinion, please click here.

A top line-up of expert speakers – including Andrew Lansley, Sir David Nicholson and Mark Britnell - will be addressing the latest developments in GP commissioning at the NAPC Annual Conference in Birmingham in October.

To find out more and book your place today please click here.