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BMA and unions call for NHS funding shake-up and an end to market-led health service

By Gareth Iacobucci

GP leaders, unions and healthcare experts have called for a comprehensive shake-up of NHS funding that pays trusts on the basis of population need rather than activity.

In a joint statement, academics and campaigners from the BMA, NHS Support Federation, NHS Consultants Association, Keep our NHS Public, and Unison, also called for an end to the market model for the NHS in England, and to the purchaser/provider split.

The statement, produced following a round table discussion on the eve of the BMA's Annual Representatives Meeting in Brighton, said the NHS would become ‘more cost-effective and equitable' if it focussed on co-operation rather than competition.

It called for a distinction between ‘choice as a lever for competition, and choice as the capacity for patients to make informed decisions about their own care', insisting that most people were not interested in ‘unfettered patient choice'.

The experts said funding should be allocated on the basis of population need rather than activity, claiming that the present payment by results / tariff system is ‘based upon narrowly defined episodes of care', can ‘generate perverse incentives in patient referrals' and does not encourage ‘the pursuit of unmet need'.

BMA chair Dr Hamish Meldrum, said: ‘Many of the reforms of recent years threaten to erode the principles of free access, care based on need, and risk-pooling.

‘We need a democratically accountable, local approach to healthcare delivery, with funding based on the needs of patients, and providers encouraged to co-operate rather than compete.

‘At a time of real economic challenge to the NHS, our proposals will maximise the effective use of scarce resources and help to ensure that patients get the services they need. We urge the coalition government to be true to their word and listen to the views of front-line health professionals.'

Dr Hamish Meldrum