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BMA: Government’s reform plans still pose an ‘unacceptably high risk’ to NHS

MPs preparing to vote on the NHS reform bill next week have been sent a personal appeal to vote against the legislation from BMA chair Dr Hamish Meldrum.

Dr Meldrum used the letter to emphasise that despite revisions made after the ‘listening exercise' the reforms present an ‘unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably'.

Dr Meldrum attacked the ‘misguided' move towards a market-based health system, saying it could destabilise services. Click here to read the full letter.

The letter comes after growing opposition to the health bill, with both the RCGP and the union Unison calling for the legislation to be abandoned and peers planning to introduce ‘wrecking' amendments.

Dr Meldrum's letter says: ‘We believe there continues to be an inappropriate and misguided reliance on ‘market forces' to shape services.'

‘This is very clear in the general direction of policy travel, such as widening patient choice to "Any Qualified Provider" across a much larger range of services, which has the potential to destabilise local health economies if not carefully managed.'

‘It is also implicit in the bill, which embeds a more central role for choice without a full consideration of the consequences and which creates ambiguity about how the trade-offs between increasing patient choice and ensuring fair access, integrated care and improved efficiency should be managed.'

Report stage and third reading of the Health and Social Care Bill for England will take place in the House of Commons next Tuesday and Wednesday, after which the health bill will move to the House of Lords.

A Department of Health spokesperson responded saying they were ‘disappointed' because the BMA had previously said they were ‘pleased that the Government has accepted the Future Forum's core recommendations, and that there will be significant revisions to the bill'.

‘We will never privatise the NHS and patients will never have to pay for NHS care. Our plans have been greatly strengthened in order to safeguard the future of the NHS.'


BMA areas of concern

  • The removal of the cap on how much income Foundation Trusts (FTs) can generate from private patients, which the BMA says could lead to reduced access for NHS patients as FTs seek to increase their income by focusing more on private care.
  • Forcing all NHS Trusts to become FTs, with the financial stringency this requires, which the BMA believes could compromise patient safety and quality of care.
  • That the legislation should reflect an intention that any increase in patients' choice of providers should not be given a higher priority than tackling health inequalities and promoting integrated care.
  • Ensuring there is a robust and transparent process which has the full confidence of the profession when it comes to how ‘failing' FTs are dealt with, in order to protect the interests of patients and the public.
  • The lack of satisfactory assurance that the Secretary of State will have ultimate responsibility for the provision of a comprehensive health service whilst also allowing other bodies, like the new NHS Board and clinical commissioning groups, day-to-day operational independence.

Click here to read the full letter