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BMA: Lansley must back down on NHS commercialisation

By Ian Quinn

The BMA has expressed its ‘profound opposition' to the Government's plans to ramp up commercialisation in the NHS, warning the white paper will pit providers and GP commissioning consortia against each other and undermine patient care.

The union's official response to the Government's white paper consultation urges the coalition to learn from what it claims are the costly mistakes of PFI, ISTCs and other market-led experiments and says the opportunities in the proposals of greater clinical input into commissioning will be overshadowed unless health secretary Andrew Lansley is prepared to back down on the principle of any willing provider.

‘The BMA remains profoundly critical of the direction that has been seen in the NHS in recent years, namely that of increased involvement of the commercial interests and the active promotion of a market approach in the NHS, which is continued by the proposals set out in the white paper,' says the response.

Pulse exclusively revealed last week that the BMA was set to tell the Government it fears the plans will lead to cheaper but not better services because of its emphasis on competition.

‘The any willing provider policy has the capacity to undermine local health economies by replacing existing multi-service monopolies with a plethora of smaller units providing more limited ranges of services,' it says.

‘This would radically affect both the efficiency and value for money of the NHS.'

Speaking at the launch of the consultation response, GPC deputy chair, Dr Richard Vautrey, said: ‘There is very little evidence to support increased commercialisation being cost effective or that it is what patients really want.

‘What we want to see is a far greater emphasis on collaboration rather than competition.'

The BMA attacks the proposed role of the organisation Monitor in promoting competition in the commissioning of services by GP consortia.

‘We do not believe that healthcare should be treated in the same way as other industries and are alarmed at the clear suggestion in the white paper that competition in healthcare should resemble that in the telecoms or energy industries,' it says.

BMA chair, Dr Hamish Meldrum, said: '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 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.'

Nick Seddon, deputy director of the right wing think tank Reform, said: ‘It's clearly a big blow to the Government that the BMA has come out with this response as the BMA has been a very powerful and very effective fighting machine for a long time.

‘What frustrates me about the BMA's stance is this oversimplification that someone public sector is good and private sector is bad.

Competition is the best way yet of getting people to do what they don't want to do. With increased competition comes better value for money.'

Kingsley Manning, director of private health firm Tribal, which is one of many firms seeking to sign deals to provide support services to GP consortia, said: ‘We understand the BMA's concern about unbridled commercialism. However, as GPs have demonstrated for 60 years, the private sector can provide good quality services for the NHS.'

BMA says Government must listen to its warnings over commercialisation Full BMA response

Click here to read the full BMA response to the white paper consultation