By Ian Quinn
The vast majority of doctors think the risks of the Government’s plans for the NHS in England outweigh the potential benefits, with most believing it will harm patient care, a major survey commissioned by the BMA has found.
The Ipsos MORI survey of BMA members reveals wide-ranging concerns about plans to ramp up competition, even among the minority of doctors who are generally supportive of health secretary Andrew Lansley’s proposals.
Half of doctors believe GP-led commissioning will damage patient care and only half of GPs believe GPs in their area will be ready to take over when PCTs are axed in April 2013.
Among the 1,645 respondents, the survey found:
• 89%- believe increased competition in the NHS will lead to fragmentation of services
• 65%-think increased competition in the NHS will reduce the quality of patient care
• 66%-fear the move for all NHS providers to become, or be part of, foundation trusts will damage NHS values
• 66%-belive the proposed system of GP-led commissioning will increase health inequalities
Almost nine in ten (88%) of members said the reforms would lead to increased competition between providers, but only a fifth (21%) believe this will improve the overall quality of NHS care.
Yet doctors believe the changes that would be most beneficial are least likely to be achieved.
Two thirds (67%) think closer working between general practice and hospitals would improve the overall quality of patient care, but only a third (34%) believe it likely that the reforms will lead to this happening.
Three fifths of respondents (61%) think it likely that the reforms will lead to them spending less time with patients, a change which only 1% would welcome.
Dr Hamish Meldrum, chairman of Council at the BMA, said: ‘This survey shows that the Government can no longer claim widespread support among doctors as justification for these flawed policies.
‘While there are widely differing opinions, with many still to decide, there are a number of key issues where the majority have very clear concerns. The Government simply cannot afford to dismiss this strength of feeling amongst the group they are expecting to lead much of the change.
‘Doctors overwhelmingly want there to be closer working between primary and secondary care, and to have greater involvement in decision-making – yet most think these are the least likely outcomes of the reforms. And nine out of ten doctors agree that increased competition in the NHS will lead to a fragmentation of services.
‘The Secretary of State has repeatedly said he wants to listen to doctors. Doctors are telling him that whole rafts of these proposals will either not achieve the intended benefit to patients, or will be harmful. He particularly needs to act on the concerns about competition.’
In response NHS Confederation acting chief executive Nigel Edwards said: ‘We fully appreciate that change on this scale is hard for those at the sharp end but a blanket rejection of competition in healthcare is not supported by evidence.’
Dr Hamish Meldrum: Andrew Lansley can no longer claim support Dr Hamish Meldrum: Andrew Lansley can no longer claim support