The BMA is asking peers to table a raft of detailed amendments to improve the health bill as it makes its way through the House of Lords, with a briefing paper published last week identifying 11 key areas it wants to see changed.
The health bill began its two-month committee stage in the House of Lords last week, which will see peers examine the legislation line by line. The bill will then proceed to a third reading and is expected to become law next April.
BMA lobbyists are continuing to campaign for the bill to be scrapped, but have conceded that at this stage of the parliamentary process the best they can hope for is further amendments.
The BMA's briefing outlines a series of changes it will lobby for, with a BMA spokesperson telling Pulse that preliminary talks were underway with peers about tabling amendments.
Dr Hamish Meldrum, BMA chair and a GP in Bridlington, Yorkshire, warned that the health bill as it is currently drawn up gives the NHS Commissioning Board too much power over CCGs.
He asked for ‘amendments and assurances that the Government's pledged devolution of power is genuine, so that commissioners will truly have the freedom to commission the most appropriate services with, and for, their patients.'
He added: ‘Because so much of the detail won't appear on the face of the bill and will instead be left to secondary legislation and guidance, it is essential to have firm assurances now about the Government's implementation plans, for example, we continue to have serious concerns about the ethics of the current proposal to incentivise commissioners.'
Key objections from the BMA include the NHS Commissioning Board being able to change a CCG's constitution without agreement, which could, for example, affect elections, voting and governance rights.
The BMA is also demanding an amendment to make it explicit that increasing patient choice will not be given greater priority than ensuring fair access for all, and amendments to ensure that financial incentives for commissioning such as the quality premium do not lead to actual or perceived conflicts of interest.
Eleven areas of concern
- The Secretary of State's duty to provide a comprehensive health service
- Competition
- Cherry-picking
- Powers over Clinical Commissioning Groups
- Incentives for commissioning
- Public health
- Education, training and workforce
- Private patient income cap
- Foundation trust failure regime
- Increasing complexity and bureaucracy
- Information and confidentiality
Source: BMA briefing
