By Gareth Iacobucci
GP leaders have become embroiled in a major row with politicians and each other over what kinds of measures the NHS will need to implement to achieve its required billions of pounds of efficiency savings.
RCGP chair Professor Steve Field and other doctors' leaders from the Academy of Medical Royal Colleges wrote to the Guardian calling for politicians to have the courage to close and aggregate A&E units and hospital services.
The letter argued plans to shift services into primary care were the only way to save billions from the NHS budget and would improve care and save lives – and should not be blocked because of their unpopularity with patients.
But the BMA hit out at the timing of the letter, warning it could encourage politicians to make swingeing cuts to frontline services.
It is also understood to have angered some politicians, coming after Conservative and Liberal Democrat opposition to hospital closures, and the decision by health secretary Andy Burnham to back-peddle on Government policy and veto the controversial proposed closure of an A&E unit at Whittington Hospital in north London.
The letter calls on doctors, managers and politicians to show ‘strong leadership and brave decision-making', warning: ‘Simply condemning change and defending the status quo as ideal is not serving the interests of patients.'
It adds: ‘Patients may have to travel further for some specialist care, but if it is significantly better care we believe centralisation is justified.
‘There is also strong evidence to support a large amount of more routine care being carried out closer to where patients live, with GPs playing a crucial role.'
Dr Johnny Marshall, chair of the National Association of Primary Care, backed the call and accused the BMA of ignoring the financial climate: ‘A lot of these things improve quality and reduce cost. Doctors need to take a strategic approach - the BMA stance just ignores the financial considerations.'
BMA chair Dr Hamish Meldrum rejected the criticism. ‘Let's lay to rest any idea the BMA is against good, evidence-based change,' he said.
‘Where we worry is about the timing of this letter. It rather concedes the point that there's going to be lots of cuts, which we would want to challenge.'
RCGP chair Professor Steve Field insisted the letter was not politically motivated, but urged GPs not to let their hearts rule their heads: ‘Doctors need to base their decisions on evidence - not the emotion of a local hospital.'