Disgruntled BMA Council members have launched a renewed fight against the Government's health bill ahead of the association's Annual Representative Meeting next week, after dismissing the changes announced by ministers as ‘mainly cosmetic'.
The group of doctors including GPC member Dr David Wrigley and consultant Dr Jacky Davis – a long-standing opponent of market-led reforms – have penned an open letter to the medical profession outlining their concerns, claiming the changes announced last week had done ‘nothing to reassure us' about the bill's ‘underlying aim to impose a fully-fledged market on the NHS'.
The letter, which the doctors have signed in personal capacities, claims the Government has crossed the ‘red lines in the sand' of the BMA and RCGP in order to stay on course with its original plans, as demonstrated by the scaling back rather than removal of Monitor's role to promote competition, and the retention of the Any Qualified Provider policy.
It says the Government's response also confirms its intention to surge ahead with policy directions opposed by the BMA including the outsourcing of the function of commissioning to private companies, exposing the system to ‘a whole new raft of even less identifiable conflicts of interest'; and extending personal health budgets.
It adds that even the good parts of the ‘curate's egg' - as described by BMA chair Dr Hamish Meldrum, the introduction of GP-led commissioning, had ‘gone rotten' as a result of the increasing powers handed to the NHS Commissioning Board.
The letter also cites a study by researchers from the London School of Hygiene and Tropical Medicine, published in the BMJ last week, which described how the bill could allow private companies to strip NHS assets ‘leading to more a expensive system that will deliver worse quality of care'.
It concludes: ‘We therefore totally reject the repeated claims of the Coalition leaders that their reforms will deliver greater NHS efficiency and that there will be ‘no NHS privatisation'.
‘Even the supporters of clinically led commissioning must be highly concerned with a return of central control in the NHS via a strengthened NHS Commissioning Board and clinical senates. Thus, even the potentially "good part" of Dr Meldrum's "curate's egg" has now gone rotten.'
‘In conclusion, the simple fact is that the Government's proposed changes to the bill are mainly cosmetic in nature. There are no 'significant' policy changes that will alter the general direction of travel and we believe the proposals will actually create even more problems for the NHS by increasing the tiers of bureaucracy.
‘We therefore urge members of the medical profession to take up the fight for the NHS by continuing to oppose this damaging bill and call for its withdrawal. We urge them to lobby their MPs, members of the House of Lords, and BMA representatives by highlighting what this bill means for the NHS, the profession and our patients.'
A Department of Health spokesperson said: 'It is clear from our response to the independent NHS Future Forum this week, and the amendments that have been published in Parliament today, that substantial changes have been made.
'The last few weeks have shown broad agreement that there is an overwhelming case for a modernised NHS, and that the principles of putting patients at the centre, focusing on results and more control for doctors, nurses and frontline professionals, are the right ones.'