Doctors press for major rethink over ‘high- risk’ reforms to NHS

The British Medical Association instead sets out a range of alternative measures to encourage the development of more integrated NHS services.

It claims greater collaboration in the NHS would be more likely to improve quality and efficiency than Government plans to increase competition.

Ministers have announced a “pause” in their flagship Health and Social Care Bill and a Future Forum of experts has been set up to draw up recommendations due to be unveiled early in June.

The coalition’s plans to carry out the biggest reforms in NHS history including giving control of £80bn in spending to GPs have attracted widespread opposition across the health service and from experts at the same time as efforts to make £20bn in savings get under way.

The BMA said feedback from doctors indicated “very high levels of concern” about the plans.

Chairman and retired Bridlington GP Hamish Meldrum said: “The message from doctors is clear and simple – the Bill must be changed significantly, if not withdrawn altogether, if the NHS is to continue to improve.

“We are right in the thick of the challenges the NHS faces, and while change is necessary, this major upheaval is not.

“We know that the NHS has to become more efficient, that chronic illness is growing, and that we need a step change in improvements in public health. Increasing and enforcing competition is not the answer – competition is not an end in itself.

“Instead, we are putting forward recommendations that aim to maximise the potential for positive change in the proposals by genuinely giving more say to patients and to clinicians at the front line.”

The BMA said disquiet among NHS staff was being exacerbated because change was being implemented despite the “pause”. It called for a more sophisticated approach to making spending decisions based on clinical networks of specialists working together with staff in primary care including GPs.

Plans to give the foundation hospital regulator Monitor a role to promote competition should be amended and instead it should be told to encourage the provision of high quality, integrated services.

NHS managers said yesterday they supported reform in the health service but called for a significant overhaul of the Government’s plans, claiming they need to be better focused on the challenges the NHS faced.

The NHS Confederation said the case for the breadth of the Government’s reforms “has yet to be clearly made”. The proposed changes were not sufficiently focused on the problems facing the NHS including the financial squeeze, variations in standards of care and delivering better integration of services.

Chief executive Mike Farrar, a former health chief in Yorkshire, said: “We are absolutely in favour of reform because it is crystal clear that we cannot go on as we are.

“But we are determined to do more to ensure the NHS concentrates its firepower on the issues that will make a difference to patients – getting better value for the taxpayer, treating people with dignity and closing the gaps between services.

The Unite union yesterday said two thirds of nearly 700 members surveyed said they had seen the treatment and care of patients reduced or rationed in the last six months.

Head of health Rachael Maskell said: “This survey confirms what we have been saying for the last year – that services are already being cut or rationed as a result of the Government’s twin-pronged approach of planning to privatise the NHS and enforcing £20bn of so-called ‘efficiency savings’ over the next four years.

“The coalition has called for a pause in the Bill’s progress while it considers the views of interested parties – it needs to draw the conclusion that this is a flawed Bill that needs to be scrapped.”