Short-term political expediency and long-term budgetary crisis have had a profound impact on the NHS.
This is the New Year message from the chair of BMA Council, who says the “extraordinary events” of the past 12 months have seen a worrying lack of understanding from the government especially during contract negotiations with junior doctors.
In his annual message, Dr Mark Porter, praised the commitment of those working across the NHS.
He said: “If you attack the people who provide the care in the NHS, attack the quality of care they are able to give their patients, attack their motives for providing that care, they feel it personally and respond passionately. The NHS is fundamentally a set of values. We will not allow these values to be condemned for the sake of political expediency.
“The government’s attempt to impose an unsafe and unfair contract on junior doctors was an assault on the safeguards that enable them to practise safely, and on the quality of patient care.
“That is why thousands took to the streets in those vehement, inspiring demonstrations around the country. And yet still there was such a lack of understanding from Whitehall that the health secretary suggested that thousands of highly educated, highly motivated junior doctors were somehow being duped; that if only they read the proposals for themselves, they would come to a different view. They did read them. Ninety-eight percent voted for industrial action.”
Dr Porter adds that questions remain over how the government plans to tackle growing budget deficits across the NHS while at the same time funding its plans for seven-day services.
“The impact on doctors and other healthcare staff is profound,” he says. “The service improvements they propose are shelved, their patients angry and colleagues who leave not replaced. If those at the frontline of healthcare are having to focus too heavily on finances, in Whitehall there is in contrast a shameful sense of detachment.
“The government has made a start towards the extra £8 billion a year it promised by the end of this parliament, but imagines the additional £22 billion the NHS needs to find will come from efficiency savings alone. As one trust chair recently wrote, ‘this is for the birds; yet it is the basis on which budgets are being set’.
“Worse than that, the government said the money it has committed this parliament, despite being less than a third of the £30 billion required to run NHS business as usual, will in addition fund seven-day services – which it has yet to even define.”
Addressing the recruitment crisis in general practice should also be a government priority, Porter said.
“General practice is one of the areas in desperate need of greater funding. It is facing unprecedented pressures. Soaring demand, a crisis in recruitment while a third of GPs plan to retire in five years, and an unresourced shift of work from secondary to primary care. And all this at a time when its share of NHS spending, and the proportion of doctors who are GPs, have sharply fallen.”
Porter also said that end-of-life care would be a priority for the BMA in 2016.
“There is a shameful variation around the UK in the provision of end-of-life care. There is also an unprecedented scrutiny in the media and from parliament of the choices and options available at the end of life, including the issue of assisted dying.
“Our project will produce reports setting out the context of the debate, and independently commissioned research into patients’ and doctors’ views and experiences.”