With a General Election due to be called at some stage in the next few months, the BMA launched its manifesto - Standing up for doctors, Standing up for health - this week.
It offers a range of ideas and policies on healthcare that the BMA hopes will promote political debate and help shape the approach of the next government.
How to manage public services during the economic downturn will be one of the key political debates. The BMA’s manifesto urges politicians to continue supporting the NHS because of its greater role in helping people during difficult times. The next government must resist quick savings and short-term cuts in the NHS.
Dr Hamish Meldrum, chairman of BMA council, said: “Tough questions are being asked about public services. But even during a time of financial stringency, continued investment in the NHS is vital.
“A slash and burn response to the need for savings would be dangerous and short-sighted, risking long-term damage to the infrastructure of the health service. Now more than ever we should acknowledge the success of the NHS and recognise the support it gives people when times are hard.”
Standing up for doctors, Standing up for health covers three key themes: ensuring the sustainability of the NHS in the longer term, supporting the medical workforce and improving and protecting the nation’s health.
On the sustainability of the NHS, the BMA is calling for all political parties to pursue evidence-based planning of services. It believes that best value for tax payers will be delivered through reforms based on cooperation and equity that seek joined up care.
The BMA calls for an end to expensive market-based reforms, such as PFI, independent sector treatment centres, Payment by Results and the split between the purchaser and provider in England.
Meldrum said: “When the drivers are profits, it has to be asked whether patients’ interests are really being served, and value for money being achieved. Creating a market means high transactional costs and bureaucracy, with money that could be spent on patient care going to private companies and shareholders.”
On the medical workforce, the manifesto points out that high quality services can only be delivered by a well supported workforce. A full complement of trained and regulated staff is required.
Meldrum said: “It would be a disastrous error to resort to measures such as cutting clinical staff at a time when demand for healthcare is increasing.”
The BMA also calls for fair working conditions and rewards, and urges the next government to ensure that good undergraduate education and postgraduate training and continuous professional development are in place and readily accessible.
More specifically, consultants call on politicians to rethink targets, invest in a consultant-based service and put more value on medical leadership.
SAS doctors want better access to training to promote the grade as a positive career choice. They also want swift implementation of the ‘new’ specialty doctor contract.
Juniors want the next government to review and improve training, negotiate a new contract, and recognise the value of overseas doctors.
Medical academics understandably desire the decline in the medical academic workforce to be halted. They also want more support for medical research, and for a balance to be maintained between patient confidentiality and access to data for medical research.
On improving and protecting the nation’s health, there is a long list of issues and the BMA clearly sees itself as having an important role to play in this sphere.
Alcohol, tobacco, obesity, organ donation and climate change are all highlighted as pressing issues for the next government.
There should be an increase in alcohol duty, support for minimum price levels, an end to irresponsible promotional activities, and a ban on alcohol advertising in the media.
The BMA also wants ours to be a tobacco-free society by 2035. Again it calls for increased taxation and support for minimum price levels. Smoking cessation services should be properly funded and pro-smoking footage in films should influence their classification.
On obesity, it wants a consistent approach to food and drink labelling based on ‘traffic light’, front-of-pack labelling recommended by Food Standards Authority. Legal obligations to reduce salt, sugar and fat in pre-prepared meals should be introduced and the advertising of unhealthy food stuffs should be banned.
The media should also be better used to promote healthy, aspirational lifestyle messages.
The BMA wants to facilitate a public debate on an opt-out system of organ donation.
On climate change, there should be binding and enforceable carbon footprint reduction guidelines for the NHS and the government should support initiatives to promote the health co-benefits of actions aimed to mitigate climate change, such as reducing car use and increasing levels of physical activity.
The overriding message of the BMA’s manifesto is that to develop a sustainable, high quality NHS, we all have to be more realistic about what it can deliver. There is a growing need to reconcile ever-increasing public and patient expectations about the role of the NHS, championed as a provider of universal and comprehensive care, with the reality of finite resources in an economic downturn.
The BMA calls for a ‘mature debate’ between the public, patients and health professionals about the true costs of delivering healthcare and how resources are allocated.
Read more on the BMA’s campaign Look after our NHS.
