Hospital Dr News

Continuing with the Health Bill is enormous risk

The structural change currently taking place throughout the NHS in England before the Health and Social Care Bill even becomes law is threatening service stability, the BMA has warned.

In its latest briefing for peers – the first since it announced outright opposition to the Bill – the union describes a picture of chaotic and poorly coordinated reform.

The briefing paper sets out why doctors have hardened their position on the Bill in the context of the wider NHS reform agenda.

It criticises an overambitious timetable. Although the legislation has not yet been agreed, changes are already taking place both nationally and locally and assumptions are having to be made about the final architecture. The end result has been chaos on the ground, it says.

Complexity is also a problem. The stated aim of reducing bureaucracy now looks meaningless as new bodies and structures are being created, all with complex interrelationships, the paper suggests.

The BMA also warns that the rhetoric is not matching the reality. The government has said it wants to empower clinicians to commission on behalf of patients, however many of the powers of the NHS Commissioning Board set out in the Bill seem overly restrictive.

Dr Hamish Meldrum, Chairman of BMA Council, said: “There has been a growing level of unease about how the reforms are panning out – we hear repeated concerns from doctors about mounting chaos on the ground. For example, Clinical Commissioning Groups (CCGs), that had initially been told they’d have freedom to form to suit their local communities, are now being told they’re too small and have to re-form.

“People are still unclear how primary care will be managed as we don’t yet know where staff currently working in PCT ‘clusters’ will eventually be based or if they’ll have jobs at all. Even at this stage, there are still unanswered questions about what statutory functions some bodies will have, making planning very difficult.”

At its November meeting, BMA council voted to change its position to outright opposition to the Bill in its entirety.

Meldrum said: “Guidance is being issued that is overly restrictive and more and more bureaucracy is being created to try to deal with issues which should have been dealt with at the beginning.  A huge amount of time, energy, money and commitment has been wasted because of a lack of a clear plan from the outset.

“We want the government to rethink its reform package and withdraw the Bill. It should be focusing on delivering high-quality, coordinated and integrated health care, not side-tracking staff with major structural reform. Continuing with this legislation, especially in a period of huge financial constraint, is an enormous risk.”

Read the full briefing.

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2 Responses to “Continuing with the Health Bill is enormous risk”

  1. Malcolm Morrison says:

    Nobody should be surprised! It is part of ‘modern’ politics and management to go ahead with putting all the changes in place BEFORE the Bill is passed! They make the assumption that The Govt. will get its way!

    Has ANY ‘reform’ of the NHS ever been otherwise? Has any of the previous ‘re-organisations’ produced better care for patients? Have not ALL the improvements come from the profession (in the form of new treatments)? We are told we must practise ‘evidence-based medicine’; how about a little ‘evidence-based management’? We regularly ‘audit’ our performance and procedures; how about a little ‘audit’ of mangement processes and procedures?

    No reform or re-organisation of the NHS has ever addressed the basic problem that has existed since the birth of the NHS (and became obvious within a few years) – that demand exceeds supply. Thus, there has to be RATIONING of some sort. Sooner or later, politicians will have to face up to this unpleasant fact; and, as it is they who decide how much cash is to be spent on the NHS each year (the budget), it is THEY who must decide what can, and what cannot, be provided by the NHS.
    Retired Orthopod

  2. sybil ashton says:

    PLEASE GPs, save our NHS from the depredations of Lansley: the tories want to get their grubby hands even further into our health service which has already been deeply damaged by Thatcher and Blair. Greed is the reason, because there are rich pickings for the private companies. Of course we do not need rationing: that is a capitalist myth. There is plenty of money sloshing around, in the wrong hands. Let’s get it in the right hands!

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