NHS Reforms Must Be More Than A 'Re-Spray Job', Says GP Leader



The government needs to make major changes to the Health and Social Care Bill if it is to win the confidence of the profession, the Chairman of BMA’s GPs Committee has said. 



Speaking to the annual GPs conference of Local Medical Committees, following David Cameron 's recent announcements, Dr Laurence Buckman said the change to Monitor’s role announced by the Prime Minister on Tuesday was encouraging but urged the government to go further.

Following criticism from health service professionals, the Prime Minister set out "real changes" to controversial plans for England's NHS reforms.

To "support integration" of services, hospital doctors and nurses will be involved in care commissioning, along with GPs, and regulators.

Proposed changes include: Doctors and nurses being involved in new consortia planning and buying care, not just Gps; New "clinical senates" will oversee integration of NHS services across local areas; and Regulatory body, Monitor, will have a duty to promote integration of care across an area.

David Cameron said the planned reforms would give GPs more commissioning powers, increase competition in the NHS and abolish primary care trusts.

Speaking to the annual GPs conference of Local Medical Committees, Dr Laurence Buckman said the change to Monitor’s role announced by PM was encouraging but urged the government to go further. The result of the listening exercise must not just be a “re-spray job to try to persuade us to accept the unacceptable,” he said.



Dr Buckman told the conference that he was saddened that the potential benefits of clinically led commissioning had been undermined by the government’s insistence on having enforced competition within the health service: 

“While we see the potential benefits of clinically led commissioning, the government’s attitude to competition takes an idea that could be fruitful and turns it into something rotten.” 



Referring to a BMA MORI poll which found that two thirds of Pathfinder GPs believe increased competition will make the quality of care worse, Dr Buckman said: 

“What the NHS needs to improve quality and efficiency is collaboration and co-operation across the primary, community and hospital care sectors. So a patient gets a seamless service in the settings most appropriate for them rather than different bits of care delivered by different providers in order to try to get a cheaper deal – a scan in one place, treatment in another, tests in another and follow-up somewhere else. 

He went on to outline what changes the BMA wants to see made to the Bill, particularly to address GPs’ concerns about the impact the changes could have on their relationships with their patients: 

“We want an explicit duty on commissioning consortia to fully involve all relevant clinical staff. We want Monitor’s primary duty to be to ensure comprehensive and integrated services rather than to promote competition. And we want a more realistic timetable for the handing over of all responsibilities to all commissioning consortia. Above all, we want patients to be reassured that their GP continues to place their needs at the heart of their clinical decisions.”

The new plans follow a consultation whose findings are due out next week.

(BMcN/GK)