Commenting on the Health and Social Care Bill for the NHS in England, Dr Hamish Meldrum, Chairman of Council at the BMA, said: “Ploughing ahead with these changes as they stand, at such speed, at a time of huge financial pressures and when NHS staff and experts have so many concerns, is a massive gamble. “
The BMA supports greater involvement of clinicians in planning and shaping NHS services, but the benefits that clinician-led commissioning can bring are threatened by other parts of the Bill. In particular, the legislation will allow competition to be forced on commissioners, even when they believe the best and most appropriate services can be provided by local hospitals. “Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients. Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services. “Commissioners should be free to choose the best and most appropriate providers, creating care pathways across hospital and community care boundaries, without fear of a legal challenge from private companies or the health regulator. “In addition to all this is the deadline for all Trusts to achieve foundation status by 2014. Forcing all hospitals to become Foundation Trusts before they are ready could impact on patient care.
