BMA Cymru Wales manifesto for a healthier Wales
June 2006
Delivering for Wales – a manifesto for Wales
BMA Cymru Wales is committed to working with all political parties and the new Welsh Assembly Government to deliver our shared aims.
BMA Cymru Wales will seek to work with all of the Welsh political parties and the new Welsh Assembly Government to develop policies which:
- provide an efficient NHS structure for the long term
- establish long-term planning and investment
- stop the NHS being used as a political rugby ball
- strengthen community based services
- develop community hospitals
- develop better integrated services
- develop managed clinical networks
- involve staff and patients in the development of services
- ensure patients are involved in decisions about their health care
- educate the public about developing a modernised health service
- inform the public on how best to use the health service
- give patients access to accurate information about health services
- establish relevant and achievable targets for access to the primary care team
- improve access to secondary care services
- extend the role of other health professionals
- improve 24-hour care provision
- make better use of technology to provide health services
- improve health services for prisoners
The British Medical Association (BMA) is committed to improving the health of the people of Wales. Over the past three years we have worked to strengthen links with patients, healthcare professionals, health service managers, government officials, political parties and the Welsh Assembly Government. We believe the Welsh Assembly Government can be the catalyst for driving forward improvements in our health service to create genuine Welsh solutions for long standing Welsh problems.
Investment
Extra investment is needed to rebuild the health service in Wales despite the significant investment already made – as we continue to play catch up and we believe this will present new opportunities to design and deliver more effective services for the people of Wales. The BMA recognises that the NHS will only survive with change and is keen to work with the Welsh Assembly Government to bring about positive and meaningful improvements for patients in Wales. Services provided by medical staff are changing constantly in the light of new discoveries and advanced techniques for treating illness and disease. Doctors predominantly lead the way in innovation, research and pushing the boundaries of healthcare embracing changes and the benefits it can deliver for patients. The BMA has been supportive of many of the measures introduced by the current Welsh Assembly Government. However, although we recognise that progress is being made, much still remains to be done.
Bureaucratic
Most health professionals recognise that the NHS in Wales is extremely bureaucratic. BMA Cymru Wales believes that the current situation where 22 local health boards working alone – are commissioning services from the trusts is unsustainable. While we understand the importance of locality teams working closely with the current local government structure on joint social service issues and working in harmony on the social agenda, we believe that there should be a new model of commissioning services with fewer commissioning units but informed by good quality data collected by GP surgeries. With a shift to a medical professionally led service, these units should be clinician led by GPs and hospital consultants providing a structure where clinicians who work in the front line every day innovate better systems which are then implemented by professional non clinical NHS managers.
Natural groups and areas lend themselves to joint working and would give the new commissioning bodies the strength that they need to work with the trusts to deliver the service to patients. Doctors are the barometers of the health service: they know their patients and know what services are needed.
This should be a natural evolutionary process, to bring about a service structure which represents the experience and views of clinicians who work in the front line of the NHS but by avoiding the intensely disruptive big bang change of previous reorganisations .
The regional office functions need to be clearly defined to fulfil a monitoring role and give an overview of the wider regional service commissioning.
BMA Cymru Wales believes that there are too many hospital trusts in Wales providing similar services to small numbers of patients. This leads to an insufficiency of clinical cases to comply with royal college training criteria and loss of economy of scale where expensive capital equipment is required. The BMA would support a change to the current structures to enhance clinical involvement in commissioning of primary and secondary care services and also to reduce the number and remit of trusts to enhance their efficiency and accountability.
Although a reconfiguration even on this modest scale would cause substantial turbulence in the system, unless a change of this type of magnitude is brought about the real opportunities at this time will be missed.
Before any reconfiguration of services takes place on a local level, the following principles must be taken into account:
- the entire patient pathway and the effects of the proposed reconfiguration on other services and organisations must be examined
- changes are evidence based
- costs of change are calculated
- consideration is given to the effects on the training of doctors
- consider the requirements for regional planning of specialist services
- clinical involvement in any proposed changes is established from the outset
- team working opportunities across primary, secondary and tertiary care are investigated.
Now is the time for statesmanship from all politicians to build a sound future for the health of Wales in the true tradition of Aneurin Bevan.