Responding to the publication of the Times Health Commission’s report1, Professor Philip Banfield, BMA council chair, said:
“This timely report rightly recognises both the scale and breadth of the challenges currently facing health services, health staff and the health of our population.
“It’s good to see the recognition of the workforce crisis that the NHS faces; the risk posed by the exodus of doctors, ground down by unsustainable workloads and poor working environments, and tempted abroad by better pay and conditions elsewhere. The Commission rightly says that retention is key, keeping hold of the essential skills and expertise we already have, as well as recruiting more staff. In this respect, some of the recommendations are welcome – such as student loan write-off, as we know the debt burden on newly-graduated doctors is huge, and the need for a vastly more supportive and flexible culture within the NHS is urgent. However, while recognising that pay continues to be a great source of frustration – and the cause of the strikes that doctors have been forced to take over the last year – the Commission sadly fails to make the obvious recommendation of restoring doctors’ pay, which would have a real impact on retaining clinicians. Without this, any meaningful hopes of addressing the near record-waiting lists will be dashed. Indeed, accelerated weekend theatre lists are all well and good, but the premium required to fund such activity risks detracting from essential investment elsewhere; doctors are already exhausted after working beyond their hours all week, already spread too thinly.
“The shift in focus from treatment to prevention, away from the ‘National Sickness Service’ we currently rely on, may be the right direction of travel, and many of the recommendations around improving public health – such as actions to tackle unhealthy foods and obesity – and reducing health inequalities align with what the BMA has been saying for many years. It is better for patients and cheaper for the Government to treat conditions early, or stop people getting ill in the first place, than intervene later when serious problems have developed.
“A move to focus more on primary care, and crucially general practice, makes sense. But we should not reinvent the wheel before getting the basics right: in general practice, we continue to lose doctors – the equivalent of more than 1,800 fewer since 2015 – and practices are struggling to provide patient services due to soaring costs. Yes, we need to slash bureaucracy and allow GPs to focus on health outcomes rather than ticking boxes, but we also need to massively invest in practices and staff. As the Commission notes, continuity of care is key, but practices cannot offer this if GPs keep leaving and practices keep closing.
“There’s a big focus on technology and what it can offer, yet we know doctors struggle with outdated hardware, woefully slow software and systems that don’t speak to each other – again it’s about getting the basics right. The notion of a digital ‘patient passport’ sounds convenient in principle but would need comprehensive safeguards around patient data, and crucially any such system must not exclude those who are not digitally engaged or literate. The Commission incorrectly paints the BMA as blockers to digital innovation, but in reality our priority has to be patient safety and security when it comes to their confidential health data, as doctors are so often left liable when these are failed.
“There is a lot to unpack and consider in this report and its recommendations, but ultimately the ability to improve the state of the country’s health and services is bound by the Government’s will to act, and crucially, invest. This change must come from listening to the doctors and colleagues that give their all on the front line every day. We are the solution, not the problem.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- Contact [email protected] for more information on the report.
- Read the BMA’s submission to the Times Health Commission.