Responding to the introduction of the Health and Care Bill in parliament today1 by the new Health Secretary Sajid Javid which brings forward reforms for the NHS, BMA deputy chair Dr David Wrigley said:
"Whilst in the midst of a pandemic and facing the largest backlog on record, the BMA has consistently raised concerns as to whether now is the right time to introduce wholesale reforms.
“We entered the pandemic with a historic workforce crisis, and this has only worsened as those staff have become exhausted with a growing number of our members telling us they plan to leave the NHS. Crucially, this legislation must be used as a key opportunity to boost the NHS workforce and strengthen accountability for the delivery of adequate numbers of staff. Having a fully-fledged workforce is instrumental to safe patient care now and in the future and to tackling the backlog of care.
“The BMA has long supported collaboration and called for the removal of enforced competition through Section 75, which the bill would achieve. However, the Government has to go further if the NHS is going to be truly protected from unnecessary and costly private sector involvement. The most effective way of doing that is to make the NHS the default option for NHS contracts and to only tender competitively where this is not possible. This is also vital to avoid the awarding of contracts without scrutiny to private providers at huge expense to the taxpayer, as was seen with the procurement of PPE and Test and Trace during the pandemic.
"It is vital that there is clinical leadership and representation embedded at every level of Integrated Care Systems, including formalised roles for representative doctors working in primary care, secondary care, and public health, to effectively achieve this. Introducing the Bill now gives rise to concerns that there may not be enough time for clinicians to engage effectively - it is after all clinicians who know their communities and where the greatest barriers to integration lie.
“The legislation also leaves open the possibility for corporate healthcare providers to gain seats on ICS boards which represents a clear conflict of interest affording them undue influence in decision-making which we believe should be left strictly to NHS and publicly accountable bodies.
"The BMA has serious concerns that proposals for increased powers for the Secretary of State could result in undue political influence over the running of the NHS. Changes to legislation in this area cannot simply be a power grab for political gain.
“The NHS since its inception has been subject to countless reorganisations, which never fully achieve what they set out to only have to go back to the drawing board. And now in 2021, the NHS finds itself in the most precarious position it has ever been in.
“The BMA will now be scrutinising this bill closely as well as seeking to influence and amend the bill in these and other key areas as the bill now progresses through parliament.”
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.