In calling for a general election, the prime minister refers more than once to the ‘national interest’.The BMA is not a partisan organisation, and has never given its support to any political party.But as doctors, we have a long-established view on what constitutes the ‘national interest’. And I think the vast majority of us would agree that this includes a health service that is well run and properly resourced, and does not have to lurch from one crisis to the next.As to which party is the best at delivering that health service, that’s a matter for you and you alone at the ballot box. But our job in representing doctors is to ensure that the health service is a central issue in the election campaign over the seven weeks between now and 8 June.There was a time when we could take this for granted. Healthcare has always been a political issue, although sometimes not in the way we would have chosen. Just as hard cases make bad law, a politicised row over a single patient’s treatment, as we have seen in some general elections, achieves little overall.General elections are the moment when the overall direction of our state is set, how we define and fund public services in the UK, for up to five years. But this election could all too easily become the ‘Brexit election’, and little else, at precisely the time when the health service in which we work is under unprecedented stress and needs the unrelenting focus of politicians from all parties to rescue it.We are seeing the organisations in which we work being pushed into intractable deficit, treatments rationed and access-time promises shelved. They are the unmistakeable signs of an NHS at breaking point.We have seen consecutive governments in denial about the state of the health service, and when it comes to elections they have treated it as little more than a political football. Our health and social care systems can simply no longer cope without urgent and coherent action.Patients want, vote for, and deserve better. We need politicians of all parties to stop ducking the crisis and come up with credible and sustainable plans for safeguarding the future of the health service. When it comes to securing the health of our nation, there could hardly be a stronger national interest.
Mark Porter is BMA council chair
The NHS is at breaking point - find out more.
Thanks Mark. We should all be looking to raise the Health Agenda at every opportunity through the debate over the next seven weeks. The NHS provision in ALL PARTS of the UK is at breaking point and there is need to lay out clearly plans to ensure the funding and capacity of the NHS is adequate for the demand that it is expected to meet across the UK. There is no future option of doing more for less or even the same as now, the pips are already squeaking... Claims that we have more doctors, more nurses (particularly if you don't count all the vacant posts) and are spending more than ever before even though they may be true are nothing more than denial as demand has risen with an increasing and increasingly aged population with increasing expectations as a result of political promises of what we can do for them.
I concur with the points made here. I would add that before we start calculating the sums needed to address these problems, we must first rediscover humanity. Failure to do so will have dire consequences:-valestreetobserver.blogspot.com/.../june-8th-vote-in-haste-repent-at-leisure.html
Thank you Mark. The only way the BMA can not sound party political is by calling all parties to legislate for the NHS to be removed from party political agendas. That is, have a cross party representation to formulate future NHS policy and direction. Only this way will we be able to put a stop to undeliverable whims that have been the down fall of the NHS over successive administraitons. The general public is all too aware how dire the situtation is. The general public will be prepared to do anything to save such a valuable institution from being eroded and fragmented by commercial hyenas ready to bite off big chunks at a time. We also need to give a listening ear to the grass roots and not the hot shots who come up with some ill conceived ideas under the guise of a 'report' and wreck major services eg Pathology as a result whilst sitting comfortably on a board of a major private pathology lab.
Some debate we can have with members writing anonymously.
I am a retired Whole Time NHS Consultant and I see gradual destruction of Medical Profession which has now extended to the young generation. It might seem odd, but I am against foreign doctors who strangulate the generation of our own qualified medical graduates. I came to this country nearly 57 years ago because of good quality post-graduate medical education it gave. Now our the places of our own medical schools are being reduce because the Government has got hold of our profession because of the mistakes of Shipman and Bristol Cardiac Unit misadventure. We should produce and maintain our own stream of graduates and post graduates. EU should not be our shelter.
Mark, your article and the anonymous commentators, illustrates how our profession is contributing to the stalemate in the NHS debate. When are you all going to start taking responsibility for leading the debate on the difficult decisions instead of just criticising? Those of us who have had over 40 years experience of dealing with the stupidity of politicians and their fluctuating ideologies, time serving administrators dedicated to maintaining the status quo and a public who won't take personal responsibility for their health and want everything for no additional expense need to now lead, even if we have to propose unpopular policies.
Doctors and other health professionals must form their own policy making body, independent of government and start the real debate. Tax rises? Who and how much? Fund everything regardless? Select aspects of health care that should be excluded from NHS funding? What fundamental principals must be maintained whatever the cost? Free access to Primary Care? Free emergency medicine, cancer therapy and terminal care? Insurance funding for sports medicine and "body maintenance" cold surgery eg cataracts, joint replacements in the over 60s? Stop funding infertility treatments and other reproductive medicine? Withdraw NHS treatment from those who gratuitously harm their and their children's bodies? Lets get provocative so people sit up, think and listen.
We professionals must stop hiding from our responsibility to provoke informed discussion on these and many controversial questions. We are the professionals who know what we would like to change to make our NHS modern and effective even if we have to stir emotions in the process. Mark and others, get some balls and get out there and make change happen instead of just bleating! And anonymous commentators, if you have any courage of your convictions put your name to your opinions!
Chris Sampson, East Sussex.
I would argue that it is our duty to protect our health system as much as possible. While the BMA has never taken a party's side during an election, it is our duty to inform the public of the facts, and specifically the fact that the current Conservative Government has grossly mismanaged the NHS and its staff. Personally, I would like the BMA to take the exceptional steps of advising the public that if they are unhappy with the situation the political situation around the NHS, they should avoid voting for the Conservatives at all costs.
The NHS is paid for by taxpayers money. Do we not have a right to representation? Why should we have to submit to a technocracy (run by the egos at the bma of course). I have no vote on who is in the bma and who is a consultant at my hospital, so how am I supposed to remove someone who implements policies I am opposed to? At least an elected politician can be ousted in 5 years, and has to run on a campaign promise.
The NHS is absolutely a political matter, and I am horrified by the patriarchal tone of those who no doubt would argue they know better than me.
After half a century, I am fed up with this constant bleating by the medical establishment. The NHS is an organisation so big it cannot exist without a political dimension. It is tax payer funded, and can always spend more than all the taxpayers can earn. Unless these realities are faced and the system changed to one that is smaller, does not pretend to be wholly universal, and is not wholly free at the point of access, it will simply wither away. Mark Porter et al are guilty of wishful thinking and dwelling in a cloud of unreality. This election is about our collective economic future, the NHS is secondary to that, because without a decent economy it simply won't exist anymore.
I am a member of the "Bleating Medical Establishment" and should have identified myself as the first to comment on this. Of course Politics has and will continue to have great interest in the NHS as it is publicly funded and the decisions about what it has to deliver are politically made. It is also of great interest to those who pay for it namely the taxpayers. Residents of the UK enjoy healthcare which is provided at a quality and a standard significantly higher than they would expect for what it costs than if it was provided as an insurance based service privately. Doctors would most certainly be much better off if they were working within a privately funded system. It is not just about doctors, the whole public sector has been seriously squeezed as a result of the financial crisis engendered by the activities of our banks and the subsequent government bailout. The NHS is at breaking point and I like many of my colleagues believe that its failure would not be in the interests of the population or indeed the government. We are now seeing an inability of those striving to maintain a high quality of care to continue to deliver and I expect that when it finally breaks it will be catastrophic as there is no system available to pick up the pieces. We are seeing GP practices literally going out of business and sticking paster solutions trying to provide some sort of service, hospitals are increasingly looking to stop doing things to reduce their spending. This is not the way to manage the crisis in which the NHS currently is, there is a need to either accept that there must be some real increase in funding and staffing to increase capacity to meet current demand or there must be clear and transparent acceptance that the government is not funding universal healthcare free for all at the point of care and what is and what is not covered. It is not for doctors to decide what balance of these constitutes the right way forward for the UK, that is what we elect politicians to do and now we need to hold them to their responsibilities. There is no magic solution and they are going to have to engage with an uncomfortable reality and in particular accept that there is not going to be an extra £350 million pounds a week pumped into the NHS by Brexit which is still believed by many. If this was true we might well be campaigning for Brexit to save the NHS however the reality is that it is simply going to bring further challenges with staffing, tariff barriers, shared research, regulation etc. all at a time when we have no resilience.
Peter Curry, Scotland
In my opinion, many doctors foolishly embraced the re-organisation of the NHS under Lansley and by taking on managerial responsibility gave politicians plausible deniability. As the NHS descends into gridlock, the public will blame doctors not the politicians who control the purse strings. I'm not a doctor but I worked as an administrator in a PCT and watched as politically naive GPs (ersatz managers) embraced their new 'power' under the dogs breakfast that transformed us, at enormous cost, into a CCG. No political party has the courage or desire to discuss the need to change the NHS social contract. It's a vote loser. Instead willing members of the medical profession were suckered into taking political responsibility. The BMA is a trade union, the Royal Colleges are essentially guilds, time these coteries started representing their members interests successfully. Karon Dahmer MA (Cantab), MBA
The reason I won't vote conservative is they haven't taken GP concerns seriously enough . Theresa May even trying to blame us for hospitals not being able to cope because surgeries aren't open enough .A very misguided thing to do .Many of us find that hard to forgive when morale is so low . We are a tiny expenditure compared to secondary care and amazingly flexible .
Patients and hospitals will suffer the consequences if the primary care recruitment crisis is not acknowledged and dealt with promptly .
It is a time bomb waiting to explode .
Lets see if we can stop its detonation by putting a few pennies into the so called transformation plans .
Everyday I also have to deal with the current governments onslaught on social care . Of course some people should be looking for work who are claiming benefits but I have never been so shocked recently by the number of deserving patients denied PIP by some callous and frankly rudimentary examination of their capabilities .Who are these assessors who see an object not a human being .I don't have time to deal with this sadly .
The NHS can only survive if social care is dealt with properly .Resource social workers ,respite services and community services and you get more patients out of hospital .CN -a GP from Dudley
Mark I whole heartedly agree with everything you have said.
Time for action. There needs to be a ten year plan that all political parties must agree to honour and we need to accept healthcare is expensive and always will be given how quickly it updates. we need to fund the gold standard treatments sustainably and properly. This plan must be drawn up by experts (doctors, nurses, allied health professionals, patients managers and representatives from the two major parties I already know my MP is very pro this idea.
I think we need to
1. Do a petition calling for the above to be debated in parliament
2. Write of to our MPs about this
3. Produce a factual easy to understand leaflet explaining the situation to the general public
4. Maybe we need to start drawing up the issues that need addressing ourselves now. I feel acute care, cancer care and certain chronic conditions are managed very well in the NHS.
The areas I personally feel really need to be focused on urgently are social care, increaed access to primary care and mental health.
I wonder if it is worth the BMA starting a campaign for this now and forming a committee? More than happy to be involved in this in some way.
Dr E Hannah FY3