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BMA kick-starts reform debate one year on

Doctors and other health leaders explored how to create a better NHS without more top-down reorganisation at a BMA-organised parliamentary seminar today. 

parliamentOne year on from the formal implementation of the Health and Social Care Act, MPs, BMA members and representatives from NHS organisations and charities discussed whether the reforms were working. 

The seminar also marks the launch of a BMA campaign that renews calls for the controversial health legislation to be repealed.

The association has highlighted three areas of concern to kick-start the debate including:

  • Competitive tendering
  • The dual role of Monitor in driving integration and competition 
  • The role played by the OFT (Office of Fair Trading) consumer and competition body in approving health service mergers.

Over-emphasis on competition

BMA council deputy chair Kailash Chand told the meeting: ‘Currently, the act treats the need to integrate services and ensure there is competition between services and providers as equally important. This is wrong. This is absolutely wrong. Integration must be given prominence over competition.’

The Labour Party has claimed £5m has been spent on lawyers’ fees as clinical commissioning groups attempt to get to grips with the new rules. 

While at a commissioning conference last month, outgoing NHS England chief executive Sir David Nicholson acknowledged there was a lack of clarity around competition.

Labour shadow health secretary Andy Burnham maintained the government had erected barriers to full health and social care integration.

‘They’ve already legislated for fragmentation, they’ve legislated to require services to be put out, they’ve legislated to give competition authorities a role in deciding whether or not two hospitals should merge,’ he told the seminar.

He called the repeal of the Health and Social Care Act 2012 ‘essential’ but emphasised ‘that it doesn’t require a new reorganisation’.

Mr Burnham insisted: ‘Politicians, people like me, down the years have made the mistake that a new policy requires new organisations and it doesn’t.’

Joined-up care

The Commons health select committee’s annual inquiry into the work of Monitor has also urged it to do more to explain the rules of competition. 

stephen dorrellSelect committee chair Stephen Dorrell (pictured below) told the seminar that too often the system did not focus resources effectively to meet an individual’s needs because of artificial distinctions between community health, primary and secondary care. 

He maintained: ‘If that’s the problem we’re trying to solve I am in favour of the system changing … of a more joined-up approach to deliver care focused on the needs of the majority users of the health and social care system.’

Liberal Democrat health backbench committee chair Paul Burstow, a former care services minister, added that there needed to be a five-year and even 20-year ‘forward look’ built into public finances to better understand the pressures on care. 

Launching the BMA campaign, BMA council chair Mark Porter said: ‘The test for any government health policy should be whether it benefits patients and, while no-one wants to see another wholesale reorganisation of the NHS, doctors remain concerned that key aspects of the act and how they are being implemented could threaten patient safety — nothing more so than the emphasis on competition over integration and its failure to improve patient care.’

Watch the BMA seminar

 Find out more about the BMA campaign

The story so far