The Government wants a ‘world-class NHS with a third-class settlement’ – spending far less than many other European countries, with patients reaping the consequences.
BMA council chair Mark Porter told the association’s annual representative meeting in Bournemouth today that a ‘failure of vision’, which extended not only to the Government but all the main political parties, meant that they failed to address the severe problems faced by the health service.
The UK spent a lower proportion of GDP on health than other leading European economies, he said. If it spent the average, the English NHS would see £15bn extra investment within five years.
He said: ‘We’re not asking for the world. We’re asking for the average. For a fair chance to create the health service our patients need and deserve, and that we want to deliver.’
Dr Porter, in his fifth and final ARM speech as BMA council chair, said the Government’s response to the NHS deficit was to ‘duck, dodge and pass it on’.
Responsibility had been placed on to the shoulders of the local NHS, whose sustainability and transformation plans – ‘grim little manifestos where they are invited to consider every option, except the one that stares them in the face – that the NHS is systematically under-funded’.
As well as passing the buck for the financial problems, the Government also passed the blame to doctors when services were under strain.
Dr Porter cited the prime minister’s criticism of GPs at the peak of the winter pressures, despite their intense workload, recruitment problems and the diminishing prospect of her Government meeting its pledge to create 5,000 new GPs by 2020.
The BMA council chair criticised the rhetoric around Brexit, the nature of which had profound implications for the medical profession and the delivery of care to patients.
He said: ‘I hear belligerent talk about who has the hardest Brexit, but while these words may be thrown around lightly in London, they will be lived in Belfast.’
Anything which threatened the level of cross-border cooperation between Northern Ireland and the Republic, which included initiatives on heart disease and cancer, would harm patients and the health service, he said.
Dr Porter also said that it was right that ensuring a reciprocal deal that ensured the rights of EU workers in the UK, including 10,000 NHS doctors, was a priority for Brexit negotiations.
But ‘fine words’ had to be turned into action, following a year in which many had been left with fundamental worries about their employment rights and long-term future.
He said it was time for the Government to take heed of the legitimate concerns that doctors raised, such as in the growing body of evidence gathered by junior doctors as part of the exception reporting process, and from GPs who were considering whether to close patient lists because of the intense pressures they faced.
The Government also needed to listen to the evidence on public health and take action, such as in childhood obesity, where he likened the content of the Government’s recent strategy to a bowl of sugary cereal, and in alcohol, where the Government in England had failed to follow the initiative set by their Scottish counterparts in pressing for minimum alcohol pricing.
Dr Porter reflected on the ‘unfinished business’ of a profession that was heading towards gender equality in numbers but not in reality.
He said: ‘This is an urgent task for us all. It’s about challenging the structures that entrench inequality, but also about challenging both our own behaviour and attitudes, and those we experience every day. Until we are truly equal, we are all diminished.’
Dr Porter, reflecting on almost 30 years of BMA involvement, paid tribute to the hundreds of doctors who step up to represent their colleagues and campaign for a better health service.
He concluded, before receiving a standing ovation: ‘We can make a difference. We can be a source of hope for our patients, a source of leadership for our colleagues, and a source of challenge for government when it fails the National Health Service.'
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