Pace and scale of Reforms
1.This meeting calls for the BMA to investigate the legality of the government’s action in implementing significant parts of the Health and Social Care bill ahead of its ratification by Parliament, and then to take any appropriate legal action.
That this meeting demands the BMA oppose the Health and Social Care bill in its entirety as the Coalition Government has no mandate to enact it.
2.This meeting believes the NHS provides a high quality, cost effective, equitable, accessible, popular service. The NHS is not broken. The government has no mandate to dismantle it and has provided no justification for the changes and no convincing evidence to support its claims. The governments proposals will work against integration of primary and secondary care, which is necessary to improve the quality, safety and efficiency of patient care.The proposals are being rushed through, untested and at enormous cost, destabilising existing management structures and putting the NHS at great risk.
That this meeting insists that the BMA must cease its policy of critical engagement and oppose the Health and Social Care Bill outright. The BMA must instead lead in the development and publication of evidence-based policies, which build upon and improve the service we already have.
The engagement of Patients
3.That this meeting instructs the BMA to inform the public, and the Coalition Government, that many GPs have signed up for pathfinder status, not because they support the Health and Social Care Bill, but through fear that the government will drive through the changes and ignore the results of any consultation.
Expansion of the market
4.This meeting believes expanding the role of the market and encouraging an ‘any willing provider’ policy is in our view the antithesis of continuity of care, integrated planning and collaboration between healthcare professionals to provide high quality patient care. These are non negotiable core values of our NHS. These values are undermined by expanding the market into healthcare provision and encouraging any willing provider.
That this meeting demands the BMA actively oppose the Health and Social Care Bill as a whole until the planned expansion of the market and offers to any willing provider are removed.
5.This meeting believes the Health and Social Care Bill will encourage a market based approach to healthcare that will worsen health inequalities, and put at a disadvantage the most vulnerable and unwell in society who are unable
to exercise true choice. This is contrary to the founding principles of the NHS to provide equitable healthcare according to need.
That this meeting demands the BMA oppose the Health
and Social Care Bill in its entirety.
Price Competition and competitive tendering
6.This meeting notes there is extensive evidence that price competition between private sector providers of health care does not provide good quality patient care. The Health and Social Care Bill plans to introduce both price competition and competitive tendering into the NHS. We believe the legislation as it stands will threaten the standard of patient care, undermine collaborative practice and the integrity of the NHS.
As our voices were not heard through consultation, that this meeting demands that the BMA actively oppose the Health and Social Care Bill as a whole until price competition and competitive tendering are removed from the legislation.
7.This meeting notes the NHS is funded by public money. Therefore the privacy laws around prices paid to private providers of medical care to the NHS should not apply. This is essential in order to ensure transparency for the tax payer and appropriate use of public monies.
That this meeting commits the BMA to lobby the government to add a clause to the Health and Social Care Bill removing financial secrecy agreements for any organisations who are providers within the NHS .
Implications for the future of education
8.This meeting believes the education of the future NHS workforce is crucial to the ability to continue high quality care and to ensure high quality clinical governance. This health and Social Care Bill threatens the delivery of comprehensive integrated education to all members of the workforce. The ability to teach will be put in peril by a multiplicity of providers with little interest or incentive to provide education.
That this meeting demands the BMA oppose the Health and Social Care Bill as it will destroy the comprehensive national delivery of high quality education.
The principle of clinician led commissioning
9.This meeting believes that the purchaser-provider split in all its various incarnations over the last few decades has not improved the NHS. This meeting agrees with the Commons Health Select Committee which stated in March 2010 that commissioning in the NHS has been ’20 years of costly failure’. Further pursuit of this failed idea will further fragment the NHS and lead to a dangerous rift between primary and secondary care.
That this meeting demands the BMA must implacably oppose any legislation that does not remove the purchaser provider split from health care provision. (meeting would like the BMA to note that this is a very important motion)
The future of Public Health
10.This meeting has concerns that the lack of clarity and guidance to GP consortia regarding public health involvement in commissioning, including the development of Health and Well-being Boards, will lead to lack of integrated working between GP Commissioning Bodies and public health specialists in effective and imaginative strategic planning of healthcare for local populations.
That this meeting demands the BMA oppose the Health and Social Care Bill in its entirety until consultation and planning between Public Health
Specialists, Local Government, and patients have been undertaken and guidelines for integrating pubic health involvement in GP consortia commissioning are established.
11.This meeting believes that the governments plans to work with the commercial food and alcohol industries to improve healthy eating and drinking habits in the general population is akin to putting the criminal in charge of the justice system, and is an insult to the intelligence of the population.
That this meeting calls for complete separation between
public health and commercial food and alcohol interests, and that the BMA demands this
A Better NHS 
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My full support indeed. Is it true that many GPs are against it?
I can only quote Michael Lewis:
I think there is something fundamentally scary about our democracy…. Because I think people have a sense that the system is rigged, and it’s hard to argue that it isn’t.
The Cockroach Catcher
I had a practice manager as a patient yesterday. She told me that what she found worrying was that at the meetings she had been to there seemed to absolutely nobody enthusiastic about the changes.
There is nothing democratic about this. David Cameron let slip recently that the privatisation and charitisation of the public services has been planned for 5 years. If so, why weren’t we told before the election?
If GPs really want to derail these reforms surely the best way would be for a mass resignation from the pathfinders. At the moment, sign-up to pathfinders is being used by the government as evidence of enthusiasm. What better way to wreck this argument than pulling out?
Conflict of interest: I am a commissioning manager in a PCT
My PCT goes to social enterprise this year. We do not want this. The PCT boards act as though government allies and my MP thinks health care is a choice. He equates this with a friend of his who, apparently, has chosen to never go to the dentist.
The public do not listen to the unions or the AHPs or the RCN. They take notice of doctors. You have a voice. Please make a stand before it is too late.
Mass resignation is always difficult for doctors. I have stated on my own blog that Govt. money is the best money to be making but it is in fact our money whether you pay tax directly or indirectly. Private Health Care providers are luring the public with nice waiting rooms and the rest. If you look at the car parks you will find who parked the Porsches there. Someone is going to make money and if the pot is dwindling where is the profit going to be. CIRCLE is the John Lewis of Private Health and they are clear that the surplus is for NHS patients. So we can all eat at the Ritz but only of the left overs.
Email just sent to Mr Cameron and Mr Clegg
“Mr Cameron
I urge you to scrutinise the wording of the Health Bill to ensure it does not bring about unforeseen changes. For instance, what protection is there against foreign companies for example from China becoming providers? I am also concerned that there is no prescribed legal and moral separation of GPs on the frontline from the GP consortia. I have already raised this with the DH but have received no real acknowledgement of the potential problems. It seems that safeguards from the problems people have been raising should be legislated for, in order to fill the gaps which people are seeing.
Again with regard to devolving controls to local councils, what true safeguards are there?
I was hopeful when you came in that you would kick start the country yet you seem to be creating a monster which could get out of hand from so many of these new approaches and actually cut the British people adrift rather than empowering them. There surely needs to be a fallback position.”