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BMA demands Bill’s drastic revision or withdrawal

BMA sets out concerns as Lords prepare to debate amendments to the Bill

Louise Prime

Thursday, 06 October 2011

The BMA has demanded withdrawal or at least substantial revision of the Health and Social Care Bill, in a letter and briefing paper sent today to every peer in the House of Lords. The Bill is due for its second reading in the upper house next Tuesday.

BMA chair Dr Hamish Meldrum warned the Lords that the Government’s health policies “implemented both through and beyond the Bill, will make it harder to create the seamless, efficient care that everyone agrees is key to future sustainability”.

The BMA acknowledges that some “significant amendments” have already been made to the Bill in response to lobbying by the BMA and others, and also that the Bill has certain positive aspects such as shifting the balance of control towards patients and their doctors. But Dr Meldrum insists that “on balance, the BMA still believes the Bill, as it currently stands, poses an unacceptably high risk to the NHS in England.”

He writes that the BMA remains concerned about how the “most radical restructuring of the NHS in a generation” will actually be implemented, especially given that rapid rollout has already begun – even before the legislation has been enacted.

Dr Meldrum asks the Lords to address in their debate the BMA’s three most pressing concerns, which are: 

  • that it must be made explicit that the Secretary of State will retain ultimate responsibility for provision of health services
  • that patients’ increased choice of provider for specific elements of their care does not take priority over the development of integrated services and fair access for all
  • there must be greater scrutiny of the plans for how to tackle ‘failing’ hospitals.

Dr Meldrum also puts to the Lords five more specific concerns that the BMA has regarding the Bill: the threat to the future capability of public health in the NHS; uncertainty over the future of doctors’ education and training; the effect of incentives for commissioners on public confidence and trust in their doctors; the unnecessary and unhelpful bureaucracy developing around clinical commissioning groups and the NHS Commissioning Board; and the proposal to abolish the cap on income Foundation Trusts can generate from private patients, which it says could worsen access to services for NHS patients.

Lords Peter Hennessy and David Owen wrote to crossbench peers on Monday, as they tabled an amendment to the Bill whereby parts of it would be referred to a select committee. They urged peers to consider their proposal to split it “to allow for a two speed appraisal of parts of this Bill”.

They wrote: “We believe there has been insufficient scrutiny of parts of the massive Health and Social Care Bill and whilst we accept it is not the role of the House of Lords to challenge the legislation in its entirety which has been given a Third Reading in the House of Commons, we do believe it imperative the House of Lords provide a mechanism for far greater in-depth consideration of a number of parts of this Bill which cover duties and constitutional issues.”

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