Darzi's Five Pledges Are Positive But Need Detail, Says British Medical Journal, UK

Main Category: Public Health
Article Date: 09 May 2008 - 3:00 PDT

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Five pledges on NHS reform in England announced by health minister Lord Darzi today (Friday 9 May, 2008) are positive in principle, but there are signs that they are so far not being met in practice, the BMA says.

Commenting on the 'Leading Local Change' document, published ahead of regional reports from Strategic Health Authorities on NHS reform, and Lord Darzi's final report, Dr Hamish Meldrum, Chairman the BMA, says:

"These principles are all positive - in fact they're impossible to disagree with. Of course it's right that changes should always be to the benefit of patients, that they should be evidence-based, and that local populations should have a meaningful say over their NHS services.

"The problem is that the public and healthcare staff alike have yet to see much evidence of these principles being delivered up to now.

"As part of the initial Darzi review, it appears that every Primary Care Trust will have to meet a centrally imposed requirement to have a new 'supersurgery'. This is despite a lack of sound evidence to show that they all need one, or that proper local consultation is always taking place.

"Lord Darzi's pledges are sound but require detail - we need to see much more flesh on the bones. The impact of these reforms will ultimately depend on such details - on the way they are taken forward locally, and on the nature of engagement with staff and the public. We will be scrutinising the outputs from the regional groups to try to make sure that these principles are really being borne out in practice.

"The BMA has already produced detailed proposals on both an NHS Constitution and Public and Patient Involvement which we believe would give detail and teeth to the minister's principles and help to ensure that the local public and clinicians really have a voice in the range and quality of the services being provided."

Juliet Dunmur, Chair of the BMA's Patient Liaison Group, adds: "The involvement of patients and the public has been patchy, and the quality of consultation has varied considerably. At the moment, there simply isn't the infrastructure to give patients a genuine voice in these changes. The new patient organisations introduced last month have not yet had an opportunity to get underway with their work."

1) The BMA's proposals for an NHS constitution and improved Public and Patient Involvement are available here.

2) The BMA is holding a series of regional meetings in each Strategic Health Authority to enable local doctors to discuss planned changes in their area: Dates confirmed so far are:

- Eastern 28 May 2008
- Southern 11 June 2008
- East Midlands/Trent 11 June 2008 (Lincoln)
- South West 16 June 2008
- West Midlands 18 June 2008
- Yorkshire 17 June 2008

British Medical Association