Further changes to the Health and Social Care Bill in order to mitigate damage to the health service were published by the BMA as the legislation reaches the Lords Committee Stage.

The BMA addresses eleven areas of continuing concern in its latest briefing paper, including:

It should be the Secretary of State’s duty to ensure effective systems are in place to deliver medical education and training. – The BMA is content that the government has tabled an amendment, which is addressing most of the BMA’s concerns and is supporting other amendments, tabled by peers regarding national workforce structures The Secretary of State must retain ultimate responsibility to provide a comprehensive health service. – An amendment tabled by Lord Mackay of Clashfern aims to achieve this, with the BMA supporting its intention

Commissioning Incentives: the BMA remains seriously concerned regarding actual and perceived conflicts of interest in terms of linking financial incentives with Clinical Commissioning Group’s performances (CCGs)

Over-restricted powers over CCGs: the BMA wants the government to prove that its pledged devolution of power is genuine by making amendments and assuring the BMA that commissioners will genuinely have the freedom to select the most appropriate services with, and for their patients

Competition and cherry-picking: the BMA asks for an amendment that explicitly states increasing patient choice will not be given greater priority than ensuring fair access for all. It also wants assurance for further safeguards to prevent providers from only offering those services that are more profitable

Dr Hamish Meldrum, Chairman of BMA Council, commented on the briefing paper, declaring:

“The BMA’s preferred option is for the Health and Social Care Bill to be withdrawn. However, during this stage of the parliamentary process, there is scope for further significant change to be made, so we have today set out the areas where we believe there still need to be amendments. We hope the Lords will agree with us and change the proposed legislation, limiting the damage this Bill could do to the NHS.

Because so much of the detail won’t appear on the face of the Bill and will instead be left to secondary legislation and guidance, it is essential to have firm assurances now about the government’s implementation plans, for example, we continue to have serious concerns about the ethics of the current proposal to incentivise commissioners.

Other areas where the BMA is seeking amendments relate to public health; the private patient income cap; the foundation trust failure regime; increasing bureaucracy and complexity, and information and confidentiality. ”

Written by: Petra Rattue