Dr. Hamish Meldrum, the British Medical Association’s Chairman of Council has called on doctors, after the final debate on the Health and Social Care Bill in the Houses of Parliament, to look forward and do what they can in order to “limit its more damaging aspects.”

Meldrum declared in a message to BMA members that he is concerned and saddened that the Health and Social Care Bill passed. According to Meldrum, although the BMA was unable to get the Bill withdrawn “it was right to have spoken loudly and repeatedly about the risks inherent within it.”

The BMA “critically engaged” with the Government in July 2010 when the plans for NHS reform were initially announced. Doctors believed that the promise to increase patient involvement within the health service and clinically led commissioning could potentially be of benefit, regardless of their concerns in terms of raising competition within the NHS.

Later on, however, when it became apparent that the government had failed to listen, the BMA opposed the plan, on the grounds that the reforms were creating chaos on the ground and that excessive central control was restricting doctors’ abilities for making improvements.

According to Dr. Meldrum, the BMA’s lobbying had “a significant impact”, which resulted in numerous positive changes to the Bill.

Although, he states:

“It would still be much better not to have had the Bill in the first place. The legislation is flawed; at its core, even with amendments, it places too much emphasis on using market forces and risks greater fragmentation of our health service.”

Secondary legislation as well as guidance is still required in order to address much of the detail of how the Bill will work in practice.

According to the BMA, questions still remain surrounding areas, such as the detailed operation of Clinical Commissioning Groups, the NHS Commissioning Board as well as the Monitor’s role in the new system of economic regulation.

Furthermore, there are still concerns regarding how similar reforms to the delivery of public health and education will fit in the new infrastructure.

The BMA “will continue to seek an evidence-based, sensible and practical approach to any implementation,” said Dr. Meldrum.

Dr. Meldrum explained:

“The passing of this Bill marks a significant moment for the NHS. As clinicians directly involved in providing care in the NHS, there will still be opportunities to try and temper some of the worst potential consequences of the legislation and keep a health service which, despite this legislation, is still putting patients first in years to come.

We may now have won this particular battle but we will still continue to fight to protect and preserve what is best about our NHS.”

Grace Rattue