BMA raises concerns about NHS trusts in financial crisis, UK

Main Category: Public Health
Article Date: 27 Aug 2005 - 18:00 PDT

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Job losses and department closures in hospital trusts in England could be on the cards because of the financial crisis of some trusts, according to the BMA's Consultants' Committee.

The Committee has been receiving examples of hospitals in difficulty and will now survey all trusts in England to get a more accurate picture of what is going on.

In the interim, Dr Paul Miller, Chairman of the BMA's Consultants' Committee has sent a letter1 to the Secretary of State for Health, Patricia Hewitt expressing doctors' concerns.

In his letter Dr Miller said that cuts would "pose a significant threat to patient care and innovation in the NHS".

He added that consultants were increasingly infuriated that despite considerable Government NHS funding, money was not getting to the frontline and there were grave concerns whether value for money was being achieved:

"The cash shortages in the NHS contrast dramatically with the generous terms negotiated with companies such as Netcare UK and Alliance Medical despite significant under-performance.

"We are deeply concerned that managers running frightened for their jobs are making knee-jerk decisions about the reduction or closure of services in response to short-term funding problems."

Dr Miller has asked to meet the Secretary of State to discuss these issues as soon as possible.

Below is the letter Dr. Miller wrote to the Secretary of State for Health

Rt Hon Patricia Hewitt MP
Secretary of State for Health
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL

26 August 2005

Dear Ms Hewitt

NHS funding crisis

I am sure that, like the BMA's consultants' committee, you are extremely concerned about the growing number of reports of NHS trusts facing serious funding shortfalls and consequent proposed cuts in patient services and in jobs. For the first time in my memory, we are now receiving widespread reports of proposed freezes on consultant recruitment and even the threat of consultant redundancies. There is a significant threat to patient care and innovation from the widespread freeze on consultant and other recruitment.

The BMA has said on many occasions that it welcomes the considerable increase in NHS funding introduced by this Government. Given the increase in funding, the prospect of widespread service closure and redundancies (including consultants) is all the more difficult to understand. Serious questions have to be asked about where the increased NHS resources are going and, in particular, whether value for money is being achieved from the funding being preferentially ploughed into contracts for clinical services with private sector providers.

The cash shortages in the NHS contrast dramatically with the generous terms negotiated with companies such as Netcare UK and Alliance Medical. This is all the more concerning when the contracts agreed with such companies have allowed payment to continue despite significant under-performance, for example the orthopaedic contracts in South Yorkshire and Trent, the Alliance Medical MRI contract and the Netcare eye contract.

We are deeply concerned that managers running frightened for their jobs are making knee-jerk decisions about the reduction or closure of services in response to short-term funding problems. Indeed, many such decisions by SHAs are penalising the good NHS performers and rewarding those with poorer records. Crucially, these decisions are being taken without the input of front-line clinicians, particularly consultants. As a result, there is no appreciation of the long-term consequences for patient services.

There is a desperate need for clinical engagement in local decision-making otherwise the potential impact of these cuts on the NHS could be catastrophic. Furthermore, most of these processes are taking place without the knowledge of the local public, surely in contravention of the basic principles of a patient-centred NHS?

The BMA's consultants committee would be pleased to work with you to try to address these difficulties and I would welcome the opportunity to meet with you to discuss our concerns with you at the earliest opportunity.

Yours sincerely

Dr Paul Miller
Chairman
Central Consultants and Specialists Committee

British Medical Association BMA House Tavistock Square London WC1H 9JP http://www.bma.org.uk