Healthcare Experts Call For New Direction For The NHS, UK

Main Category: Public Health
Article Date: 29 Jun 2010 - 0:00 PDT

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The NHS would become both more cost-effective and equitable if it were operated on its founding principle of co-operation rather than competition, a group of medical bodies, unions and healthcare experts say.

In a joint statement - the result of a round table event to discuss alternatives to the market model for the NHS in England - academics and campaigners from the BMA, NHS Support Federation, NHS Consultants Association, Keep our NHS Public, Unison, and others, call for:

- New mechanisms to allocate NHS funding more equitably and efficiently: the document calls for funding to be allocated on the basis of population need rather than activity by trusts. It warns that the present payment by results / tariff system is "based upon narrowly defined episodes of care", can "generate perverse incentives in patient referrals" and does not encourage "the pursuit of unmet need"

- An end to the purchaser-provider split: abandoning the purchaser-provider split in the NHS would be likely to generate substantial savings, the document says.

- A new vision of what 'choice' means: the statement says there is a distinction between choice as a lever for competition, and choice as the capacity for patients to make informed decisions about their own care. It says that unfettered patient choice as it has so far been conceived in the NHS is not what most patients want.

Dr Hamish Meldrum, Chairman of Council at the BMA, says:

"The BMA, like many other groups, has long been concerned at the costs and perverse incentives resulting from the market structure that has been imposed on the NHS. Many of the reforms of recent years threaten to erode the principles of free access, care based on need, and risk-pooling. We need a democratically accountable, local approach to healthcare delivery, with funding based on the needs of patients, and providers encouraged to co-operate rather than compete.

"At a time of real economic challenge to the NHS, our proposals will maximise the effective use of scarce resources and help to ensure that patients get the services they need. We urge the coalition government to be true to their word and listen to the views of front-line health professionals."

Notes

1. View the full statement here.

2. The round table event, An NHS Beyond the Market, was hosted by the BMA on 14 April 2010, in association with the NHS Support Federation, the NHS Consultants Association, and the Keep our NHS Public Campaign

3. The statement is published ahead of next week's BMA Annual Representatives Meeting, where doctors will be debating a call for the NHS to "abandon the wasteful costs of duplication, bureaucracy and competition inherent in an NHS market.": see here.

Source:
British Medical Association

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