Friday 2 September 2011

The BMA!

So the BMA are launching a " kill the bill " campaign. They have reversed their position in welcoming the work of the Future Forum and the changes that were proposed, retreated back into their comfort zone and now want to kill all chances of reforming the service for the benefit of patients.

I think the time someone spoke some home truths about this union. Let's be clear on the role of the BMA. This is not an organisation that puts patients' interests first, or wants to defend the NHS. It is the doctors' trade union and has always put what is good for the doctor before anything else. No reason why a trade union should not do this. It's their job. And they have been most effective in doing it. But do not allow them to get away with the deception they are defending the NHS or have the citizens' interests at heart, because in this case they most certainly do not.

For too long politicians have indulged the BMA. The attitude is , as Nye Bevan put it in his mammoth struggle with the BMA when he was setting up the NHS , we "stuff their mouth with gold". One of the major failings of New Labour was to cave in to the BMA on doctors contracts. So we now have a situation where a very large number of doctors are paid more than the PM.

And I would not object to good salaries for highly professional and dedicated staff, but what I do object to is the lack of customer focus. Why don't more doctors surgeries open at the weekends or late evenings so those of us who work can see them without having to take a day off work? Some already do, but it should be the norm not the exception. And why is it often so difficult to get an appointment, so you are left with the impression you are being granted a favour rather than your right? And we all know of doctors surgeries that won't register " difficult" customers like the homeless or travellers or the profoundly mentally ill, all because they are too much trouble! Perhaps Hamish Meldrum, the Chair of the BMA, who writes in the Guardian today about his concern for poorer people loosing out in reforms, could turn his attention to those of his members who take such attitudes.

There are many wonderful doctors in our NHS. It is rightly why we all hold them in such high regard and trust them. I have met many of them over this last year. There are many progressive doctors who want to work with the third sector, who know reform is needed and are keen to take control of commissioning to make change happen.
But they are let down by some dinosaurs in the BMA who put sectional and vested interest before what is good for the NHS and the citizens who own it .

Yes, that’s right - citizens own the NHS and its citizens that doctors serve! And I have to say that the article in the Guardian with the BMA of all organisations posing as defenders of the poor is laughable.I was amazed by Meldrum's comments when he said we should oppose extending choice because " articulate middle class patients" will be able to take advantage and the less well off will not. What an idiotic argument. Of course less well off citizens find it harder to exercise their rights. That's true in education , welfare etc. But the answer to that is not to stop extending choice but to ensure we put resources into advocacy and support to people to exercise choice . Its a spurious argument, which masks their opposition to giving us all more choice over our health service. It is also deeply patronising to poorer communities ; assuming if you are poor you don't have the ability to exercise choice. The NHS Constitution ( which i thought the BMA supported) guarantees choice to citizens. Are the BMA now arguing these rights be removed from us?

So let's be clear when we hear their "kill the bill" demands. This is not because they are supporting the NHS; remember this organisation opposed the setting up of the NHS back in 1947. They have regressive and patronising views on the role of the third sector . They oppose competition and a greater diversity of providers , because they think it effects their dominance of the health sector.

There is a deep irony in their calls to stop "privatisation " and more competition. What is the biggest private sector involvement in the NHS? Doctors! Doctors are not public servants. They are independent private contractors. Indeed as I pointed out in my report for the government on choice and competition the role of independent private sector firms in the NHS is quite small, overall, less than 4%. Much less than doctors. So let's not allow the BMA to masquerade as defending the NHS in their new campaign .

We have been through a major review of the Bill in the Future Forum work. The Government have accepted significant change in their proposals. It would be appalling if yet further concessions were made to the vested interests of the BMA.
So my message to Lansley, Cameron and Clegg. Stand firm. Time to face down the BMA . It is no time for wimpishness. Governments have been too accommodating to the BMA in the past. Of course let's listen to their concerns. That is what the FF did. And reflected those concerns in the changes we proposed and the Government accepted. But it must be a NO to their demand to kill the Bill. It's time to show who runs the NHS and who it exists to serve.
As I said when my colleagues and I presented our FF reports to the Cabinet; the NHS belongs to the people; not the BMA.

The real defenders of the NHS are those who know reform is essential in the light of financial pressures, rising demand and the need to reallocate resources from hospitals to the community. Competition will drive more choice and move resources where they are needed. As I have said before " competition is not a disease". Don't let us allow the BMA to undermine reform, because that will, in the long run threaten the very basis of a service free and universal.


love the NHS said...

With major concerns over a bad bill that will send the NHS towards being an insurance service AKA US style healthcare, a "listening" exercise (but no "doing" of any substance) and a total lack of any robust evidence for widespread change of a system that was largely working after years of under investment by all sides, make no mistake, this is about private companies making money out of healthcare in this country, the governments advisors stated so in the US less than a year ago.

This bill is a canerous growth for patients, the mess it makes will simply get worse until it kills, unless effective & rapid treatment is taken. Yes, for your healths sake, kill the bill

Dr Ron SInger said...

Don't like this man's ability to be calm and objective. Also doesn't seem to know that all consultants, junior doctors and many GPs are salaried, not part of the private sector. Even Independent Contractor GPs have direct pension links and many a national contract with the government.

Doctors support the NHS as a system that brings the most good to the most people. Privatisation ie letting the private sector provide more and more services in the name of 'choice' or competition and 'take over' commissioning, will result in some good to fewer people. That was Hamish Meldrum's point

Ron Singer, President Medical Practitioners' Union-Unite (not a BMA member