An online survey undertaken on behalf of BMA suggests that the majority of doctors are not convinced that potential benefits of the Government’s plans for the NHS in England outweigh the risks.
The Ipsos MORI survey of BMA members, carried out in January 2011, revealed widespread concern about plans to increase competition, even among the minority of doctors who are generally supportive of the changes. Overall, the survey suggests that doctors believe the changes that are most likely to be achieved are those which are least welcome. For example, almost 88% think it is likely that the reforms will lead to increased competition between providers, but only 21% believe this will improve the overall quality of NHS care. Conversely, doctors believe the changes that would be most beneficial are the least likely to be achieved. For example, 67% think closer working between general practice and hospitals would improve the overall quality of patient care, but only 34% believe it likely that the reforms will lead to this. In terms of the impact on their own roles 61% think it likely that the reforms will lead to them spending less time with patients, a change which only 1% would welcome. Commenting on the survey, Dr Hamish Meldrum, chairman of council at the BMA, said: “This survey shows that the Government can not claim widespread support among doctors as justification for these flawed policies. While there are widely differing opinions, with many still to decide, there are a number of key issues where the majority have very clear concerns. The Government simply cannot afford to dismiss this strength of feeling amongst the group they are expecting to lead much of the change. Doctors overwhelmingly want there to be closer working between primary and secondary care, and to have greater involvement in decision-making – yet most think these are the least likely outcomes of the reforms. And nine out of ten doctors agree that increased competition in the NHS will lead to a fragmentation of services.” There are mixed views about the impact of the proposed system of GP-led commissioning. Sixty-six per cent agree it will increase health inequalities and 49% that it will reduce the quality of patient care. Eighty-four per cent of GPs have taken, or their practices have taken, at least one step to prepare for the reforms. For example, attending a meeting about clinicianled commissioning. But only 49% agree that GPs in their local area will be ready to take on new roles leading commissioning. Dr Meldrum adds: “The Secretary of State has repeatedly said he wants to listen to doctors. Doctors are telling him that whole rafts of these proposals will either not achieve the intended benefit to patients, or will be harmful. He particularly needs to act on the concerns about competition.”
