NHS reforms risk health service meltdown

The NHS is heading towards “operational and financial meltdown” due to a financial squeeze, misguided government policies and rising demand from patients, the leader of the UK’s 44,000 GPs has warned.

Family doctors are so disillusioned by changes being foisted on them and the direction of the NHS that the health service could “run out” of GPs, Dr Laurence Buckman, chairman of the British Medical Association’s GPs committee, said.

Buckman told the BMA’s annual GPs conference on Tuesday morning that many family doctors in England feel they have no real say in the clinical commissioning groups (CCGs) of local GPs that will assume significant powers from next April as a result of health secretary Andrew Lansley’s controversial NHS shakeup.

Buckman described the previous 12 months as “a very eventful year”. He added: “A year full of events we don’t like or think are a waste of time, money and effort. As the NHS in all four countries lurches towards the buffers of financial and operational meltdown, we find that instead of the clear thinking the NHS desperately needs right now, we have regulation, bullying micromanagement and disssipated effort.”

The radical restructuring of England’s NHS in the Health and Social Care Act would lead to profit-making private healthcare firms cherrypicking which NHS services to run and the “odious” sight of the health service having to compete with them to deliver patient care, Buckman told the 400 GP representatives at the BMA conference.

“Make no mistake: this act risks endangering the NHS in England. Even before it became law, changes were coming that have fragmented care. Now private organisations have the green light to pick off the best bits,” he said, adding that while ministers claimed the reforms would make the NHS a one-stop shop for patients, “under these reforms patients will be lucky if they can get it in five visits”.

While the vast majority of GPs support the central plank of the act – putting them in charge of commissioning services for patients – Buckman said “those GPs [also] see the insistence of ministers that the NHS has to spend its money competing with the private sector as odious”.

His wideranging critique of Department of Health policy in England also included a warning that plans to let patients register with a GP anywhere, rather than near their home, by getting rid of traditional practice boundaries, “is madness”. While the BMA has agreed to help ministers pilot the scheme before it potentially becomes common practice across England, “their version will destabilise [GP] practices for little benefit and ruin continuity of care and record”.

Turning to coalition plans to change NHS staff pensions, Buckman accused ministers of alienating the UK’s 44,000 family doctors: “The government wants us to pay more, work longer and have a smaller pension. They will pay the price for this, whatever the result of the ballot [for possible industrial action]. They have recklessly squandered GPs’ goodwill.

“For a scheme that is in surplus, that was only sorted out four years ago, that was structured to give more money to lower paid NHS workers, to be thrown away so that we can all pay more to Treasury as a tax – for that’s what this is – is so wilful I cannot believe that anyone sensible would do it,” he added.

Ministers are determined to press ahead with the reforms, which have been opposed by almost every group of health professionals, who point out that the NHS pension scheme already generates a surplus of £2bn a year.

The reforms – which would force GPs to retire later before they picked up a lower pension – are so unpopular that they are prompting worrying numbers of GPs to retire earlier than planned, Buckman added. “GPs are retiring because not only are they getting older but the work is getting harder and the pension reforms are making those in their 50s rush for the exit.

“Trainee GPs see an uncertain future and go abroad, or take on short-term posts from which they can escape. Workforce problems need sophisticated solutions. Please, someone listen before we run out of GPs,” Buckman added.