23 April 2004
The Department of Health has hit back at a British Medical Association claim that its reforms could lead to a two-tier NHS.
In a speech to the Association's junior members' forum in Edinburgh on April 18, BMA chair James Johnson warned that reforms of doctors' training, increased competition and the phased introduction of foundation trusts could lead to wide variations in the quality of NHS services.
Initiatives to give patients greater choice over where and when they are treated were welcome. But he added: 'If information about health care is only available to white, middle-class English-speakers, we will disadvantage the patients we most need to empower. A possible solution would be for lay people that know the system to navigate these patients towards sources of information.'
The introduction of competition on services and the piecemeal implementation of foundation status could lead to the closure of 'unprofitable' services.
After a period of relative harmony while new contracts for GPs and hospital consultants were implemented, Johnson's comments may mark a cooling of relations with the government.
In response, the department offered a robust defence of its reforms. 'Foundation trusts will operate in a system that upholds the values and principles of the NHS,' it said.
'They will remain fully integrated within the local health economy, and are subject to a statutory duty to work in partnership with other NHS and social care organisations. They will be required to use their freedoms in a way that does not undermine other trusts' ability to meet their obligations.'
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