NHS reforms are not helping patients, say hospital doctors

8 Mar 07
Senior hospital doctors believe that major NHS reforms, such as payment by results and Patient Choice, will fail to improve the service patients receive, according to a British Medical Association survey.

09 March 2007

Senior hospital doctors believe that major NHS reforms, such as payment by results and Patient Choice, will fail to improve the service patients receive, according to a British Medical Association survey.

The poll of 265 consultants in England will be worrying for the government, coming at a time when ministers hoped to regain clinicians' backing for their reform programme.

The survey showed they have much work to do to reduce doctors' scepticism – 53% said PBR would worsen or considerably worsen patient care.

Only 11% said choice would improve patient care, while a third believed moving care out of hospitals and into the community would result in better services.

Independent sector provision would make patient care poorer, according to 72%, while 58% said they had examples of patients being adversely affected by a national initiative.

More than half (56%) said they or their colleagues had experienced problems because clinically effective treatments or procedures were no longer available or restricted.

BMA consultants' leader Jonathan Fielden said senior doctors were implementing better services for their patients – 81% of respondents had initiated service improvements in the past year. However, their efforts were being hampered by funding constraints and poorly thought through government policies.

'The government is wasting millions of pounds on health reforms that have not adequately involved senior doctors and consequently fail to benefit patients,' he said.

'Consultants are going the extra mile to bring down waiting lists only to be told to slow down and be less productive. Meanwhile, work continues to be diverted away from NHS hospitals to under-performing independent sector providers at greater cost. Plans to increase recruitment or buy new, modern equipment are being put on hold or abandoned because of a lack of money.'

He added that many of the doctors who took part in this survey felt unable to speak out openly.

'There is a culture of fear in the NHS and doctors are under severe pressure to meet targets and keep their mouths shut. Doctors want to be at the forefront of health reforms, both locally and nationally, to ensure government policy has clear benefits for patients.'

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