Health secretary Andrew Lansley, who is being warned by doctors that his NHS shake-up puts support workers bidding to keep their jobs at a disadvantage. Photograph: Andrew Winning/Reuters
The key role of family doctors in the restructured NHS will be curtailed by moves that could see private firms given an unfair advantage when bidding for future contracts, doctors’ leaders are warning.
The British Medical Association (BMA) has voiced serious doubts that general practitioners (GPs) will receive the leadership role promised by health secretary Andrew Lansley to help justify his controversial shakeup.
They fear rigged rules will let big firms such as KPMG and McKinsey beat groups of NHS employees in the race for contracts to supply support services to the planned clinical commissioning groups (CCGs), led by GPs, which are due to start controlling NHS budgets locally from April 2013.
Dr Laurence Buckman, the chairman of the BMA’s general practitioners committee, voiced his concern after draft guidance from the Department of Health emerged that family doctors’ representatives said showed that ministers are secretly planning to privatise parts of the NHS, despite pledges to the contrary.
“The government promised a greater role for clinicians in its plans to reform the NHS and created CCGs, placing local GPs and other healthcare professionals in a leading position in the commissioning process. Yet now it seems barriers are being put in place that would undermine the ability of clinicians to take local decisions,” said Buckman.
The health department’s draft guidance “gives the commercial sector an in-built advantage and appears to be yet another worrying step towards an NHS focused on commercial priorities”, Buckman added.
Andy Burnham, the shadow health secretary, said he shared the BMA’s anxiety. “David Cameron says he wants the NHS to be a ‘fantastic business’ and it is increasingly clear that this is the real agenda driving the government’s reorganisation of the NHS, rather than empowering clinicians. The truth is the government has mis-sold its plans and failed to build a consensus behind them. Even people who once supported them are now having major doubts and walking away,” he said.
The row is over who will deliver support, such as IT backup, to the commissioning groups. Small groups of NHS employees will not be able to compete with large, well-resourced firms with legal, technical and accounting expertise, for contracts to carry out payroll duties and supply information on local people’s health, the BMA fears.
The doctors’ union wants NHS staff already providing such support to groups of primary care trusts to continue doing so after the reforms take effect in 2013. They should be allowed to provide continuity for the service at a time of financial pressure and structural upheaval and “should not be forced into an unfair competitive process with large, commercial organisations”, said Buckman.
Dr David Wrigley, a member of the BMA’s ruling council, warned that the NHS could lose out financially if private firms secured most of the work of the planned commissioning support units. “Remember these CSUs will be in charge of billions of pounds of taxpayers’ money, running the contractual and tendering process for NHS contracts to treat patients and pay hospitals, and if run by the independent sector they of course will want to make their profit from this chunk of money – profits that could have been recycled back in to the NHS to treat patients”, he said.
A health department source dismissed the BMA’s claims as “nonsense”.
“Laurence Buckman says that this process would undermine clinicians’ ability to take decisions. But under our plans clinicians will be freed to make decisions about what’s in the best interest of their patients. They will be in the driving seat,” the source said.
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One response
Are we surprised that these grotesque Hu-rays are dismantling the NHS? It doesn’t put any money in their friends and families back pocket.