BMA council chairman Hamish Meldrum has warned MPs that the government’s health reforms continue to put the NHS at risk.
In a letter to all MPs, Dr Meldrum claims the plans outlined in the Health and Social Care Bill present an ‘unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably, now and in the future’.

The bill is due to enter its report stage when the Commons returns after its summer break next week, followed by its third reading. It will then move to the Lords.

Ban the bill
Dr Meldrum tells MPs that the BMA still believes the bill should be withdrawn or, at the very least, be subject to further substantial amendments despite the government’s efforts to address some of the concerns through the NHS Future Forum earlier this year.

He says there continues to be an inappropriate and misguided reliance on market forces to shape services in England, with the bill embedding ‘a more central role for choice without a full consideration of the consequences’.

He adds this has the ‘potential to destabilise local health economies’. Dr Meldrum also says that ‘insufficient thought has been applied to the unintended knock-on effects and long-term consequences of proposals in the bill’, for example on medical education and training and on public health.

Cause for alarm
The BMA is particularly concerned about:

• The removal of the cap on how much income foundation trusts can generate from private patients, which the BMA says could lead to reduced access for NHS patients as trusts seek to increase their income by focusing more on private care
• The proposed ‘quality premium’ for commissioners — which the BMA insists must be judged against well-defined quality measures not financial performance — must remain separate from GP practice income and only be used to improve patient care
• Forcing all NHS trusts to become foundation trusts, with the financial stringency this requires, which the BMA believes could compromise patient safety and quality of care
• The lack of satisfactory assurance that the health secretary will have ultimate responsibility for the provision of a comprehensive health service while also allowing other bodies, such as the new NHS Board and clinical commissioning groups, day-to-day operational independence.