The BMA has called for the Health and Social Care Bill to be amended and strengthened in the best interests of the NHS and patient care

A stressed male doctor with his head on his hands behind a pile of work.

British Medical Association (BMA) representatives in the North East called on local MPs to push for amendments to the Health and Social Care Bill, as discussions on the bill got underway on 22 November 2021 in the House of Commons.

In a letter sent to local MPs, BMA Regional Council Chair Dr George Rae warned politicians that this is the ‘wrong bill at the wrong time’, and called for their support in ensuring that it is amended and strengthened in the best interests of the NHS and patient care.

Under the legislation, the North East and Cumbria will become the largest geographical integrated care system in the country, and the BMA council is concerned that the varying needs of all communities in both urban and rural areas will be insufficiently accommodated, given the current pressures on the NHS.

In his letter, Dr Rae warned that, amid the ongoing pressures of the COVID-19 pandemic, the largest ever backlog of care to contend with, and patients in the North East facing unacceptable waits for treatment, this bill comes at a precarious time for the NHS.

‘It is not the right time, for the NHS or for patients, for the biggest reorganisation of the NHS in a decade, and for a bill which fails to address dangerous workforce shortages; risks unnecessary and destabilising outsourcing to private providers; fails to empower and engage with local clinical leadership; and gives politicians greater powers to interfere in operational NHS decision-making’, said Dr Rae.

‘As a doctor working in the NHS, I witness daily the huge pressures facing the workforce, which is still tackling the ongoing pressures of the COVID-19 pandemic and the huge backlog of care it has created. Waiting lists are at a record high of 5.7 million, and the BMA estimates the workforce is short of around 50,000 doctors’, he added.

Protect the NHS 

The BMA is calling on local MPs to ensure that the Bill is amended to ‘truly protect the NHS from destabilisation [resulting from] outsourcing of more contracts to private providers by establishing the NHS as the default option for NHS contracts’.

The BMA council acknowledges that the removal of enforced competition is a welcome recognition of the need to reduce the fragmentation and destabilisation caused by frequent and unnecessary outsourcing, but it warns that, without additional safeguarding, the Bill may allow contracts to be awarded to private providers without proper scrutiny or transparency.

It is calling for amendments to the Bill, which ensure that the Secretary of State’s accountability to Parliament for safe staffing and workforce numbers is improved, and calls for regular and transparent reporting. In addition, it is calling for assurances that the increased powers for the Health Secretary over the NHS are not politically driven, and are balanced with local health and social care needs, which should include clear safeguards and limits on the use of these powers, as well as the re-instatement of the duty of the Health Secretary to provide secure and comprehensive healthcare.

Furthermore, it calls for private sector bodies with influence over commissioning decisions to be prevented from sitting on local commissioning boards.

The council is urging MPs to ensure that the Bill is amended to require that strong, independent clinical leadership and patient representation is embedded at every level of integrated care systems, which should include formalised roles for local medical committees, local negotiating committees, and public health doctors.

This article originally appeared on Medscape, part of the Medscape Professional Network.

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