An interesting story today about the British Medical Association and their calls for an independent NHS free from political control - not in keeping with the current poll on PL. The paper includes a broad outline of how they would like to see the NHS run in the future. Firstly they want to see the board appointed by Parliament, comparing their set up to a cross between the BBC and a board run nationalised industry. They would have a constitution setting out rights and responsibilities. It is hoped that by removing the politics from the NHS and day to day tinkering, it will avoid headline grabbing interference and let the professionals get on with the job. It will also allow a more localised service.
Secondly, there is reference to an inevitable "rationing" of services. This goes back to a phrase I first heard less than 12 months ago - providing "core" services. For me this is a minefield - what is a core service? Is an elderly granny with a poor hip part of the core service? Is someone with self inflicted lung cancer part of the core service? Is a new born baby with a 50/50 chance of living a core service? Who is going to define this? As far as I can see, health care is either a core service or it isn't - you don't draw the line a one kidney or age or anything else, surely? It is reported that the list of services provided should be decided through debate between politicians, professionals and the public. Well if that isn't going to be the most controversial impossible debate since we (apparently) solved the Irish question, I'm not sure what is.
I am pleased the debate is finally starting to move. There is a long way to go and I do fear that the solution put forward by the BMA is not the right answer. It is fantasy land to think that this board would be free from political involvement and the chance of ever coming to an answer on core services will never be solved - especially not if the three corners of the debate are politicians, professionals and the public! I do firmly believe that the professionals should be leading the reform of the NHS and I welcome this first step. Will the Government be willing to do what is best for the NHS though or will they continue to grab the headlines and blame the workers?
The full report can be seen here.
Comments
I have just been reading the
I have just been reading the brilliant Dr Crippen over at NHS blog doctor and it turns out that this discussion paper wasn't as widely consulted on after all and is by no means a fair reflection of what the members of the BMA might think. It seems a particular problem Dr C has along with others is this use of core services.
I was concerned it was me against the politicians and the doctors for a time there, but it seems that it is not the full picture after all... phew