Date Published: 7 March 2007

Consultants say health reforms block innovation in patient care (UK)

Four out of five leading hospital consultants in England say they have initiated changes to improve patient care in the last year, but many are being hindered by ill-thought out government health policies, according to figures released today by the British Medical Association (BMA).

Over 265 lead consultants, representing local senior doctors, responded to a snapshot survey which was carried out by the BMA at the beginning of this year. They were asked for their views on key government health policies including patient choice, independent sector provision and Payment by Results.

Examples of positive changes that consultants have initiated include pioneering treatment for cancer, rapid access clinics, simplifying referrals and admissions and using technology more effectively.

Two out of three respondents reported that planned services had been abandoned or delayed and approximately three out of five said they or their colleagues were experiencing problems because clinically effective treatments or procedures were no longer available or were restricted.

Other key findings from the survey include:

  • 72% of respondents believed that independent sector provision would worsen or considerably worsen patient care
  • 58% of respondents said that they had examples where national initiatives had impacted adversely on patient care
  • 11% respondents reported that the key government health policy of patient choice (where patients have a choice of at least 4 or 5 hospitals) would improve patient care and only a third felt that the policy of “care closer to home” would improve patient care.
  • 53% of respondents believed that Payment by Results would worsen or considerably worsen patient care

Dr Jonathan Fielden, Chairman of the BMA’s Consultants’ Committee, said today:

Consultants are clearly innovators of change and are initiating ways to improve patient care yet their efforts to improve services and efficiency are 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. 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 continued:

Sadly many doctors who took part in this survey feel 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.

The BMA is gathering evidence of the effects of government NHS reforms as part of its ‘Caring for the NHS’ campaign and the Association will publish its vision for the NHS in the spring.

Source: British Medical Association, UK

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