Doctors condemn "patient choice" initiative as no real choice at all
http://www.100md.com
《英国医生杂志》
BMA conference delegates condemned the government抯 initiative to increase patients?choice as failing to deliver real choice to patients and voted overwhelmingly against the expansion of private treatment centres, which they said were draining resources from NHS hospitals.
Dr Chaand Nagpaul, a GP in north London, proposed two motions at the BMA抯 annual representatives?conference in Llandudno this week questioning the value of the initiative and private treatment centres.
He called the government抯 plan to give patients a choice of four or five centres in which to have their operation a "political gimmick" that failed to deliver what patients wanted from the health service.
"What patients want is the NHS on their doorstep and more time with their GP," he said. "What is being offered by the government is a choice of where patients can have their operation. Patients do not get to choose their surgeon or what investigations or treatment they have."
The promotion of choice for patients, as described by Mr Blair, left unclear lines of clinical accountability if things went wrong, Dr Nagpaul said. It was also wasting NHS resources and contributing to the creeping privatisation of health care.
His motion for the government抯 initiative to be piloted before national implementation was carried by the conference. However, Dr Nagpaul failed to win support for the BMA to directly oppose the government抯 plans.
Doctors also raised concerns about private treatment centres. Dr Nagpaul said that because they were standalone units they could "cherry pick" uncomplicated patients, leaving the NHS to deal with any complications that might arise.
"To make matters worse, they抣l perversely gain at the expense of NHS hospitals, by being paid the same national tariff prices under 憄ayment by results?as NHS hospitals, who will be treating the remaining more expensive, complex ill patients for no extra money," he added.
Dr Nagpaul抯 motion highlighting the diminishing continuity of care and responsibility of private treatment centres and the diversion of public funds to private profit was overwhelmingly carried by the conference. Delegates also voted overwhelmingly that pressure should not be put on primary care organisations to commission care from private treatment centres at the expense of local NHS facilities.
An amendment from Mrs Anna Athow, a consultant surgeon at North Middlesex University Hospital in London, for the BMA to oppose the introduction of private treatment centres and to increase capacity within the NHS instead was also overwhelmingly carried.
In his keynote speech Mr James Johnson, chairman of the BMA, described the changing provision of health care as a "defining moment in the history of the NHS."
"The two major political parties both saying that health care no longer needs to be provided by the state just because it is paid for by the sate," he said.
While John Reid, the health secretary, has given assurances that the amount of health care provided to the NHS from the private sector will not grow to more than 10% to 15% of the total NHS output, "the Tories are privately saying you can have the lot—reducing the NHS to a funding stream," said Mr Johnson.(Llandudno Zosia Kmietowic)
Dr Chaand Nagpaul, a GP in north London, proposed two motions at the BMA抯 annual representatives?conference in Llandudno this week questioning the value of the initiative and private treatment centres.
He called the government抯 plan to give patients a choice of four or five centres in which to have their operation a "political gimmick" that failed to deliver what patients wanted from the health service.
"What patients want is the NHS on their doorstep and more time with their GP," he said. "What is being offered by the government is a choice of where patients can have their operation. Patients do not get to choose their surgeon or what investigations or treatment they have."
The promotion of choice for patients, as described by Mr Blair, left unclear lines of clinical accountability if things went wrong, Dr Nagpaul said. It was also wasting NHS resources and contributing to the creeping privatisation of health care.
His motion for the government抯 initiative to be piloted before national implementation was carried by the conference. However, Dr Nagpaul failed to win support for the BMA to directly oppose the government抯 plans.
Doctors also raised concerns about private treatment centres. Dr Nagpaul said that because they were standalone units they could "cherry pick" uncomplicated patients, leaving the NHS to deal with any complications that might arise.
"To make matters worse, they抣l perversely gain at the expense of NHS hospitals, by being paid the same national tariff prices under 憄ayment by results?as NHS hospitals, who will be treating the remaining more expensive, complex ill patients for no extra money," he added.
Dr Nagpaul抯 motion highlighting the diminishing continuity of care and responsibility of private treatment centres and the diversion of public funds to private profit was overwhelmingly carried by the conference. Delegates also voted overwhelmingly that pressure should not be put on primary care organisations to commission care from private treatment centres at the expense of local NHS facilities.
An amendment from Mrs Anna Athow, a consultant surgeon at North Middlesex University Hospital in London, for the BMA to oppose the introduction of private treatment centres and to increase capacity within the NHS instead was also overwhelmingly carried.
In his keynote speech Mr James Johnson, chairman of the BMA, described the changing provision of health care as a "defining moment in the history of the NHS."
"The two major political parties both saying that health care no longer needs to be provided by the state just because it is paid for by the sate," he said.
While John Reid, the health secretary, has given assurances that the amount of health care provided to the NHS from the private sector will not grow to more than 10% to 15% of the total NHS output, "the Tories are privately saying you can have the lot—reducing the NHS to a funding stream," said Mr Johnson.(Llandudno Zosia Kmietowic)