GP leader calls for slowdown in NHS reform

The government must slow down its reform of the NHS, which has introduced “unproven, expensive and destructive change”, a doctor’s leader warned today.

Hamish Meldrum, chairman of the British Medical Association’s (BMA’s) GPs committee, said change was necessary to get the “best out of us” but warned that the top-down and speedy way in which it had been introduced was not working.

“There’s not much evidence of constructiveness or coherence of thought,” he told the annual conference of local medical committees.

“It’s a bit like throwing all the crockery in the air in the hope that not only will nothing get broken, it’ll all land in a nice, neat table setting.

“We’ve had reorganisations in the past, but this government must win the prize for the fastest about turn in the history of the health service.”

For example, Dr Meldrum said that while practice-based commissioning (PBC) “might be fine in principle”, its implementation was being blocked by a “crude, inflexible” system of payment by results and a lack of cooperation with primary care trusts (PCTs).

He warned GPs must be given proper incentives to help shift services from hospitals into their surgeries and be given properly equipped premises in which to do this – in short, the government must provide “the environment” to allow doctors to reform themselves.

“I have a message for [NHS chief executive] Ian Carruthers – unless PCTs pull their socks up and start incentivising and cooperating with GPs, they haven’t a snowball’s chance in hell of meeting the target of universal coverage of PBC by December,” he said.

His comments echo those made by NHS Confederation chief executive Gill Morgan yesterday, where she told a conference of health managers that ministers must give local leaders the autonomy to implement change from the bottom up.

She criticised the “malign culture” of targets that was leaving healthcare workers “too concerned with what we report than what we deliver”.

However, Dr Meldrum warned that it would be increasingly difficult for GPs to help reform the health service when many junior doctors were unable to find work.

A report from the BMA yesterday said there would be about 21,000 junior doctors competing for 9,500 training posts in England in 2007, and warned many of the remaining 11,500 were likely to leave the country rather than take up non-training posts.

Jo Hilborne, chairman of the association’s junior doctors committee, said it was “outrageous” that doctors who have spent five years at medical school and at least two years in postgraduate training could now face unemployment.

Speaking to today’s conference, Dr Meldrum warned ministers: “Shutting off the life-blood of general practice is not just a disgrace, it’s mad.”