In its response to the government’s listening exercise, the BMA said it is vital for the future of the NHS that the Bill is withdrawn, or ‘changed significantly’.

The BMA demanded a number of changes to the proposals, including putting an ‘explicit duty’ on commissioning consortia to involve doctors in secondary care, public health and academia.

It said: ‘The existing duty in the Bill on commissioning consortia to "obtain appropriate advice" is insufficient to ensure that the best clinical practice is enshrined in commissioning.

‘Clear guidance should be developed on models for how this can be achieved in practice, such as by developing clinical networks alongside the strategic and decision-making functions of commissioners.’

The BMA also called for economic regulator Monitor’s primary role to be amended to protecting and promoting high quality, integrated healthcare services, not promoting competition.

It said the powers given to the NHS Commissioning Board are ‘inappropriate’ and the Board should be required to consult with consortia before making use of its powers.

Currently the proposals allow the Board to change a consortium’s constitution or dismiss its accountable officer without the consortium’s agreement.  

The BMA warned that the pace, scale and timing of the proposals present a ‘huge risk’ and called for a flexible timetable for the scrapping of PCTs and SHAs.

BMA chairman Dr Hamish Meldrum said: ‘The message from doctors is clear and simple – the Bill must be changed significantly, if not withdrawn altogether, if the NHS is to continue to improve.

‘We are right in the thick of the challenges the NHS faces, and while change is necessary, this major upheaval is not.’

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