Delegates at the BMA's Annual Representatives Meeting in Cardiff voted in favour of a motion which stated that ‘successful commissioning requires decisions based on population health needs’ and opposed the ‘privatisation and fragmentation of the NHS’.
The motion insisted that ‘commissioning bodies should be required to use local NHS services as the preferred provider, unless the local NHS services cannot provide the services or capacity required’.
Delegates did not carry the section the motion which called for ‘the development of a payment system to incentivise collaboration between healthcare providers', but instead took it as a reference.
Presenting the motion on behalf of the Holland division, Dr Anthea Mowat warned that with local commissioning there is a risk of a 'postcode lottery’.
Dr Mowat argued that the government’s proposed clinical senates may not do enough to promote collaboration, especially with public health doctors. Dr Mowat said that ‘one way’ to promote effective collaboration may be payment.
However Dr Mark Temple, from the Welsh national council agued that paying doctors to collaborate would be counter-productive.
‘If you have a payment incentive it is not collaboration, it is a market,’ Dr Temple said.
Dr Andrew Linder from the Eastern national council warned that multiple providers would ‘destabilize’ the NHS.
‘These providers will suck the blood out of hospital services,’ Dr Linder said.
Dr Helena MeKeown from the Salisbury division spoke against the fourth part of the motion, calling for safeguards against a ‘postcode lottery.’
‘Clinical commissioning has the potential to prevent the slash and burn cuts we are already seeing [in the NHS],’ Dr McKeown said.
To avoid slash and burn local colleagues ‘must be allowed to prioritise', Dr McKeown said.However speaking in favour on safeguards, Professor Reinhard Heun from the Birmingham national council warned that inequalities resulting in a ‘postcode lottery’ would lead to ‘complaints and costly legal battles’ for doctors.
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