Consortia need freedom to choose providers

Should BMA chairman Dr Hamish Meldrum resign for failing to express doctors' opposition to the Health Bill?

It was a question we posed in a blog on GPOnline last week and web users have been voting on it ever since.

Dr Meldrum's future is in doubt as grassroots medics blame the BMA for doing too little to oppose the government's NHS shake-up. Whether Dr Meldrum should resign is a matter for him after the BMA's special meeting on 15 March where its response to the Health Bill will be debated.

One of the criticisms of Dr Meldrum is that the BMA's 'critical engagement' policy has failed to win any concessions from government. However, last week NHS chief executive David Nicholson appeared to offer one when he said providers would not be allowed to compete for NHS services on price.

The GPC has presented ministers with the opportunity to back another with its plea to allow consortia to draw up a list of preferred providers. It's a move which very much formalises a GP splash of a fortnight ago in which the DoH and Monitor agreed consortia would be able to sidestep competition rules if commissioning decisions were in patients' best interests.

In this week's GP newspaper we give two GPs the opportunity to explain why they are for and against the reforms.

Dr Charles Alessi, National Association of Primary Care forum member and Surrey GP, argues: 'Someone needs to make the judgments around prioritisation of care within a budget. Do we prefer to let people who are divorced from care make that judgment?'

GPC chairman and north London GP Dr Laurence Buckman argues that consortia 'will find themselves utterly controlled by both the Board and Monitor' and that when price competition was an issue in the 1990s, clinical quality fell. It's a fascinating debate, so let us know what you think at or by emailing us at

The DoH hopes the Bill will become law by the end of this year and there is still time to have your say to attempt to influence the government and it's NHS 'evolution'.

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