Dr Hamish Meldrum, chairman of council at the BMA, said: ‘There is little evidence in this response that the government is genuinely prepared to engage with constructive criticism of its plans for the NHS.
‘Most of the major concerns that doctors and many others have raised about the White Paper seem, for the most part, to have been disregarded.
‘The response completely fails to acknowledge that proposals to increase competition in the NHS will make it harder for staff to work more co-operatively. While we still believe that clinician-led commissioning can improve patient care, this document does not provide assurance that it will be implemented effectively.’
He concluded: 'The government also seems to have ignored the warnings of the BMA and many others about the pace and scale of these reforms.’
Dr Clare Gerada, chairwoman of the RCGP, said the college was pleased the government had engaged with clinicians over the plans, and that GPs remained centre stage.
She said: 'However we still have a number of questions. These include the pace of change and how this sits alongside having to make unprecedented savings; how to balance patient choice with health inequalities (those with the greatest health needs are often those with the least ability to exercise choice); and how the policy of ‘any willing provider’ may impede the development of effective coordinated services as well as drive up the cost.
'Our starting point is what delivers the best outcomes for our patients. We firmly believe putting GPs at the centre of commissioning is the right way forward and we will continue to engage with the department to shape the policy so it is safe for patients, safe for GPs and safe for the NHS.'
The NHS Confederation warned the government must be ‘realistic’ about the dangers of transition.
Nigel Edwards, chief executive of the NHS Confederation, said: ‘The scale of the challenge facing the NHS is immense. NHS organisations are grappling with three major issues, all at the same time: unprecedented efficiency savings, major management cuts and radical structural reforms.
'There is a real squeeze on hospital budgets that will seriously effect their income. NHS leaders up and down the country are really worried about the prospects for the next two to three years.
'While we support the objectives of these reforms, we have to get there first. The absolute priority is to be realistic about the dangers of transition and take firm action to avert them so the reforms have a chance of success.’
He added: ‘No one should be in any doubt that these reforms are both radical and high risk.’
Unison, the public sector union, criticised Mr Lansley’s decision to push ahead with the NHS reforms as a ‘big mistake’.
It said the government’s failure to stick to its election pledge of no more top-down NHS reorganisations was ‘disgusting’. It called for the government to ‘see sense’ and reverse its decision.
Karen Jennings, head of health at Unison, said: ‘Lansley’s so-called consultation was a sham and a foregone conclusion. By forging ahead with his plans in the teeth of fierce opposition from leading health experts, patient groups, staff, unions and GP’s themselves, he is showing an utter disregard for the long term future of the NHS.’
Royal College of Physicians
Patrick Cadigan, registrar of the Royal College of Physicians, welcomed the inclusion of arrangements to include health professionals in consortia.
‘More broadly, the government is right to adopt a more phased approach to its reforms. Whichever way you look at it these are an ambitious set of proposals that happen to coincide with the biggest efficiency drive in the service’s history.
‘Robust piloting of the plans, doing more to get staff on board, and a degree of flexibility around their implementation will all be key to ensuring that the plans deliver for patients in the ways intended.
There should be no place for dogmatism when we are talking about so many people’s lives, and this amount of public money."
Click here for all the latest from the health White Paper consultation response