Health Bill Falls Shorts, Says BMA

With MPs on the Bill Committee soon to consider the clauses on commissioning in the Health and Social Care Bill for England, a new British Medical Association (BMA) briefing says some of the legislation goes against government pledges to put doctors ‘in the driving seat’ and could ultimately prevent them from delivering improvements to patient care.

When the Health White Paper was published in July 2010 it was promised that the Bill would devolve power to consortia and give them the freedom to decide what services they would commission. The BMA has been scrutinising the wording in the Bill and believes that the powers of the Secretary of State and the NHS Commissioning Board will be overly restrictive and controlling, going against these pledges to devolve power.

Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, said:

 “The NHS Commissioning Board will be given sweeping powers to get involved with the way consortia operate. Time and time again in the Bill we see no mention of the need to consult consortia on matters that will have a direct and potentially very significant impact on the way they operate. And when it comes to the dissolution of a consortium, the most serious act of all, there is no requirement to consult the consortium or the public, and no recourse for appeal.

“We are very concerned about how restrictive the Bill is and want to see that, at the very least, there is a duty to consult consortia written into the legislation. At the moment the Secretary of State and the NHS Commissioning Board are being granted powers that are far too wide-ranging and seem to go against the promise to devolve power to local clinicians.”

The BMA is concerned that:
  • The NHS Commissioning Board will not be able to operate autonomously and free from political control
  • The Secretary of State will be able to impose any conditions on consortia without review. While there may be times, such as during a public health emergency, when the Secretary of State needs to direct from the centre, at the moment the wording is unacceptably broad
  • The NHS Commissioning Board will be able to dismiss a consortium’s Accountable Officer and bring in a replacement who will not be allowed to come from the local area, thus undermining the importance of local determination
  • The NHS Commissioning Board will be able to dissolve consortia and change consortia areas, without consultation
The briefing paper on the clauses relating to the NHS Commissioning Board and consortia is the first in a series to be produced by the BMA, specifically covering areas of the Bill which cause doctors the greatest concern.


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