The vast majority of doctors are not convinced that potential benefits of the government’s plans for the NHS in England outweigh the risks, an online survey for the British Medical Association (BMA) suggests today.

An Ipsos MORI survey of BMA members, carried out in January this year, reveals a range of views, but widespread concern about plans to increase competition, even among the minority of doctors who are generally supportive of the changes.

The statements garnering the highest levels of agreement among the 1,645 respondents include:

• Increased competition in the NHS leading to a fragmentation of services (89% agree)
• Increased competition in the NHS reducing the quality of patient care (65% agree)
• The move for all NHS providers to become, or be part of, foundation trusts damaging NHS values (66% agree)
• The proposed system of clinician-led commissioning increasing health inequalities (66% agree)

Overall, the survey suggests that doctors believe the changes that are most likely to be achieved are those which are least welcome. For example, almost nine in ten (88%) think it is likely that the reforms will lead to increased competition between providers, but only a fifth (21%) believe this will improve the overall quality of NHS care. Conversely, doctors believe the changes that would be most beneficial are least likely to be achieved. For example, two thirds (67%) think closer working between general practice and hospitals would improve the overall quality of patient care, but only a third (34%) believe it likely that the reforms will lead to this.

In terms of the impact on their own roles, three fifths of respondents (61%) think it likely that the reforms will lead to them spending less time with patients, a change which only 1% would welcome.

Dr Hamish Meldrum, Chairman of Council at the BMA, said: “This survey shows that the government can no longer claim widespread support among doctors as justification for these flawed policies. While there are widely differing opinions, with many still to decide, there are a number of key issues where the majority have very clear concerns. The government simply cannot afford to dismiss this strength of feeling amongst the group they are expecting to lead much of the change. Doctors overwhelmingly want there to be closer working between primary and secondary care, and to have greater involvement in decision-making - yet most think these are the least likely outcomes of the reforms. And nine out of ten doctors agree that increased competition in the NHS will lead to a fragmentation of services.”

Dr Meldrum added: “The Secretary of State has repeatedly said he wants to listen to doctors. Doctors are telling him that whole rafts of these proposals will either not achieve the intended benefit to patients, or will be harmful. He particularly needs to act on the concerns about competition.”

(BMcN)