BMA annual representative meeting: BMA to hold special conference to discuss privatisation of NHS
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《英国医生杂志》
The BMA is to hold a conference in the autumn to discuss developments in the NHS, through which many more healthcare services in the NHS will be provided by private companies.
Representatives at the BMA抯 annual meeting in Llandudno last week unanimously passed a motion that drew attention to parts of the government抯 NHS Improvement Plan, published last month, which contained proposals encouraging the progressive involvement of multinational healthcare corporations in the delivery of health care in England and the development of a "case management approach" (NHS Improvement Plan, p 38, paragraph 3.16).
The motion, proposed by Mr Richard Rawlins, a consultant orthopaedic surgeon from Bedford and a member of the BMA council, also drew attention to the fact that one of the groups involved in providing private services for the NHS, the UnitedHealth Group, had appointed Dr Richard Smith, editor of the BMJ, and Mr Simon Stevens, the prime minister抯 senior health adviser, to lead the company抯 expansion in Europe.
Mr Rawlins told the conference that, although the chairman of the BMA抯 council, Jim Johnson, had told the conference on its first day that he welcomed the NHS plan, representatives had not had the opportunity to consider the changes, "much less welcome them."
"Only just now are we realising just how far reaching the changes are; only just now are we identifying the details in which the devil most certainly resides," he said.
"The Plan pledges that every primary care trust in England will adopt the approach to caring for vulnerable older people promoted by UnitedHealth Group. This is a $28bn corporation based in Minneapolis which last month recruited as its vice president with a responsibility to expand its European business the prime minister抯 senior health policy adviser, Simon Stevens—who set out the original NHS plan when he was adviser to Alan Milburn—and the editor of our own BMJ, Dr Richard Smith.
"Paragraph 3.16 of the five year plan now requires strategic health authorities to develop a 慶ase management approach?for implementation by April 2005."
"Every PCT will adopt this model between 2005 and 2008 when there will be over 3000 community matrons using case management techniques to care for around 250 000 patients," Mr Rawlins said.
"Presumably, those patients who choose to have their case managed by a doctor will have to turn to the private sector," he continued, adding: "The Department of Health has already paid ?m for a pilot service, of which ?.7m will go to UnitedHealth."
"If we take these developments together with concerns already expressed about foundation hospitals, patient choice, and independent sector treatment centres, many of us see a pattern reflecting the increasing insurgence of multinational healthcare corporations into our national, public health service.
"This may be no bad thing. It may be that these developments could, and should, be welcome, but Mr Chairman, have we all read and digested the new five year plan? Have we fully considered its implications? Do we welcome a health management approach for the care of ourselves and our patients? Does the BMA have a view on their methodologies?
"Or is it not now essential that our council organise a conference to properly and fully consider these plans and proposals to develop for this association our own policy? The answer must be yes."
He asked the conference to consider whether their patients wanted their health care managed by community matrons or by doctors.
Dr Jacky Davis, a consultant radiologist from the Whittington Hospital, north London, seconded the motion.
She said that many of the changes to the NHS had been introduced with little reference to the public or to doctors—the BMA had opposed the private finance initiative, foundation hospitals, and diagnostic and treatment centres to little effect.
Are doctors happy to see the NHS funded by the government but provided by private organisations, and hospitals become commodities that can be bought and sold, she asked
"We need a debate about the bigger picture . . . otherwise we could wake up in five years time and ask what happened to the NHS. We need to influence the bigger picture before we find ourselves trapped in it with no way out."
Simon Eccles, the chairman of the Junior Doctors Committee, spoke against the motion, saying that holding such a conference, to consider the issue, could cost the association between a third and half a million pounds.(BMJ Annabel Ferriman)
Representatives at the BMA抯 annual meeting in Llandudno last week unanimously passed a motion that drew attention to parts of the government抯 NHS Improvement Plan, published last month, which contained proposals encouraging the progressive involvement of multinational healthcare corporations in the delivery of health care in England and the development of a "case management approach" (NHS Improvement Plan, p 38, paragraph 3.16).
The motion, proposed by Mr Richard Rawlins, a consultant orthopaedic surgeon from Bedford and a member of the BMA council, also drew attention to the fact that one of the groups involved in providing private services for the NHS, the UnitedHealth Group, had appointed Dr Richard Smith, editor of the BMJ, and Mr Simon Stevens, the prime minister抯 senior health adviser, to lead the company抯 expansion in Europe.
Mr Rawlins told the conference that, although the chairman of the BMA抯 council, Jim Johnson, had told the conference on its first day that he welcomed the NHS plan, representatives had not had the opportunity to consider the changes, "much less welcome them."
"Only just now are we realising just how far reaching the changes are; only just now are we identifying the details in which the devil most certainly resides," he said.
"The Plan pledges that every primary care trust in England will adopt the approach to caring for vulnerable older people promoted by UnitedHealth Group. This is a $28bn corporation based in Minneapolis which last month recruited as its vice president with a responsibility to expand its European business the prime minister抯 senior health policy adviser, Simon Stevens—who set out the original NHS plan when he was adviser to Alan Milburn—and the editor of our own BMJ, Dr Richard Smith.
"Paragraph 3.16 of the five year plan now requires strategic health authorities to develop a 慶ase management approach?for implementation by April 2005."
"Every PCT will adopt this model between 2005 and 2008 when there will be over 3000 community matrons using case management techniques to care for around 250 000 patients," Mr Rawlins said.
"Presumably, those patients who choose to have their case managed by a doctor will have to turn to the private sector," he continued, adding: "The Department of Health has already paid ?m for a pilot service, of which ?.7m will go to UnitedHealth."
"If we take these developments together with concerns already expressed about foundation hospitals, patient choice, and independent sector treatment centres, many of us see a pattern reflecting the increasing insurgence of multinational healthcare corporations into our national, public health service.
"This may be no bad thing. It may be that these developments could, and should, be welcome, but Mr Chairman, have we all read and digested the new five year plan? Have we fully considered its implications? Do we welcome a health management approach for the care of ourselves and our patients? Does the BMA have a view on their methodologies?
"Or is it not now essential that our council organise a conference to properly and fully consider these plans and proposals to develop for this association our own policy? The answer must be yes."
He asked the conference to consider whether their patients wanted their health care managed by community matrons or by doctors.
Dr Jacky Davis, a consultant radiologist from the Whittington Hospital, north London, seconded the motion.
She said that many of the changes to the NHS had been introduced with little reference to the public or to doctors—the BMA had opposed the private finance initiative, foundation hospitals, and diagnostic and treatment centres to little effect.
Are doctors happy to see the NHS funded by the government but provided by private organisations, and hospitals become commodities that can be bought and sold, she asked
"We need a debate about the bigger picture . . . otherwise we could wake up in five years time and ask what happened to the NHS. We need to influence the bigger picture before we find ourselves trapped in it with no way out."
Simon Eccles, the chairman of the Junior Doctors Committee, spoke against the motion, saying that holding such a conference, to consider the issue, could cost the association between a third and half a million pounds.(BMJ Annabel Ferriman)