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| Version 1 | Version 2 |
|---|---|
| Doctors call for major NHS change | Doctors call for major NHS change |
| (10 minutes later) | |
| Doctors have called for radical changes in the way the NHS in England is run. | Doctors have called for radical changes in the way the NHS in England is run. |
| The British Medical Association says the NHS should only provide core services - agreed after a public debate - because resources are limited. | The British Medical Association says the NHS should only provide core services - agreed after a public debate - because resources are limited. |
| It is also calling for the NHS to be managed by an independent board to take the day-to-day running of the service away from political control. | It is also calling for the NHS to be managed by an independent board to take the day-to-day running of the service away from political control. |
| The government rejected limiting NHS services, and said change had to result in a better service for patients. | |
| The BMA proposals are contained in a paper setting out a vision of the future for the NHS. | |
| If we are going to retain an equitable, universal approach within limited resources then priority setting is inevitable James JohnsonBMA chairman | If we are going to retain an equitable, universal approach within limited resources then priority setting is inevitable James JohnsonBMA chairman |
| James Johnson, BMA chairman, said there needed to be an end to 'constant political dabbling' in the NHS. | James Johnson, BMA chairman, said there needed to be an end to 'constant political dabbling' in the NHS. |
| The BMA says the constant development of new, effective, treatments and drugs - plus the fact people are living longer - means rationing is already happening in the NHS. | The BMA says the constant development of new, effective, treatments and drugs - plus the fact people are living longer - means rationing is already happening in the NHS. |
| It says the suggestion of a list of core services is designed to recognise the NHS cannot pay for everything, but to make the service fair and equitable. | It says the suggestion of a list of core services is designed to recognise the NHS cannot pay for everything, but to make the service fair and equitable. |
| Comprehensive range | Comprehensive range |
| Mr Johnson said: "The NHS should provide a comprehensive range of services, available to all on an equal footing. | Mr Johnson said: "The NHS should provide a comprehensive range of services, available to all on an equal footing. |
| "If we are going to retain an equitable, universal approach within limited resources then priority setting is inevitable. | "If we are going to retain an equitable, universal approach within limited resources then priority setting is inevitable. |
| "Politicians need to acknowledge this and that it happens already but in a non-transparent and piecemeal fashion. | "Politicians need to acknowledge this and that it happens already but in a non-transparent and piecemeal fashion. |
| We resist any call to make the NHS a slimmed-down, emergency service Andy BurnhamHealth Minister | We resist any call to make the NHS a slimmed-down, emergency service Andy BurnhamHealth Minister |
| "A clear and transparent approach is needed." | "A clear and transparent approach is needed." |
| Hamish Meldrum, head of the BMA's GPs committee added: "The core services the NHS provided would be very substantial and should cover the necessary services for core health care." | Hamish Meldrum, head of the BMA's GPs committee added: "The core services the NHS provided would be very substantial and should cover the necessary services for core health care." |
| The BMA's proposals for an independent board would see the establishment of a board of governors who would be appointed by ministers. | The BMA's proposals for an independent board would see the establishment of a board of governors who would be appointed by ministers. |
| They, along with an executive management board, would control the day-to-day running of the health service. | They, along with an executive management board, would control the day-to-day running of the health service. |
| This, says the BMA, would free up ministers to consider broader health policy, particularly on public health issues which could help reduce health inequalities. | This, says the BMA, would free up ministers to consider broader health policy, particularly on public health issues which could help reduce health inequalities. |
| The proposal for an independent board is not backed by Prime Minister Tony Blair or, it is understood, his likely successor Gordon Brown. | The proposal for an independent board is not backed by Prime Minister Tony Blair or, it is understood, his likely successor Gordon Brown. |
| However, BMA leaders say they believe it is the best way forward, despite the lack of success of similar schemes in Oregon in the US and in New Zealand. | However, BMA leaders say they believe it is the best way forward, despite the lack of success of similar schemes in Oregon in the US and in New Zealand. |
| Written constitution | Written constitution |
| The NHS should also have a written constitution, the BMA says, which would be a "written agreement between the government, the NHS and the public". | The NHS should also have a written constitution, the BMA says, which would be a "written agreement between the government, the NHS and the public". |
| It would set out the NHS's core values, and would contain a charter setting out what the public could expect from the NHS - and what the NHS could expect from the public. | It would set out the NHS's core values, and would contain a charter setting out what the public could expect from the NHS - and what the NHS could expect from the public. |
| The BMA's report, which will be discussed at its annual conference in July, also suggests limiting the involvement of the private sector in the NHS. | The BMA's report, which will be discussed at its annual conference in July, also suggests limiting the involvement of the private sector in the NHS. |
| It says the private sector should only be used "when there is no NHS capacity", and that it should be used to "support rather than supplant" the health service. | It says the private sector should only be used "when there is no NHS capacity", and that it should be used to "support rather than supplant" the health service. |
| The report also calls for public involvement in the running of the NHS to be bolstered through the establishment of new elected local health councils. | The report also calls for public involvement in the running of the NHS to be bolstered through the establishment of new elected local health councils. |
| Government response | Government response |
| Health Minister, Andy Burnham, said further independence within the NHS should only be considered if it led to improved services. | Health Minister, Andy Burnham, said further independence within the NHS should only be considered if it led to improved services. |
| On core services, he said: "We resist any call to make the NHS a slimmed-down, emergency service, because that's what it would become if we started rationing care. | On core services, he said: "We resist any call to make the NHS a slimmed-down, emergency service, because that's what it would become if we started rationing care. |
| "The only losers would be the poorest people. The NHS should continue to be comprehensive and universal." | "The only losers would be the poorest people. The NHS should continue to be comprehensive and universal." |
| Nigel Edwards, director of policy at the NHS Confederation, said: "We need to confront the reality that if the public do not want cost to be a factor in NHS decisions than they may have to prepared to pay more in order to have every treatment funded." | Nigel Edwards, director of policy at the NHS Confederation, said: "We need to confront the reality that if the public do not want cost to be a factor in NHS decisions than they may have to prepared to pay more in order to have every treatment funded." |