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Doctors fear secondary care money drain

Government funding shift threatens NHS stability and morale, says BMA survey

Ninety-five per cent of doctors fear that government plans to siphon 5 per cent of NHS spending from secondary care into primary care, will destabilise hospital funding, according to a new poll published by the British Medical Association (BMA) News.

Responding to proposals in the the new White Paper, Our Health, Our Care, Our Say, just one per cent of respondents in the survey felt that the government can or will provide the necessary resources for community-based healthcare without damaging secondary care facilities.

The survey also suggests that the government risks more than just a destabilised secondary care sector - 80 per cent of respondents were concerned that policy direction ìwill lead to tensions between the primary and secondary care sectorsî.

London consultant psychiatrist, Warwick Onyeama, said the proposals would lead to ìsquabbling over whose budget covers what serviceî.

The poll has compounded fears that hospitals may not want to treat those that could be dealt with elsewhere, or even worse, that primary care providers may compete for patients traditionally reserved for hospital treatments, even where primary care may be inappropriate.

Mark Porter, a consultant anaesthetist said that the white paper ìreads like a set of principles for separating elective care from emergency careî.

He added: ìWhen there is a problem in elective care, one wants to know that the emergency team is in the same building.î

Another GP emphasised that some surgeries could be carried out in a GP clinic but only ìif the government can risk a death from routine surgery without the back-up to resuscitate an arrestî.

In some respects, the most damning aspect of the survey is that only 44 per cent of those surveyed felt that the White Paper's directives to deliver healthcare closer to the community would be better for patients.

Some doctors fumed at the new plans. GP Maureen Douglas, said: ìMany of us are beginning to assume that destabilisation has to be the desired end point.î

However, health policy analyst, Ray Rowden said the funding plans would not increase competition between primary and secondary care any more than already exists.

ìThere will be competition anyway with Payment by Results, practice-based commissioning and a stream of new private providers,î he commented. ìI think the BMA just have to get real. This is happening anyway and there's no point complaining about it.î

Payment by Results 'not working well'

Over 200 doctors were canvassed by BMA News, the results of which have been published in their Doctors Decide poll.

30th September 2008

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