BMA, NHS GP Doctors Do Not Want Competition, Value for Money or Patient Choice

By: Nadeem_Walayat

The British Medical Association (BMA) representing NHS GP Doctors has belatedly gone on the offensive against the coalition government's plans for reforming the NHS by introducing a market for competing GP consortiums to manage most of the NHS £100 billion budget. NHS GP's do not want competition because it would mean a more commercial health service where patients are able to freely move to the better run GP surgeries which risks putting failing GP surgeries out of business and fellow GP's out of work.

"The BMA has consistently argued that clinicians should have more autonomy to shape services for their patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency."

In a strong statement to British Health Secretary Andrew Lansley, the BMA adds: "We urge the government and NHS organisations to focus on those areas where they can truly eliminate waste and achieve genuine efficiency savings rather than adopt a slash-and-burn approach to health care, with arbitrary cuts and poorly considered policies."

The coalition government announced their plans in June after apparently being so impressed by the performance of the NHS Primary Care Trusts (PCT's) that it intended to scrap ALL PCT's in favour of GP Consortia's directly managing patient treatment commissioning (the process could take 2-3 years to implement).

The plans for the consolidation of GP practices into GP consortiums in an attempt to introduce real competition between surgeries for patients which means that the less performing GP surgeries could disappear as they will be unable to compete for patients in a more market orientated value for money environment due to their inability to provide health services to the satisfaction of a large % of their patients as illustrated in the wide disparity at the quality of health service deliver by the UK GP Patient survey.

The anticipated changes are set against the current system which contrary to what the population believes GP's are Independant PRIVATE contractors to the NHS WITHOUT COMPETITION. GP's are basically a law onto themselves, and in the vast majority of cases totally unaccountable where complaining against GP's amounts to a total waste of time which is why the NHS is riddled with inept GP's as there is no real mechanism to get rid of those that are not up to the job, an issue which market forces will attempt to address.

Therefore under a more competitive GP health servicing market as consortia compete against one another for patients, those surgeries that rank at the bottom that prove unable in satisfying and thus retaining patients, should find themselves forced to merge and to restructure with new staff employed so as to ensure that the consortia's are better able to compete against one another for patients. This also means for the reforms to work then there must be at least 2 competing consortia per locality, and preferably more other wise the reforms will FAIL and result in even worse patient health care experience as there will be NO incentive for GP's to treat patients but every incentive to deliver as much as possible of the £100 billion NHS budget into the back pockets of GP's which is probably what GP's expect to happen as occurred following the 2003 Labour GP contracts as illustrated by the below GP Pay graph that contributed to the 2009 MP expenses scandal as GP pay took off into the stratosphere whilst MP's watched on in envy therefore triggering the expenses abuse.

NHS Bankrupting Britain

The country continues to run an annual £156 billion budget deficit i.e. the government spends £156 billion a YEAR more than it earns in revenue which is contributing towards igniting Britains inflationary debt spiral, that risks an accelerating trend towards an hyper inflationary bust leaving savers with worthless paper and the economy in ruins, i.e. bankrupt unless urgent action is taken to bridge the gap between government revenue and spending.

The NHS budget under Labour has grown from £40 billion in 1997 to £121 billion for the last financial year. NHS budgets increasing in line with inflation (CPI) would have seen the budget under a Conservative regime rise to stand at £51.6 billion, and probably nearer £60 billion to allow for an ageing population. So the Labour government is in effect spending an extra £60 billion a year, more than double that which the Conservative would be spending on the NHS.

Against this extra spending instead of Brit's experiencing the impact from effectively paying for TWO NHS's, the NHS is experiencing year in year out loss in productivity, i.e. the more the government spends on the NHS the LESS output the NHS delivers as more tax payer funds disappear into the NHS black hole. In theory this suggests that the NHS budget could in-effect be halved to £60 billion and still deliver a functional health service that the the country can afford. Off course that is not going to happen, but still a mere 10% cut in the NHS budget would contribute some £12 billion of annual savings from this out of control spending black hole that like a cancer is eating through the countries balance sheet.

The government's annual budget deficit is running at £156 billion a year or at 23% of the total budget i.e. the the governments total revenues are £520 billion against estimated expenditure of £676 billion, hence a deficit of £156 billion added to the national debt known as the Public Sector Net Debt (PSND) currently standing at about £850 billion, though excluding the hidden tax payer liabilities that extend to several more trillions of pounds. Nevertheless £850 billion of debt now costs about £40 billion in interest per year to service, as the debt grows so does the cost of servicing the debt, more so as the supply of government bonds increases then so will the market demand ever higher interest rates to buy this flood of debt which illustrates why running anywhere near an £156 billion annual budget deficit is NOT sustainable, as it would ignite the earlier mentioned inflationary debt spiral as interest payments soar which therefore requires urgent action to CUT the deficit to BELOW 6% of GDP / £75 billion, with some £80 billion necessary to be cut comprising of tax increases, economic growth and spending cuts in the region of £60 billion.

However the coalition government has officially tied one arm behind its back by stating that they will continue to increase the two largest areas of government spending, the NHS and Pensions which amount to 1/3rd of total government spending, which means that deeper budget cuts will have to be borne by other spending departments which may not be possible to achieve.

NHS Pumping Out Bogus Performance data

A lengthy report earlier this year into the REAL performance of one of Britians top ranked hospitals placed The Mid Staffordshire NHS Foundation Trust as a killing field for patients that walk through its doors, this is set against NHS phony statistics on hospitals and GP surgeries that relentlessly paint a picture of everything is great, against the facts of actual patient experience as reported by the Telegraph.

Telegraph

Up to 1,200 patients are thought to have died unnecessarily at the trust between 2005 and 2008.

A damning report on the deaths found chronic staff shortages, receptionists in casualty departments assessing the urgency of cases and nurses switching off equipment that did not know how to use.

Both trusts are “Foundation Trusts” a status supposedly awarded to only the best in the NHS.

We were told by the Department of Health that Mid-staffordshire NHS Trust was a one off, an aberration, but barely a few days later further details leak that it is barely the tip of the ice-berg with another 24 Hospitals with the similar problem of being engaged in the process of reducing their waiting lists by unnecessarily killing off patients, all according to the NHS produced phony data are doing well as reported by the Daily Mail

Twenty five hospital trusts should be urgently investigated over fears that thousands of patients may have died unnecessarily, an expert said last night.

Excessive death rates at the trusts could be down to serious failings in the way patients were treated, according to Professor Sir Brian Jarman.

He said a total of 4,600 more patients had died at the 25 trusts than would be expected between 2007 and 2008

Remember these are are NHS trusts that are ranked by the NHS as the BEST hospitals in Britain ? Why ? because as with the rest of the NHS, they self certify their OWN performance data. Which means a hospital's such as the Mid Staffordshire can hide 1,200 unnecessary deaths.

The same applies to as many as 1/5th of GP surgeries that self certify themselves as being good, but actual patient experience does not match the phony statistics, in this regard the Department of Health funded UK Patient GP Survey enables patients to find the truth about their GP Surgery as per actual patient experience - To find out your GP's actual performance visit the UK GP Patient survey results site.

The only answer to the NHS GP and Hospital delivery crisis is in greater competition between surgeries and hospitals which ultimately means privatisation, as the existing system of no real competition means the incompetent are rewarded with more resources in the face of inability to deliver whilst those that excel are punished with less resources so as to pull all services down towards the under performing mean.

The only way excellence can be rewarded and act is the goal to be achieved is if competition drives out the inept and incompetent GP surgeries as they lose patients and resources to the better run GP surgeries which can only happen in a private system of healthcare delivery, where patients would in effect be handed NHS credit cards to enable them to buy healthcare at ANY health facility whether NHS run or private.

Given the actual performance of the NHS, I would imagine that closing 15% of the worst performing NHS Hospitals and GP Surgeries would result in IMPROVED life expectancy for Brit's as well as contribute £15 billion of annual savings to help bring the unsustainable £156 billion annual budget deficit under control.

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By Nadeem Walayat

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Nadeem Walayat has over 20 years experience of trading derivatives, portfolio management and analysing the financial markets, including one of few who both anticipated and Beat the 1987 Crash. Nadeem's forward looking analysis specialises on UK inflation, economy, interest rates and the housing market and he is the author of the NEW Inflation Mega-Trend ebook that can be downloaded for Free. Nadeem is the Editor of The Market Oracle, a FREE Daily Financial Markets Analysis & Forecasting online publication. We present in-depth analysis from over 500 experienced analysts on a range of views of the probable direction of the financial markets. Thus enabling our readers to arrive at an informed opinion on future market direction. http://www.marketoracle.co.uk

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