ENGLAND must follow Scotland in the way it funds health services, by shunning the private sector and not forcing competition into the NHS, the leader of the UK's doctors said yesterday.
Dr Hamish Meldrum, the chairman of the British Medical Association (BMA), said the NHS in England had to get rid of the "damaging market in healthcare".
The concerns, highlighted at the start of the BMA's annual conference in Edinburgh, were echoe
d by doctors in Scotland.
Scotland has increasingly moved away from England in the way it runs the health service.
In 1990, the Conservative government introduced the internal market system in the NHS, whereby hospitals have to compete to win contracts from health authorities and GPs.
In 1997, the Labour Party's manifesto pledged to get rid of the system.
The conference, attended by more than 400 doctors, also heard of other differences, including increased private sector involvement and the prospect of so-called "polyclinics" south of the Border.
Dr Meldrum, who was born and trained in Edinburgh, said: "Devolution has always been portrayed as the three Celtic nations breaking away from England. In the case of the NHS, it's been the other way round. England has broken away from the rest of the UK."
Dr Meldrum said there was no evidence the internal market had increased efficiency and decreased costs and praised the move away from the system in Scotland. He added:
"The BMA wants to see an NHS untarnished by a market economy, true to its beginnings, giving the public a fair, caring, equitable and cost-effective health service – not a service run like a shoddy supermarket war. If it can be done here in Edinburgh, it can be done in England.
"Let's stop pretending that healing the sick is like trading a commodity. Let's stop diverting doctors' energies into unholy bidding wars for jobs they already do. Let's follow the Celtic lead and get rid of the market in healthcare once and for all."
Dr Meldrum added: "I'm not saying that everything's perfect north of the Border, but at least there seems to be a shared agenda, a willingness and an eagerness to pull together that you don't see south of Hadrian's Wall or east of Offa's Dyke," he said.
Dr Peter Terry, the chairman of the BMA in Scotland, praised the SNP government's approach to the NHS in Scotland and said doctors supported the principles underpinning their policies – to maintain a universal and free health service based on clinical need. He said:
"I think the English should follow us. I didn't like it (the internal market] and I don't think anybody did. It did not seem to be of any benefit to patients and the administration costs were huge."
Dr Terry also criticised increased private sector involvement in the NHS in England.
"I no longer recognise the NHS in England as the NHS as it was initially intended," he said.
A spokeswoman for the Scottish Government said: "The Scottish Government is committed to the principle of a mutual, collaborative NHS in Scotland rather than a competitive market approach adopted elsewhere in the UK."
BACKGROUNDWHEN the internal market was introduced into the NHS, the idea was to drive down costs and increase efficiency.
In England, GPs or primary care trusts are given a budget they must use to commission services from other parts of the NHS. For example, if they have patients with diabetes who need to go to a consultant-led diabetes clinic, they must buy this service from a hospital. So hospitals compete to attract patients to receive the money for providing that care. The internal market has helped the private sector establish itself as a provider within the NHS. It has also helped support the "patient choice" agenda, whereby people have a say in where they are treated.
Scotland abolished the internal market almost ten years ago.
Health boards are given a budget calculated using the Arbuthnott formula, which takes into account factors such as population size, death rates and levels of deprivation. The health board then decides what services to fund, using that budget. GPs do not have to commission services; they send patients to where they believe they will get the best care.
While doctors have praised Scotland's shunning of the internal market and opposition to the private sector, others suggest these factors have helped to drive down waiting times in England, which is on track to meet an 18-week total waiting target by the end of the year, compared with a 2011 deadline in Scotland.
Doctors persuade government to block GP practices run by private firms A LEGAL loophole which could make it possible for private companies to run GP practices and other health services in Scotland is to be closed, the health secretary will announce today .
Nicola Sturgeon is due to address GPs at the British Medical Association conference in Edinburgh, and is taking action to end any possibility of private firms getting a foothold in the Scottish NHS, as has happened in England.
The move comes after doctors called for a campaign to close loopholes in Scottish legislation that would allow the private sector into the NHS.
While the SNP-led administration has signalled its opposition to the involvement of private companies, doctors had feared that this could change in future, especially if a different party came to power.
A motion put forward by Scottish doctors at the BMA conference urged the association to call for legal amendments to block private provision of services.
Currently, private-sector involvement could be allowed under three separate pieces of legislation.
But Ms Sturgeon's announcement will ensure such a possibility is put out of reach.
A Scottish Government spokeswoman said: "Nicola Sturgeon has always made clear that she does not see the NHS in Scotland moving towards more private-sector involvement."
In 2006, private company Serco made a bid to manage a GP practice in Harthill, Lanarkshire, but was unsuccessful.
However in England, several GP practices are now run by private firms and there have been concerns that if such companies, including Serco and United Healthcare, establish any kind of foothold in Scotland then the situation will escalate.
Dr Peter Terry, chairman of the BMA in Scotland, said: "Concern about private-sector involvement in primary care is that it will be driven by profit.
"It also relies more on locum doctors to provide the service, meaning you do not get the same continuity of care you would from a regular GP.
"The service ends up being more fragmented, which does not help patients."
The full article contains 1103 words and appears in The Scotsman newspaper.
