BMA meeting: Trust in doctors is key to meeting the challenges facing the NHS, says BMA chairman

BMJ 2011; 342 doi: (Published 27 June 2011) Cite this as: BMJ 2011;342:d4054
  1. Matthew Limb
  1. 1London

The chairman of the BMA Council, Hamish Meldrum, has warned that trust between doctors and patients could be put at risk by the government’s reorganisation of the NHS.

Speaking ahead of the BMA’s annual representative meeting in Cardiff this week, Dr Meldrum said that he welcomed suggested “improvements” to the government’s Health and Social Care Bill made from the “listening exercise.”

But he said that some aspects of the bill were still a matter for concern, including the way commissioning arrangements would work in practice and the so called “quality premium.” Under this scheme, GPs would receive a bonus for spending NHS funds carefully or effectively and would lose a portion of their income if they spent unwisely.

Dr Meldrum said that trust could break down if patients suspected that their GPs were being rewarded for how well they do financially while rationing services or prescriptions to save funds.

He said that commissioning decisions would have to be taken with “absolute transparency,” involving other clinicians and patients in a way that would retain trust.

Dr Meldrum said that the need to retain trust would be a major theme of his speech today, which launched the four day meeting in Cardiff.

He said that people trusted doctors more than any other profession, citing a new survey conducted by Ipsos Mori showing that 88% of adults trust doctors to tell them the truth, much higher than the percentages for trust in NHS managers (40%), bankers (29%), government ministers (17%), and politicians generally (14%).

Trust would be key to getting through some of the biggest challenges ever faced by the NHS. “We must never take trust for granted,” he said.

Among other areas of concern over which feelings among BMA members were “running high,” Dr Meldrum said, were the scale of cutbacks to NHS services and the timetable for financial savings, which will be debated in a series of motions at the conference.

He said that there had to be a rational basis for efficiencies, which should be based on evidence of providing services more effectively rather than seemingly arbitrary deadlines and balance sheet targets set by managers.

“We still haven’t seen a very clear narrative of how savings will be made. We will certainly react strongly to a knee-jerk, slash and burn approach,” he said.

He said that the BMA would continue to work constructively with the government, adding that the mood over the past few weeks was more “productive” than in previous months.

He said he did not want to predict the outcome of this week’s debates but that he saw the decisions to be taken by members as critical in determining the profession’s response to the challenges ahead.


Cite this as: BMJ 2011;342:d4054