Dr Ian Bogle: "Doctors feel undervalued"

Dr Ian Bogle, chairman of the British Medical Association council, told the association's annual conference in Belfast that government policy had placed the very future of the health service under threat.

He also accused the government of setting out to deliberately undermine the public's confidence in doctors.

Dr Bogle said the government's reforms, which have established different systems in the four home countries, threatened dangerous fragmentation of the health service.

He said initiatives such as walk-in centres and the telephone helpline NHS Direct also posed a serious threat to the continued role of the GP.

Frightening pace of change

The pace of change was "frightening", Dr Bogle said, and doctors were "apprehensive and fearful for their future".

He also rounded on the government for leaking stories to the media before consulting the medical profession.

"It seems a government that puts public image ahead of policy initiatives that are properly planned and evaluated has failed to appreciate the consequences of its actions," he told the conference.

"The mismatch between patient demand and available resources is calling into question the ability of the NHS to provide comprehensive healthcare.

"Walk-in clinics may pander to public demand for 24-hour access to the NHS. But will they relieve pressure on an understaffed and under-resourced service?

"Will they undermine the GPs' gatekeeping role, which could alter the fundamental basis of general practice and have horrendous financial consequences for both secondary and primary care?"

Dr Bogle accused the government of being obsessed with waiting list targets that distorted clinical priorities to the detriment of patient care.

"As a result, hospital doctors are working at greater intensity than ever before as they struggle to cope with rising emergency admission and lengthening queues for outpatient clinics."

Morale is low

Doctors were becoming increasingly "disheartened and disillusioned", he said.

The problems had been compounded by the way the government and the media had overreacted to the Bristol heart babies scandal, Dr Bogle said, giving the impression that poor practice was far more common than it actually was.

"Many doctors feel increasingly unable to cope with the demands made on them by their professional lives," he said.

"They are being pressurised into working at ever-increasing intensity, often in order to meet imposed and irrelevant targets.