Page last updated at 12:34 GMT, Monday, 7 July 2008 13:34 UK

NHS 'run like a supermarket war'

By Nick Triggle
Health reporter, BBC News, Edinburgh

Doctor generic
Doctors have voiced their opposition to polyclinics

Doctors have urged England to follow Scotland's example in avoiding the use of the private sector and competition in the NHS.

British Medical Association chairman Dr Hamish Meldrum said the health service in England was being run like a "shoddy supermarket war".

Doctors at the BMA's annual conference voted for the NHS in England to only use private firms as a last resort.

Officials said the private sector was only used when it could improve care.

I'm not saying everthing is perfect north of the border, but at least there seems to be some shared agenda - not a service run like a shoddy supermarket war
Dr Hamish Meldrum
British Medical Association

Ministers have tried to create an NHS market by using the private sector and encouraging hospitals to compete for patients. About one in 10 elective operations are now done by private providers.

Meanwhile, successive administrations in Scotland have preferred to use private health firms only as a last resort when the NHS cannot provide the treatment.

England's approach has led to quicker progress on waiting times with hospitals closing in on an 18-week waiting target by the end of the year compared to the deadline of 2011 in Scotland.

But Dr Meldrum, who was born and trained as a doctor in Edinburgh, suggested the market reforms were an "English disease" which had not improved quality or efficiency, and fragmented services.

He added: "I'm not saying everything is perfect north of the border, but at least there seems to be some shared agenda. Not a service run like a shoddy supermarket war.

"If it can be done here in Edinburgh, it can be done in England."

Increasing interest

Jacky Davis, a consultant radiologist from London, said it was not just hospital care that firms were interested in as there were signs of increasing involvement in GP care and managing local health services.

She added: "The UK health system is a £100bn oyster that the commercial sector would want to crack open."

Dr Peter Terry, chairman of the BMA in Scotland, said: "I no longer recognise the NHS in England as the NHS as it was initially intended, where competition and privatisation drive service delivery, not the collaboration and partnership approach taken here in Scotland."

It comes as the BMA released a poll showing that 36% of the 1,000 polled did not think government changes had made the NHS better, although 42% did.

Half were opposed to the use of the private sector, while a similar number thought they would have to contribute towards their care within 10 years.

Doctors also attacked the government for its "anti-GP rhetoric" in its attempt to get them to work longer hours and introduce polyclinics.

Ministers want to see a network of polyclinics - health centres with a range of services available under one roof - set up across England.

On Sunday, health minister Lord Darzi maintained they would not lead to closures of GP surgeries.

But doctors passed a motion saying they would lead to longer journeys for patients and threaten existing GP surgeries.

Dr George Rae, a GP from the north east of England and member of the BMA's GPs committee, said: "Many polyclinics are likely to be run by for-profit multi-national companies.

"The investment will not be good value for money¿ the government would be better putting the money into GP practices. We can achieve all the goals."

But the Department of Health denied the polyclinics - or GP-led health centres as it calls them - were being imposed as the scope of them was being determined by local consultations.

And on the issue of the private sector, a spokeswoman added the government's approach was "pragmatic not ideological".

"Where independent sector providers offer high quality patient care, innovation, good value for money and meet local needs, we will continue to bring them in to work as part of the family of NHS providers."

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