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Health Select Committee inquiry into the NHS Next Stage Review

• The emphasis on quality in the review reports is welcome, but proposes a number of organisational additions, new structures and other quality initiatives, which will require adequate resources.
• The BMA supports the call for greater clinical involvement at all levels in the running of the NHS and stronger clinical leadership, but has reservations about how easily this will be achieved in reality.
• We continue to have serious concerns over the procurement of new GP practices and GP-led health centres across the country, particularly in areas where there is little or no identified need for the new services.
• The government’s continued efforts to stimulate the internal NHS market through the extension of patient choice and competition do not have the support of the BMA. We consider this approach to be a major barrier to effective collaboration between different parts of the NHS and the development of more integrated care pathways that will improve the patient experience and health outcomes.
• We welcome the creation of NHS Medical Education England (MEE) and call for it to be properly constituted, given real powers, a strong input from the medical profession and from doctors in training in particular.
• Workforce planning is an area that has been largely neglected in recent years. The increased emphasis and responsibility for workforce planning at a local level with PCTs and service providers must be augmented by strong and expert direction and oversight at a regional and national level. The new structures proposed to achieve this have a very challenging task ahead.
• One notable difference of opinion between the Department of Health and the BMA on the NHS constitution is our proposal that the NHS should operate under the guidance of an independent Board of Governors and Executive Management Board.
• Our concerns over the NHS Next Stage Review process are outlined in a BMA position statement submitted to the Committee as supplementary information.