The British Medical Association (BMA) has “misunderstood” commissioning support plans, the Department of Health has claimed.
In a statement to MiP a spokesperson from the DH said it will be BMA members that determine what form commissioning support takes in the future, not the government.
“The BMA has misunderstood our plans for commissioning support,” said the statement.
“All commissioning decisions, including on the back-office functions of commissioning support, will be made by Clinical Commissioning Groups themselves and cannot be delegated to other organisations.”
The release of government plans showing CCG support is “likely” to be solely provided by large, commercial organisations has caused the BMA to renew its opposition to the entire Health and Social Care Bill.
Dr Hamish Meldrum, Chairman of the BMA Council, said draft guidance by the Department of Health Developing commissioning support: Towards service excellence, will serve to “seriously undermine” GP commissioning roles and “restrict their freedom and independence”.
The deliberation following publication of the guidance led to the BMA Council passing the motion to call for a “rapid organisation” of a public campaign of opposition to the bill.
“It would be a real shame if the BMA’s new position means they feel unable to work with the government on making the Bill a success – for the benefit of patients, and indeed for their members.”
An “urgent” meeting has also been requested with the Secretary of State for Health to raise the BMA’s concerns.
As reported by Management in Practice on Wednesday 23 November (Warning of private sector commissioning ‘advantage’), the DH guidance reveals an “encouragement” for commissioning support units – born from PCT clusters – to form social enterprises and partner with the private sector from 2016.
The BMA claimed the introduction of commercially-focused criteria to determine eligibility for providing commissioning support will make it “almost impossible for CCGs to have their own, in-house support staff”.
“A key plank of the government’s NHS reforms was to entrust GPs and other health care professionals to lead on the commissioning of services for patients to ensure local health needs were met,” said Dr Meldrum.
“These latest proposals from the government have the potential to seriously undermine this role, restricting the freedom and independence that clinically-led commissioning groups need to make locally sensitive, locally accountable, patient-focused decisions.
“Doctors tell us about the chaos they are already seeing on the ground as more and more change is implemented. The government should be focusing on ensuring the skills and experience of staff in current PCT clusters are retained. They will be invaluable in supporting the development of CCGs and providing much needed continuity during this period of huge financial pressure and structural overhaul.”
The BMA is urging CCGs to review and change their structures to ensure they do not become dependent on external commissioning support.
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“No, they need to do much much more. People are against the bill. Do not change our NHS, the government came in with no manifesto to do so” – Theodora Munroe, London
