Commenting on the BMA’s report, Nigel Edwards, director of policy at the NHS Confederation which represents over 90 per cent of NHS organisations, said:
“The BMA’s report contains a large number of positive recommendations for the future of the NHS which are worthy of further discussion. We fully agree that it is vital for managers and clinicians to work well together and build effective relationships to develop excellent local services.
“However, as the BMA recognises, there are various challenges of a written NHS constitution that defines a list of core services. One of the main problems is that a list of entitlements will, by its nature, also include a list of what the public is not entitled to. International experience suggests that this process of defining basic lists is extremely difficult.
“The NHS exists in a cash-limited system and has a multitude of competing priorities. It is extremely difficult to reach a consensus on expensive drugs and treatments that pleases everyone.
“There are difficult ethical issues that we need to grapple with as a society about how we make choices in a cash-limited NHS. We need to confront the reality that if the public do not want cost to be a factor in NHS decisions than they may have to prepared to pay more in order to have every treatment funded. We agree with the BMA that the public is ready for this debate.
“We welcome the BMA’s analysis of an independent board for the NHS and they make some interesting suggestions. The NHS Confederation agrees that the NHS should be more independent of central government control. However, the structure of this is far less important than ensuring real devolution of power to local NHS trust level as this is where the best decisions are made.”