A group of medical bodies, unions and healthcare experts have said if the NHS was run on its founding principle of co-operation rather than competition, it would become more equitable and cost-effective.

Academics and campaigners from the BMA, NHS, Support Federation, NHS Consultants Association, Keep our NHS Public, Unison and others, held a round table event to discuss alternatives to the market model for the NHS in England, coming up with a joint statement calling for:

  • New mechanisms to allocate NHS funding more equitably and efficiently: the document calls for funding to be allocated on the basis of population need rather than activity by trusts. It warns that the present payment by results / tariff system is “based upon narrowly defined episodes of care”, can “generate perverse incentives in patient referrals” and does not encourage “the pursuit of unmet need”.
  • An end to the purchaser-provider split: abandoning the purchaser-provider split in the NHS would be likely to generate substantial savings, the document says.
  • A new vision of what ‘choice’ means: the statement says there is a distinction between choice as a lever for competition, and choice as the capacity for patients to make informed decisions about their own care.

It says that unfettered patient choice as it has so far been conceived in the NHS is not what most patients want.

Dr Hamish Meldrum, Chairman of Council at the BMA, said: “We need a democratically accountable, local approach to healthcare delivery, with funding based on the needs of patients, and providers encouraged to co-operate rather than compete.”