Published: 17/04/2003, Volume II3, No. 5851 Page 8 9

Doctors are increasingly disillusioned with the government's handling of the NHS and rising numbers say they see no improvements from increased expenditure, the British Medical Association has claimed.

Latest figures from the BMA's regular monitoring of members' views show that 83 per cent of GPs and 82 per cent of consultants say they have not seen any improvements from the extra cash pouring into the NHS. This is up from around 65 per cent in November 2002.

BMA chairman Dr Ian Bogle told the BMA's junior members forum in Belfast last weekend that the NHS was facing a 'crisis of confidence' as excessive focus on targets prevented money getting to the frontline.

He said: 'This is damaging at every level. Doctors are demoralised because of the government's attempts to manage the NHS from the centre. Managers are privately saying that they have lost trust in the government. The government is suspicious of doctors and the public no longer has confidence that the government can deliver a first-class NHS.'

While the BMA did not oppose targets in principle, he added, money needed to be spent on areas where it was of real benefit to patients. The survey found that money was being wasted chasing targets that were not clinically meaningful. Examples included:

Funding evening or weekend consultant-led clinics to prevent slippage on out-patient waiting-list targets. But consultants claim they often find patients in these clinics already had a routine appointment later the same week and only a few days past the deadline.

Time and resources focused on seeing all suspected cancer patients within two weeks even though lung cancer rarely requires urgent treatment. This draws resources away from other lung patients who do need urgent treatment, such as cystic fibrosis sufferers.

The creation of diagnostic and treatment units to protect elective surgery in acute hospitals.

The units have a less stressful working environment and are drawing skilled nurses away from acute wards.

NHS Confederation policy director Nigel Edwards said: 'Many of the targets have played a key role in helping concentrate minds and focusing resources on the issues that really matter to patients.'

However, there was still scope to develop the way targets are set and monitored to make sure doctors and managers work together.

lJunior doctors have called for an end to bullying, harassment and discrimination. The BMA's junior members forum last week claimed that 80 per cent of junior doctors had experienced some form of bullying. They want the BMA to launch an anti-bullying campaign.