The vast majority of doctors are not convinced that potential benefits of the government’s plans for the NHS in England outweigh the risks, an online survey for the BMA suggests today (Thursday 3 March 2011).  An Ipsos survey of BMA members, carried out in January this year, reveals a range of views, but widespread concern about plans to increase competition, even among the minority of doctors who are generally supportive of the changes.

The statements garnering the highest levels of agreement among the 1,645 respondents are:

• Increased competition in the NHS will lead to a fragmentation of services (89% agree)
• Increased competition in the NHS will reduce the quality of patient care (65% agree)
• The move for all NHS providers to become, or be part of, foundation trusts will damage NHS values (66% agree)
• The proposed system of clinician-led commissioning will increase health inequalities (66% agree)

Overall, the survey suggests that doctors believe the changes that are most likely to be achieved are those which are least welcome.  For example, almost nine in ten (88%) think it is likely that the reforms will lead to increased competition between providers, but only a fifth (21%) believe this will improve the overall quality of NHS care.  Conversely, doctors believe the changes that would be most beneficial are least likely to be achieved.  For example, two-thirds (67%) think closer working between general practice and hospitals would improve the overall quality of patient care, but only a third (34%) believe it likely that the reforms will lead to this.

In terms of the impact on their own roles, three fifths of respondents (61%) think it likely that the reforms will lead to them spending less time with patients, a change which only 1% would welcome.

The survey suggests that doctors fall into three distinct groups according to their views on their personal role in relation to the proposed reforms.   A third (33%) are broadly opposed, around a fifth (18%) are broadly supportive, and just over a third (36%) say they are waiting to see what happens. The scale and strength of concern varies significantly across the three groups, but even within the ‘pro-reform’ group (those who say they want to help lead the changes or are keen to get involved) two thirds (67%) agree that increased competition in the NHS will lead to a fragmentation of services.  And, while generally most positive about the proposed system of GP-led commissioning, a fifth of this group (22%) still think it will reduce the quality of patient care.

There are mixed views about the impact of the proposed system of GP-led commissioning.  Two-thirds (66%) agree it will increase health inequalities and half (49%) that it will reduce the quality of patient care.  A vast majority (84%) of GPs have taken, or their practices have taken, at least one step to prepare for the reforms, for example, attending a meeting about clinician-led commissioning. Only half of GPs (49%) agree that GPs in their local area will be ready to take on new roles leading commissioning.

• Read the press release on the BMA website
• Download the survey topline (PDF)
• Download the full computer tables (PDF)
• Download the final report (PDF)

Technical note

Ipsos invited 18,456 BMA members in England (doctors in all branches of practice - GPs, consultants, junior doctors and Staff and Associate Specialist doctors, medical academics, public health doctors, and consultants) to complete an online survey between 17 and 28 January 2011.  It received 1,645 responses – a response rate of 9%.  The data was weighted to match the profile of BMA membership.