NHS Doctors ‘Gagged By A Culture Of Fear’

The British Medical Association accused the government yesterday of instilling “a culture of fear” across the NHS to stop doctors revealing how health service reforms are putting patients’ lives at risk.

The BMA surveyed senior consultants in hospitals throughout England and found 56% knew of clinically effective treatments being withdrawn by their NHS trust to save money or comply with policy directives.

Jonathan Fielden, chairman of the association’s consultants’ committee, said the vast majority of doctors were enthusiastic about change, but their efforts to improve services were being hindered by ill-considered government policies. Dr Fielden said: “Sadly, many doctors who took part in this survey feel unable to speak out openly. There is a culture of fear in the NHS and doctors are under severe pressure to meet targets and keep their mouths shut.”

The survey was sent to the lead negotiators representing doctors at 289 trusts in England. It found 61% knew of planned services being abandoned or delayed and 58% had examples of national initiatives impacting adversely on patient care.

Only 11% of the consultant negotiators thought the government’s policy of offering patients a choice of at least four hospitals would improve the care they received. Just over half the respondents believed that the system of payment by results – encouraging hospitals to compete for patients – would worsen patient care. And 72% said treating NHS patients in the private sector would lower standards.

Dr Fielden said examples of medical facilities being withdrawn for financial reasons included a Midlands radiologist who had to rely on charities to fund a new treatment for breast disease, and a Surrey consultant who had to deny some patients a pioneering treatment for prostate cancer because of lack of funds.

Dr Fielden said: “The government is wasting millions of pounds on health reforms that have not adequately involved senior doctors and consequently fail to benefit patients. Consultants are going the extra mile to bring down waiting lists only to be told to slow down and be less productive. Meanwhile, work continues to be diverted away from NHS hospitals to under-performing independent sector providers at greater cost. Plans to increase recruitment or buy new modern equipment are being put on hold or abandoned because of a lack of money.”

The BMA sent the survey to 289 lead negotiators and received 265 replies.

A Department of Health spokesman said: “Giving people more choice and control over their care and treatment, and where they receive it, is the solution, not the problem. While some doctors may find this challenging, it corresponds with what people are telling us, with 63% wanting to be offered choice of treatment and hospital.”