The British Medical Association has launched a renewed attack on the current corporate culture in the National Health Service, which, it claims, is on the brink of a “dark and dangerous period” fuelled by the current economic downturn.

Speaking at a BMA meeting this week, Chairman of the Constants’ Committee Jonathan Fielden applauded achievements by the NHS such as reduced waiting times and cleaner hospitals, but slammed the “aberrant corporate cultures” in some hospitals that has lead to significant failings and damaged patient care.

According to Fielden, behind these “blots on the NHS landscape” - including the substandard care seen at the Stafford hospital that lead to patient deaths - are common themes of a greater emphasis on targets than quality and a disregard for safety.

In addition, he stressed that staff are not being listened, pointing to the results of a new survey by the BMA in which 74% of hospital doctors said they had experienced concern over patient safety, malpractice or bullying, and while 70% had raised the issues with their trusts, 46% said they were unaware of any action being taken. And worryingly, 15.5% said their trusts had indicated that their employment could be negatively affected by voicing their concerns.

Fielden has also called for the Service to dump its independent management consultants, on which it reportedly shelled out a whopping £350 million in England alone last year. Management consultants are motivated by different incentives than doctors, he argued, and stressed that public money must not be diverted away from patient care into the hands of shareholders.

“Let more money remain in the NHS - hard-earned taxpayers’ money going where they want it - into patient care, not the pockets of shareholders. It is the ethos, the faith that is at the heart of the Health Service that drives us. One that management consultants, brought up in the tarnished world of finance fail to understand”, Fielden claimed.

Stark choices
He went on to highlight that, because of the difficult economic climate, the health service is, for the first time, potentially facing budget cuts so will be forced to make some “stark” choices, but stressed that doctors should be making these decisions in partnership with patients and healthcare colleagues, “not faceless bureaucrats, accountants, and those out to fleece the taxpayer”.

Another area the BMA considers a potential threat to the NHS is the Independent Sector Treatment Centre programme, whereby privately-owned centres are paid by the NHS to carry out certain procedures. According to a recent estimate, nearly £1 billion was paid to ISTCs for work that was not actually undertaken, which Fielden says represents “a dangerous waste”, especially during a time of economic recession and budget cuts.

However, supporters of private sector involvement remain steadfast in their belief that a competitive culture within the health service will help to increase choice and boost the quality of care, and according to a spokesperson for the Department of Health, the ISTC programme “has helped improve health services for patients, reduce waiting times and improve patient choice”.