Proposals for a National Health Service (NHS) Constitution will not protect the Service from being used as a political football and could reinforce the “increasing commercialisation” of health care in England, Dr Hamish Meldrum, chairman of council at the British Medical Association (BMA), has warned.

Brief details of the proposed NHS Constitution, which will be published next year alongside the Health Bill, were included in the Queen’s Speech to Parliament yesterday. In a short, eight-minute speech which mainly focused on measures to deal with the global economic downturn, she said that: “because the health of the nation is vital to its success and wellbeing, a bill will be brought forward to strengthen the National Health Service. The bill would create a duty to take account of the new National Health Service constitution that will set out the core principles of the service and the rights and responsibilities of patients and staff. The bill would also introduce measures to improve the quality of healthcare and public health.”

The proposed NHS Constitution, which was published and sent out for consultation on June 30 following Professor Lord Darzi’s next-stage review of the NHS, seeks to reaffirm rights to NHS services, free of charge and with equal access to all, and it enshrines patient rights to choice and to drugs which have been approved by the National Institute for Health and Clinical Excellence (NICE) and recommended by clinicians, says the Department of Health. The consultation closed on October 17.

The BMA welcomes the proposals in principle and agrees that NHS patients deserve a clearer idea of both their rights and responsibilities, but is concerned that, in its current form, the Constitution “will be used to reinforce reforms which are increasing the commercialization and fragmentation of health care,” said Dr Meldrum.

The government has missed an opportunity to depoliticise the delivery of health care, he said, adding: “We would like to see a Constitution which reduces the role of politicians and gives health professionals, patients and the public a greater say in the day-to-day running of the NHS.”

The NHS Confederation, which represents over 95% of organizations within the Service, broadly welcomes the proposals, but the final test of the Constitution will be how it is used to enable choice and helps drive the move towards more personal care, said Nigel Edwards, director of policy at the Confederation.

He added: “it is important to stress that leaders in the NHS know the economy is in a downturn and that things will be getting tougher in public services. The NHS Constitution provides the framework for the debate that will have to take place about the difficult choices which will have to be made in the coming years.”