Choose and Book a ‘fiasco’, claims BMA chair

The chairman of the British Medical Association has criticised the government’s choice agenda and dubbed Choose and Book a “fiasco” that takes no account of how GPs and hospitals work.

Jim Johnson told the BMA’s annual meeting this week that Connecting for Health was facing problems because it had failed to listen to doctors, nurses or patients.

A survey of more than 2000 members of the public conducted by YouGov for the BMA last week found ‘choice of where to have an operation’ came bottom of a list of 10 options of where those surveyed thought NHS funding should be prioritised.

Cleaner hospitals, improved accident and emergency and shorter waits for outpatient appointments were the top three priorities rated by the public.

Johnson said: “The BMA has been saying for a long time that patients are not so interested in a choice of five hospitals but they want a good service in a clean local hospital”.

He told doctors at the annual representative that Choose and Book “has been a fiasco so far because people who do not work with doctors or patients have devised a system which does not begin to understand the basis on which GPs refer and hospitals organise clinics.

“This is just a mini example of the much bigger mess that could be coming our way with Connecting for Health if the new systems are not planned with the involvement of the nurses and doctors who deliver the services to patients.”

Johnson said the few doctors who were helping to develop Connecting for Health were enthusiastic about the possibilities it offered for improving patient care but that there had been little attempt to engage grass roots clinicians or even the leaders of the professions.

He added: “If government is really willing to consult and involve doctors in planning the new system we can help to get it right both for patients and doctors and save a lot of heartache, embarrassment and wasted expenditure.”

The meeting called on the Department of Health to provide resources that would lead to patients being able to make decisions based on accurate and relevant information supported by medical recommendation.

Dr Hamish Meldrum, chairman of the General Practitioner Committee of the BMA, raised the issue of the confidentiality of patient records at the meeting. He said that the integrity and confidentiality of the patient record was crucial to the trust and confidence that patients have in their GPs.

He added: “Last week’s news showing just how easy it is to buy highly confidential bank account details demonstrates just how easy it is to abuse such power and threaten the whole trust on which our system of patient care is based.”

Health secretary Patricia Hewitt told the meeting that listening to doctors and patients was top of her list of priorities. She said the government was half through a ten year programme of change for the NHS.

She added: "I believe we will now move quite quickly to a more bottom up approach with less emphasis on targets so that on initiatives like patient choice there will be an in-built dynamic for continuous improvement which will be good for patients and far more satisfying for staff."