According to Hamish Meldrum, chairman of the British Medical Association (BMA) council, new research shows that patients with formal educational background are more likely to prefer treatment in hospitals with higher standards of clinical performance, as opposed to people without such qualifications, who do not place as much significant importance for the clinical quality beyond an average level. In toto, the research findings suggest that offering patients greater choice may aggravate health inequalities.
Dr Meldrum also voiced his concerns regarding the Department of Health’s (DoH’s) ‘insistence’ on the setting up of new general practices under the new Alternative Provider Medical Services (APMS) route, through which Primary Care Trusts (PCTs) can contract to deliver primary care services locally from a range of providers, including those in the commercial sector. The DoH believes that the APMS route has enhanced PCTs’ abilities to develop services to offer greater patient choice, improved access and greater responsiveness to local needs.
However, Dr Meldrum noted that the turnover of doctors employed by the private organizations holding APMS contracts is often high and their running costs are greater than for those run under the traditional General Medical Services (GMS) or Personal Medical Services (PMS) route. Additionally, their Quality and Outcome Framework (QOF) scores are also comparatively lower.
The BMA has urged the government to make health a major element of Public Service Agreements (PSAs), and locate the Minister of Public Health in the Treasury, in order to enhance public health.