The BMA Council has taken a decision to oppose the whole Health and Social Care Bill following a publication of draft guidance for commissioning support organisations.

Following the publication of draft guidance from the DoH - Developing commissioning support: Towards service excellence – the BMA will be urging clinical commissioning groups (CCGs) to urgently review and where necessary change their structures to ensure they are able to fulfil their statutory functions without using private commissioning support.



The BMA Council warned that plans laid out in the guidance were likely to lead to support services for CCGs in England being provided solely by large commercial organisations after 2016.

The guidance makes a number of recommendations about how CCGs should function, including how they should access technical and 'back office' support, such as analysing sensitive population data.

The BMA is concerned that from 2016 commissioning support units formed by current PCT clusters would be encouraged to form social enterprises and partner with the private sector, rather than remaining part of the NHS.

Commercially-focused criteria to determine eligibility for providing commissioning support would also be introduced, making it almost impossible for CCGs to have their own, in-house support staff, the BMA said.



BMA Council chairman Dr Hamish Meldrum said: ‘These latest proposals from the government have the potential to seriously undermine [CCGs'] role, restricting the freedom and independence that clinically-led commissioning groups need to make locally sensitive, locally accountable, patient-focused decisions.



‘We will be urging CCGs to urgently review and where necessary change their structures to ensure they are able to fulfil their statutory functions without becoming dependent on external commissioning support.'

Despite the BMA’s outright opposition to the Bill, GPC chairman Dr Laurence Buckman said the BMA would ‘absolutely not’ be calling for members to step down from CCGs.

‘We will continue to encourage GPS to take part in clinical commissioning,’ Dr Buckman said.



Following these deliberations, the Council passed the following motion: In view of the implications of the recently published DoH document 'Developing Commissioning Support: Towards Service Excellence', BMA Council:

Publicly announces its opposition to the whole Health and Social Care Bill.

Calls for rapid organisation of a public campaign of opposition to the Health and Social Care Bill.



The BMA will be considering its next steps as part of its continuing activities on the Bill.