A call to get rid of the damaging market in healthcare once and for all came today from BMA Chairman Dr Hamish Meldrum in his keynote speech opening the British Medical Association's annual conference held this year in Edinburgh.
Speaking to more than 400 UK doctors, Dr Meldrum said: "We've had the market in England for nearly 20 years. Where's the evidence that it works?
Dr Meldrum continued: "Where's the balance sheet that shows that the argued-for and promised increase in efficiencies and decrease in costs outweigh the transaction costs and bureaucracy of the market? Show me the evidence that for most of what we do - emergency care, long-term conditions and primary care - the market improves rather than detracts.
"Instead we get competition not collaboration; fragmentation not continuity; inefficiency not efficiency. Not good for doctors, not good for patients, not good for the NHS."
Devolution had always been portrayed as the three Celtic nations breaking away from England. He said: "In the case of the NHS it's been the other way round; England has broken away from the rest of the UK" He urged doctors to look at the Scottish model which operates without a competitive market among healthcare providers.
"The BMA wants to see an NHS untarnished by a market economy, true to its beginnings, giving the public a fair, caring, equitable and cost-effective health service. Not a service run like a shoddy supermarket war. If it can be done here in Edinburgh, it can be done in England.
"Let's stop pretending that healing the sick is like trading a commodity. Let's stop diverting doctors' energies into unholy bidding wars for jobs they already do. Let's follow the Celtic lead and get rid of the market in healthcare once and for all. What a pity Ara Darzi missed his golden opportunity to do that."
"I'm not saying that everything's perfect north of the border, but at least there seems to be a shared agenda, a willingness and an eagerness to pull together that you don't see south of Hadrian's wall or east of Offa's dyke."
Dr Meldrum said that the BMA had come up with a credible alternative to the English system with much greater patient, public and professional decision making, freed from day-to-day political interference, at both a national and local level. Allied to this would be a system of collaborative commissioning, with doctors from primary and secondary care working together, with patients, to determine the best way to ensure that the best use is made of the finite resources of the NHS.
"Politicians in England, including Lord Darzi, may talk about this, but nothing in their policies will deliver it whilst they remain obsessed with the market and with commercialisation of the NHS" said Dr Meldrum.