Doctors say the NHS is facing its last chance

Doctors said yesterday that the NHS was facing its "last chance" to survive, and that they would not be made into "scapegoats" if the £40bn of extra funding failed to turn the service around.

Dr Ian Bogle, chairman of the British Medical Association, said that the NHS's existence would be threatened if the five-year investment plan, announced in the Budget last month, failed to deliver results.

To check that improvements were being made, GPs and consultants would be sent a series of surveys about the extent of changes to patient care, Dr Bogle said. "If you invest that amount of money from the public purse, and you don't make it work, you will have a health service, but it won't be the NHS as envisaged by Beveridge and put into action by Bevan.

"We have got to make this work or the health service, which at one stage was said to be the best in the world, may not exist."

His comments followed a meeting of the BMA Council on Wednesday, where members applauded the "gigantic sums" of money being devoted to the NHS after years of under-funding.

But the investment had to "make a difference" by the next general election or alternative methods of funding health care, such as private insurance, were bound to be considered. Dr Bogle said: "If three years down the track, our surveys show that the public and patients don't think that the NHS has improved, then inevitably someone will say, 'We have got to look at something else.'"

Without visible improvements, there was also a danger that ministers would make doctors the "scapegoats", as had happened under previous governments.

"We are well aware if this doesn't succeed in about three years' time, which will be election time, the scapegoats could be those working in the health service.

"They [the Government] might be unable to resist the temptation to blame the staff but that is something they must not do."

GPs and consultants were determined to do all they could to help turn the NHS round. But ministers had to let doctors get on with their jobs rather than being "shackled" by endless targets and initiatives. Dr Bogle said: "It is not helpful to have the Government perpetually giving targets to itself and to health professionals. Professionals are sick to death of being shackled in this way and having clinical priorities altered by government targets."

The BMA Council also backed proposals for a radical review of the prescription charge system under which 50 per cent of the population does not pay for medicines, but some patients with chronic conditions are not exempt.

But there were "enormous anxieties" that the new devolved system of primary care trusts, which each have budgets of about £100m, had been set up too quickly.

* More than 300,000 health workers, including clerical, ancillary and ambulance staff, are to receive pay rises of up to 6.5 per cent, it was announced last night. Unison said it had accepted the offer, which will give a minimum increase of 3.6 per cent, or £400 a year, after a ballot of its members. But the union said that even with the increase, minimum rates would be £4.47 an hour, which were still too low for a modern health service.