Are BMA's worst fears becoming a reality?

The ink is yet to dry on the Health Minister's announcement on the second stage consultation concerning the reorganisation of our NHS. Yet already there are jungle drums raising concerns about a potential "take over" of primary care and community care, and done deals.

BMA Cymru Wales, in its response to the first stage of the NHS Wales reform consultation, made the point that the new organisations sprouting from the reform, need to be new and fresh, to ensure balanced investment across patient services and ensure that re-focusing care into community and primary care, to free hospital services to get on with the job they are best at -becomes a reality and not an aspiration.

So what do we see this week? In North Wales, a new Director of Primary Care has been appointed, for the new combined NHS Trust of Wrexham and Glan Clwyd.

This maybe a short term appointment, it may have a rationale if hospital Trusts have been given the go ahead to take responsibility for primary care services. But I thought we were waiting for further detailed consultation on a proposed way forward. Whatever the truth of the matter, or however it has come about, it gives the impression that the new Hospital Trusts will in fact BE the newly proposed "unified organisations" - i.e. a Hospital Trust takeover. First impressions are everything I was always told!

GPs fear that primary care will become a cinderella service in any kind of "Trust takeover". We're still awaiting the full details of Edwina Hart's plans for an integrated body. If the developments in North Wales are anything to go by, could we be seeing hospital Trusts taking over? If so it has the risk of re-balancing the care, cash and power as difficult as ever.

If the WAG want to get ALL of the medical profession on board with these radical changes, we need better communication of the intention, and greater involvement with the process at the key decision making points. BMA Cymru Wales wants this one off opportunity of reform to get it right for patients and doctors. We have a unique insight into how health services work. We should have - our members are at the sharp end of service delivery every day - listen to us.