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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 November 10; 335(7627): 955.
PMCID: PMC2072041

More NHS reorganisation is announced in Queen's speech

The prime minister set out his priorities for the health service in the Queen's speech this week—with plans to legislate for a new quality control regulator and changes in the way doctors are regulated and in the rules concerning assisted reproduction and embryo research.

Gordon Brown used his first Queen's speech to announce the creation of a new regulator, whose aim will be “to ensure clean and safe services and high quality care.”

The new body, to be known as the Care Quality Commission (or Ofcare for short), will take over the functions of the Healthcare Commission, the Commission for Social Care Inspection, and the Mental Health Act Commission. It will be set up under the proposed Health and Social Care Bill and will have the authority to fine hospitals and shut down wards.

The move has been criticised by Hamish Meldrum, chairman of the BMA, for requiring yet further reorganisation of the NHS.

“While we recognise some of the arguments for rationalising the process of regulation, the BMA is concerned that, only a few years after the Healthcare Commission was set up, it is about to be abolished to make way for yet another new regulatory body,” he said. “As soon as doctors and managers start getting used to one system, it's all change.”

The Health and Social Care Bill also includes measures to abandon the criminal standard of proof (that is, beyond reasonable doubt) in cases where doctors' fitness to practise is questioned. Instead doctors could be struck off the medical register on the lower civil standard of “balance of probabilities.”

But the move does not have the support of the profession, said Dr Meldrum, who is urging the government to rethink the proposal.

“The BMA is keen to ensure that patients are protected from the small minority of doctors who represent a threat to patients. If a doctor is at risk of losing their livelihood then surely nothing less than the current criminal standard of proof will do,” he said.

The draft Human Tissue and Embryo Bill, which was published in May this year, will also be debated in the next session of parliament. It aims to update the Human Fertilisation and Embryology Act 1990, which is based on scientific knowledge and debate from the 1980s.

The new bill has already been criticised by a cross party group of MPs and peers, in a report published in August. The committee said that the new bill should include a provision to record on birth certificates the fact that a child has been born after egg or sperm donation. At the moment parents are not obliged to tell children that they were conceived from donated sperm or eggs, and children can't check who their biological parents are until they reach the age of 18.

The draft bill also makes provision for single women and lesbian women to have the right to access fertility treatment and for the creation of hybrid embryos in stem cell research. The bill is expected to be open to amendments from backbench MPs to alter current limits on abortion.

However, a draft bill on reform of the coroners system has been shelved. It proposed plans to establish a new chief coroner and to give coroners greater powers to conduct more thorough investigations.

Dr Meldrum said, “The BMA has been calling for reform of death certification since 1971. The system is in dire need of an overhaul, and it's frustrating that this has been delayed yet again.”

Articles from The BMJ are provided here courtesy of BMJ Publishing Group