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Doctors concerned over new healthcare plans

Date published: 10/02/2006

Patients will be confused by plans to introduce a new kind of non-medically qualified healthcare professional, according to medics. The British Medical Association (BMA) claims that proposals for medical care practitioners (MCPs), who would be allowed to diagnose patients and prescribe drugs, could affect the quality of care patients receive.

The Department of Health has launched a consultation on the new MCP competence and curriculum framework and the BMA has submitted its response. The MCPs will work in hospitals and the primary care sector, without needing to be medically qualified. They will perform similar duties to junior doctors under the supervision of a consultant.

The medical association wants assurances from ministers that the proposals will not adversely affect patient care or compromise training of junior doctors and has questioned the need to expand new roles. Dr Jo Hilborne, chairman of the BMA's junior doctors' committee, said: "Caring for patients is not as straightforward as these proposals make it sound. It?s not just a question of knowing how to do one routine procedure ? you need to be able to recognise when a patient has complications, and you need to know what to do when the unexpected happens.

"Our main concern is for patient safety, but these plans could also cause major workforce problems in the future." A BMA survey of 374 patients found that just 52.3 per cent would be prepared to allow a surgical care practitioner, under the direct supervision of a consultant, to perform a basic procedure on them. This compares with nearly 90 per cent who would be prepared to be operated on by a fully supervised junior doctor.

The government insists that the MCPs will help doctors and nurses to treat patients in a similar way to physicians assistants in the United States and will benefit patients by reducing waiting times and improving access. "The NHS is working at its best and most efficient when every member of the team is working to the peak of their skills," health minister Lord Warner said.

"By introducing new roles we are able to offer patients skilled practitioners who are able to manage the care of patients in primary and secondary care ? freeing up general practitioners and hospital doctors to deal with more difficult cases, more time for additional training to develop their specialist skills, research and development and meeting future working time legislation. The new curriculum framework for MCPs outlines national educational and practice standards and proposed regulatory frameworks. MCPs will be regulated healthcare professionals and graduates with a science-orientated first degree or healthcare staff who have a first level qualification in certain disciplines.

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