The chairman of the BMA council has warned that the BMA faces a real fight—a challenge—to raise morale and restore professional control "undermined and eroded by the nature and pace of NHS structural change." Addressing the BMA's annual representative meeting in Belfast this week, Dr Ian Bogle pointed out that in the latest upheaval the purchaser-provider split had been retained and competition replaced with cooperation. The cash limited unified budget was now reality, and priority setting, or as he preferred, rationing, was now firmly on every local healthcare agenda. Health authorities and health boards were expected to develop health improvement programmes, but, inexplicably, the commissioning process in England and Wales excluded any input from hospital consultants.
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