HUNDREDS of senior doctors will today call on the Prime Minister to halt the Government’s radical programme of health service reforms amid growing concerns that market forces are starting to tear apart the fabric of the NHS.

A group of 300 consultants have sent an open letter to Tony Blair voicing fears that reforms designed to make hospitals compete for patients for cash rewards and expand capacity with use of the private sector will destroy the spirit of collaboration in the NHS.

The letter comes as doctors convene for the annual conference of the British Medical Association, during which the Government is expected to come under sustained attack for failing to inform health professionals or consult the public about what it is trying to achieve.

The conference, held in Manchester, is likely to be the most combative in recent years as the biggest reforms in NHS history begin to take hold. Dozens of motions have been tabled stating vigorous opposition to the perceived privatisation of the health service, the introduction of market forces and various threats to the traditional doctor-patient relationship.

Jim Johnson, the chairman of the BMA, said that the motions all represented an underlying anxiety and anger at the Government’s failure to explain how the reforms might work or consider their knock-on effects. Concerns include not only patient choice and private-sector contracts for NHS work, but also the health service’s new £6 billion IT system, which many doctors fear will compromise patient confidentiality.

“There is a lot of hostility to all these issues,” Mr Johnson said. “We simply don’t know what is going on, where things are going and if they will work.”

In a move designed to rally support and show goodwill towards the medical profession, Patricia Hewitt will tomorrow become the first Health Secretary to speak at the BMA conference. Harry Keen, the president of the NHS Support Federation, the lobby group which organised the open letter to Mr Blair, said that the NHS was at a crossroads and there should be a “time out” on the reforms.

“Senior doctors working in frontline services are sending a clear message of their concern at the serious consequences of some of the Government’s biggest reforms,” he said. “These major changes in our health services should await the verdict of wider public debate or the NHS as a collaborative network will be lost, unlikely ever to return.”

In the letter, the 300 signatories gave warning that the Government should be wary of costly plans for patient choice when the effectiveness was unproven. Ministers have pledged that patients will have a choice of at least five hospitals or treatment centres to have their operation by the end of the year, growing to even more in the future.

The group that signed the letter accepted that the private sector could improve capacity and reduce waits but said that it was crucial to build

NHS capacity rather than transfer it permanently to private providers.

The consultants also expressed concern about the “payment by results” funding system for England, under which NHS trusts are paid according to how many patients they treat. They said that the system would make treating the elderly and chronically sick “financially unattractive”.

• A new breed of paramedic focused on treating patients in their homes rather than taking them to hospital is to be proposed in a major review of the ambulance service, Ms Hewitt confirmed yesterday. The Health Secretary said that instead of sending an ambulance, specially trained paramedics on motorcycles and in cars could be dispatched to carry out treatment in the patient’s home. The scheme, which was revealed in The Times last week, is designed to relieve the pressure on accident and emergency departments.

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