`Paper shuffling' takes cash from patient care

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DOCTORS WILL seek to draw a line in the sand today to halt the decline in the National Health Service against what they see as a flint- hearted government bent on counting costs rather than caring for patients.

In a clear signal that the honeymoon with Labour is over, BMA representatives will hear demands for a motion of no confidence in the Government's handling of the NHS. The meeting will also hear calls for the introduction of charges for patients to bridge the growing gap between demands and resources.

Doctors are sceptical of ministers' claims to have cut bureaucracy, angry at the diversion of money to cut waiting lists and dismayed that the pounds 21bn pledged last year over the remainder of the Parliament has failed to yield improvements in the frontline services. Morale had suffered, stress was growing and disillusionment had seized the profession, BMA leaders said.

Doctor Vivienne Nathanson, head of health policy, said: "There is a recognition that the pounds 21bn has not provided enough of a cushion ... we need something to help us do more."

A proposal for a consultation charge to see a GP, which might be set at pounds 10, was rejected two years ago but its reappearance on this year's agenda is an indication of doctors' growing despair of meeting patients' needs.

Ministers pledged to cut pounds 1bn from the cost of NHS bureaucracy over this Parliament and announced on Friday that over pounds 100m had so far been saved. But Dr Nathanson said that was not the way it appeared on the ground.

"Whatever attempts have been made they haven't succeeded in cutting the bureaucracy faced by doctors on a day-to-day basis. We will hear examples of the amount of time doctors spend filling in forms and shuffling paper rather than face to face with patients providing treatment and care."

The critical tone of the conference was set by the Primate of All Ireland, Dr Robin Eames, in a scathing attack on the government last night.

In his eve-of-conference sermon in St Anne's Cathedral, Belfast, Dr Eames, Archbishop of Armagh, said reforms demanded by ministers were being driven by commercial considerations and implemented at a break-neck pace that threatened the personal care which was the bedrock of medicine. "Bureaucracy in its many aspects is threatening to stifle the real nature of caring for patients," he said.