Dr Sandy Macara, chairman of the British Medical Association, said that ministers had lied about hospital waiting lists and misled the public with dubious statistics, while steadfastly denying the 'undeniable' - that a two-tier system of health care was now in place, with patients of fund-holding doctors given priority over others who needed treatment more urgently.
The NHS 'reforms' launched three years ago had become an 'uncontrolled monster,' cheating patients and disillusioning doctors who were pressurised to toe the line if they wanted to keep their jobs. 'Our professionalism is challenged . . . by compromise of conscience as the price of survival, and even by temptation to self-interest over the best interests of our patients. Evidence mounts daily of intimidation, of gagging clauses, of fear to put one's head above the parapet.'
Speaking at the annual meeting of the BMA's junior members' forum in Edinburgh, Dr Macara said patients had been left 'confused, bemused and frequently cheated by slow-tracking and claims of falling waiting times which belie their own experience, as they follow the money which was supposed to follow them, and fall by the wayside when the money runs out . . .'
Bureaucracy was the overall beneficiary of the NHS changes, Dr Macara said, with 11 per cent of NHS funds now devoted to administration compared with 4 per cent in the mid-Eighties.
And there were other victors of the internal market, he added, referring to recent NHS scandals; '. . . the slick computer salesman who exploited the incompetence of managers in Wessex, the West Midlands and elsewhere, to the tune of tens of millions of precious pounds, and the salesmen of BMW cars to managers in the Lothian region.'
Evidence that the changes have improved patient care is scarce but there is growing evidence to the contrary, he went on. As early as 1992, the Medical Defence Union said that patients were being discharged from hospital too early as a result of the changes; one year later the Audit Commission said that GP fund-holding lacked accountability, and the Clinical Standards Advisory Group said patients needing specialist treatment were at risk.