NHS Reform: In praise of ‘cherry-picking’

The British Medical Association (BMA) has always been a trade union with elements of professionalism on the edges. Its report this week on the NHS reforms was the work of unadulterated, self-serving trade unionism. Our modern trade union leaders would have been embarrassed to publish it, even Bob Crow.

It tries to portray competition as the opposite of co-operation, when competition is the opposite of monopoly, in this case a public sector medical monopoly. Competition describes an arrangement under which teams of people co-operate with each other to find better ways of serving customers than rival teams of collaborators. The co-operation of which the BMA speaks is a weasel word for producer domination.

The BMA says it wants integration, which it also contrasts with co-operation. And here its argument is more subtle. There is a case for integration when the term refers to co-ordinated rather than episodic management of treatment.