Dr Meldrum said: ‘The BMA has given very careful consideration to these wide-ranging proposals, and we hope the government will demonstrate that it really does want doctors to be in the driving seat by listening to what doctors are telling them.
‘Doctors want to build on the principles of the NHS, and to maintain and improve services despite the hugely challenging financial climate.
‘However, success depends on working in partnership with others, a holistic approach to care and a reduction in bureaucracy. The insistence on a market-based approach risks fragmentation, inefficiency and increased transaction costs.’
The problem is that there isn't a scrap of evidence anywhere in the world that says that more competition causes inefficiency, and I challenge the BMA to produce some. Introducing competition into the opticians market in the 80s is what gave us cheaper spectacles from Specsavers. Competition for airlines gave us cheaper fares. More recently, the arrival of Firefox on the browser arena is what gave us better, faster, safer internet browsers. Microsoft had disbanded the Internet Explorer team because they didn't need to make it any better.
As I like to tell people here, I would have fired a couple of people who dealt with a health problem of mine, if I had a choice, and I like the idea that they wouldn't get the gravy but that someone else would instead.
And yes, it works inside organisations too. Tom Peters in In Search of Excellence talked about how certain companies had sales teams competing for the same turf, and they all worked harder as a result and achieved better sales, despite the fact that it looks wasteful to the sort of bureaucrats that run most large companies.