Tom Smith writes from the BMA conference in Edinburgh.

At its Annual Representatives Meeting today, the BMA debated copayments in a fiery, passionate and characteristically chaotic thirty minute session.

Representatives debated a six-part motion. After a vote, they supported the principle that patients who buy their own treatments should not be denied NHS care; called for a Royal Commission to explore the implications; and came within a hair’s breadth of voting to ‘demand’ the introduction of copayments in the NHS.

8 July 2008 - Tom Smith on the today's health policy debate.

I’m on my way to the BMA’s Annual Representative meeting in Edinburgh, really interested to hear what doctors are saying (off camera) about the latest stage of the reform programme.

Do BMA representatives see opportunities for greater clinical control? Do they believe that quality will be prioritised? What do they think is going on now in the NHS, and how do they see their role in reform?

Tom Smith analyses reactions to the Darzi report.

Tom Smith on the impact of Lord Darzi’s Next Steps review.

What are the chances of the Darzi review changing the terms of debate on NHS reform? Despite the political gloom that has engulfed the government over recent weeks - and the Prime Minister in particular - this edition of Health Policy Today looks at the potential for the Next Steps review, due to be published on Monday afternoon, to help the government shift debate away from its political failings and onto its reform agenda.

Can Gordon Brown shift the terms of the debate onto reform?

Tom Smith on today’s health policy debate.

Today’s press (and reports from the weekend) carry three key themes: speculation about the implications of top-ups, questions about the long-term viability of collective finance, and the attitudeof GPs to NHS reform. My personal favourite, however, and not completely divorced from the third topic, wasy esterday’s Desert Island Discs when Lord Ara Darzi told Kirsty Young his top eight tunes.

by Alan Maynard, professor of health economics, University of York

Ninety-nine NHS organisations now have Foundation Trust (FT) status. Most of them are acute trusts, but an increasing number are in mental health and related services. The objective of the FT initiative was to achieve greater efficiency by giving greater autonomy to hospitals within a rigorous framework of financial regulation in particular. Has this objective been achieved?