GPs have warned the government that its proposals to link financial rewards to hospital performance will discriminate against trusts in deprived areas and hamper their attempts to improve.
The government signalled its intention in today's Queen's speech to press ahead with its so-called "traffic light" system of rating hospital and health authority performance.
The proposals, unveiled in the NHS plan in the summer, will grade high-performing NHS bodies as "green", average-performing trusts as as "yellow", and poorly performing trusts as "red".
Trusts given a "red" classification run the risk of having their management board replaced by special NHS recovery teams, and will have restricted access to a £500m performance fund.
BMA GPs' committee chair John Chisholm said labelling organisations as "red" could be "seriously counterproductive", would damage staff recruitment and retention and make it more difficult for the hospital to recover. He said he feared that the criteria would discriminate against hospitals in socially-disadvanted areas.
The BMA's fears appear to be borne out by an unofficial ranking of health authorities published tomorrow which shows that the majority of poor performing HAs are in deprived inner city areas, noticeably in the north of England.
Compiled by John Appleby and Chris Deeming of the independent Kings Fund health think-tank, the rankings use the Department of Health's own methodology to predict how health authorities will be rated.
The rankings, which are previewed today by HSJ Online, show that a quarter of health authorities are likely to receive a "red light" classification, and that 80% of these are in the north of the country.
According to DoH performance critieria, the top ranking authority is Dorset, while the worst performer is Manchester. In all, 70% of health authorities ranked "green" are in the south of England.
The BMA said it feared too much emphasis was being placed on "micro-management from the centre" and that it had yet to be convinced of the fairness of the criteria used to classify hospitals under the traffic light system.
