Tuesday 31 January 2012

College antics and my motion for the Royal College of Radiologists EGM

More on the Colleges

Following last week’s behind the scenes antics that led to the failure of the Academy of Medical Royal Colleges to release an agreed joint press statement about the Health and Social Care Bill, ordinary members and fellows have been venting their frustration at their College Presidents.
Their voice has been amplified by the technology of social media such as Twitter, Facebook and various blogs. Dr David Wrigley, a member of BMA Council, has set up the Lobby Your College website, which is endorsed by the NHS Consultants’ Association (which I co-chair). It has received nearly 6,000 hits in less than a week, turning up the heat on the Colleges.

This outpouring of frustration and anger at the Colleges is not surprising when you get an idea of what actually happened last week. The President of the Royal College of Psychiatrists, Professor Dr Sue Bailey, gave a remarkable insight in her blog.
This was the most important sentence:
I left the Academy building at 2.30pm on Tuesday afternoon in the honest and 100% belief that we had an agreed statement, which would absolutely acknowledge that the only College dissenting from this view was the Royal College of Surgeons in England.” (ed)
For starters, this is a significant indictment of the lack of solidarity the RCS showed to the rest of the profession

The Academy statement included the following strongly worded sentence, which would have had devastating to Lansley’s beleaguered reforms, coming form 19/10 Colleges:
The Academy and Medical Royal Colleges are not able to support the Bill as it currently stands. Unless the proposals are modified the Academy believes that Bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high quality integrated care to patients.”

The piles the pressure on the Royal College of Surgeons, which looks even more out of touch and isolated after today’s BMJ editorial by Walshe, which states:
“Even at this late stage, the government would be wise to withdraw the bill”

This editorial effectively demolishes the latest RCS position on the bill, which states:
The College also encourages the Bill to be implemented without unnecessary delay, otherwise we believe that delays to this process will ultimately be to the detriment of patients.”
Quite frankly, this is a scary statement considering no one has seen the NHS reform Risk Register, which Lansley refuses to release despite be instructed to do so by the information Commissioner. I’m sure surgeons wouldn’t operate on a patient without knowing about their medical history and anesthetic risks!

Too many Royal Colleges have failed to survey the views of their members and reflect the detailed published critiques of the Health and Social Care Bill. They seem to ignore the fact that the only way to understand this bill with a degree of authority is to have expertise in constitutional law, public law, commercial law and health policy. None of the Colleges have this expertise in-house, unlike the BMA which has a legal team and a Health Policy and Economic Research Unit. The BMA position is a democratically mandated position of opposition to the bill in it’s entirety. That is also the view of the only independent team of experts that have all the health policy expertise necessary to unravel this bill, namely Allyson Pollock et al’s team of lawyers and health policy academics.
It is therefore also worrying the Professor Terence Stephenson of the Royal College of Paediatrics and Child Health has called on his College Officers to make judgements on the bill rather than listening to the experts and his wider membership.

My own College, the Royal College of Radiologists (RCR) has taken a much more sensible approach and has effectively backed the original Academy statement by stating that the College cannot accept the bill as it currently stands and must continue to oppose it. However this doesn’t go far enough, so I personally called for an Extraordinary General Meeting (EGM) of the RCR to debate motions regarding the bill. The Bye Laws of the RCR state that 40 Fellows are required to call for an EGM and I achieved this within a morning. However the RCR Council called the EGM themselves, before I submitted the names. Good on them, I say!
I have since sent the following motion to the EGM, which has been accepted by the Chief Executive of the RCR for debate. This also required 40 Fellows and over 60 have now signed up. There have been a couple of dissenters that say that this is too political and nothing to do with the College, but this open letter penned to the Colleges last year, signed by these doctors demolishes their arguments. The bill will fundamentally undermine professional values and the doctor patient relationship, and will have negative consequences for education and training standards. This is everything to do with the Colleges.

Here is the motion to be debated on the 16th February 2012:
That this meeting:
(a) welcomes the RCR statement that it cannot support, and must continue to oppose the passage of the Health and Social Care Bill in its current form;
(b) considers that the Health and Social Care Bill, if passed, will damage the NHS and widen healthcare inequalities, with detrimental effects on patient care in England;
(c) cannot support the Health and Social Care Bill without seeing the NHS reform Risk Register
(d) calls upon the RCR to publicly call for withdrawal of the Health and Social Care Bill;
(e) calls upon the RCR to seek an alliance with the BMA, RCN, RCM and other willing Royal Colleges and NHS stakeholder organisations to collectively call for the withdrawal of the Health and Social Care Bill.
(f) calls upon the RCR to hold a joint press conference with the BMA and other willing Royal Colleges and NHS stakeholder organisations, to make a joint public statement calling for the bill to be withdrawn

I really hope that fellows of the RCR will set an example and set the ball in motion to finish off this disastrous bill. It is vitally important to realise that the policies that enshrined in this bill to deliver an external market driven health system, are mutually reinforcing. If one of these key policies falls, the whole edifice of the bill falls. That is precisely why the concessions Lansley will give to the Lords, will not be any of his key red lines polcies that deliver his market. Even the talk of “integration” is meaningless. For example, the disastrously expensive Health Maintenance Organisations in the United States are based on “integrated care” models.
The bottom line is that a man that says “no top down reorganisation of the NHS”, when the NHS Chief Executive says the reforms “can be seen from space” is not to be trusted.
Let’s Kill the Bill.


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