The Health and Social Care Bill is now reaching the final stages of its legislative process, following months of discussion in the House of Lords. The House of Lords will begin the final stages of scrutinising the Bill on Wednesday 8 February. It is then likely that the Bill will pass back into the House of Commons for a final consideration before being given Royal Assent.
The current position of the Royal College of Surgeons on the Health and Social Care Bill is:
The College has worked with all parties to improve the Health and Social Care Bill and there have been substantial changes made to the Bill as a result of our advice and recommendations. Like others, we do have some remaining concerns but will continue to work with parliament to improve the proposed legislation. The College believes that the Bill should be implemented without unnecessary delays, as otherwise procrastination, without an alternative cogent plan, will lead to further chaos and be to the detriment of patients.
The College has been a leading organisation in highlighting the damaging effects of piecemeal cost-cutting in the NHS, cuts that often going against clinical best practice. We are concerned that the NHS is denying patients access to surgery as a means of saving money in the short term, when what is needed is long-term improvement like reconfiguration.
We largely support the aims of the reforms to modernise the healthcare system. We believe that cutting bureaucracy and giving patients and their clinicians the right to decide the best treatment for individuals is fundamentally right. We also believe that commissioning should be based around the patient, supported by the relevant clinicians and healthcare staff.
Below are a number of the key areas where the College has worked and influenced the Bill ensuring that the voice and concerns of surgeons and patients have been heard.
Any Qualified Provider:
RCS worked at the early stage of the proposals to introduce the idea of any ‘qualified provider’ rather than allowing any ‘willing provider’ to lessen the risk of cherry picking by the private sector. Under any qualified provider the onus will be on the provider to provide adequate cover for emergencies as well as to provide education, training and research.
Clinical involvement in the proposed structures:
In the RCS’ initial response to the Bill we called for greater clinical involvement in the NHS Commissioning Board and for more detail on the sub-national commissioning structure in the NHS. As a result, when the Bill was amended in June, the Government’s response stated that the ‘NHS Commissioning Board would seek clinical advice through regional clinical networks and Clinical Senates’. We welcomed these proposals as a positive addition to address our concerns in the Bill. We cited the example of our established regional network of surgeons across the surgical specialties as a way of engaging with the new NHS structures as they are established. A requirement was also introduced on Clinical Commissioning Groups to have a secondary care clinician as part of the Group.
- Through our work with the Academy of Medical Research Charities and the launch of our report on surgical research and innovation, From Theory to Theatre , we successfully lobbied on amending the Health and Social Care Bill from the Secretary of State of Health having merely ‘a duty to incentivise research’ to ‘the Secretary of State, NHS Commissioning Board and Clinical Commissioning Groups having a duty to promote and incentivise research and innovation.’ The NHS Commissioning Board will now be able to award payments to promote innovation in the provision of health service.
Education and Training:
The reforms of education and training are not specifically part of the Bill except for an overall duty on the Secretary of State to maintain an effective system for the planning and delivery of education and training which the College pushed to be included. The latest publication by the Department of Health entitled ‘Developing the Health Care Workforce: from Design to Delivery’ sets out further details. We have concerns in the document about the emphasis placed on providers and Local Education and Training Boards (LETBs) with little role for the profession and are pressing at the highest levels for greater professional involvement.
Whilst these discussions do not form part of the Health and Social Care Bill’s legislation, the College will continue to work with politicians and policymakers to call for changes and improvements to be made to these proposals and again ensure that the voice of surgeons and surgical patients is heard.
For more information please contact email@example.com or call 020 7869 6047