Special Bulletin:
Health and
Social Care Bill -
where we stand

Given our widespread concerns over many serious and as yet unresolved issues, The Royal College of Radiologists cannot support, and must continue to oppose, the passage of the Health and Social Care Bill in its current form.

The areas of the Bill about which the College has grave concerns are:

• The Bill does not currently contain a clear duty on the Secretary of State for Health to take direct responsibility for the provision of comprehensive and equitable health care for the whole of the population of England, taking action whenever there are problems.
  
• There should be an overriding duty on the Secretary of State to ensure that a high quality and integrated health service is delivered in the best interest of patients.
  
• There is great risk of widespread, and potentially embedded, health inequalities across the NHS.
  
• Recognising that whilst competition has for some time played a role in the NHS, we remain alarmed that the dangers of unfettered competition as outlined in the Bill will adversely affect integrated care in both clinical oncology and clinical radiology.
  • Clinical radiology has already seen the negative impact of outsourcing on integration. Procuring radiology services from different sources would have a hugely detrimental impact on integration adding costs to the NHS overall.
  • In a tertiary specialty such as clinical oncology, fragmentation will impact negatively on the capacity to deliver coherent care locally. It will also undo the excellent national co-ordinated patterns of care achieved through the cancer agenda. The capacity to deliver the right care in the right place to the right patient would be seriously undermined.
    
• The NHS will lose its Provider of Choice status and in doing so open services to EU competition law, which would have serious implications for the provision of care.
• Whilst we support the broad aim of commissioning of services based around the needs of patients with clinical involvement at all levels (for example national commissioning of radiotherapy services), we disagree with the proposed method of implementation. Clinical Commissioning Groups must be core within the NHS.
• We remain concerned that the Risk Register has still not been released. We have strongly campaigned for this and continue to do so.
• Workforce flexibility in the UK is at severe risk of being reduced by local commissioning.

Whilst not specifically part of the Bill, the College also remains deeply concerned about the consequences for education and training as a result of the passage of the Bill, especially the real risk of fragmentation of training, the loss of independence of the deaneries and lack of clarity over the role of the professions.

We have been in direct contact with Ministers this week to emphasise our concerns. They have indicated that they are listening. We hope they may still alter the course of some key elements. We have fully engaged with key events around the Bill throughout this week including:

1. A meeting of the Academy of Medical Royal Colleges (AoMRC) on Tuesday
2. A parliamentary meeting of the Royal Colleges and others chaired by Lord Owen on Wednesday
3. A meeting between the British Medical Association (BMA ), the Royal College of Nursing (RCN) and the AoMRC on Thursday.

We recognise that widespread changes to the NHS are already underway, such as the dismantling of the SHAs and PCTs. A coherent and authoritative way forward will be necessary to avoid severe harm and detriment to patients and to the NHS as a whole. The Royal College of Radiologists remains committed to working hard on your behalf with all relevant parties in order to address our very serious concerns about the Bill.

In view of the potential implications, Council has called an Extraordinary General Meeting at 2.30 pm on Thursday 16 February 2012 at the Royal Institute of British Architects (RIBA), 66 Portland Place, London W1.