Bob Bury

Health Act: Little pleasure in saying “I told you so”

Of course, no-one likes saying ‘I told you so’. Actually, scrub that, I love it – it’s not often I’m right about something.

Right about what? Well, it wasn’t just me of course, far from it, but those smug words did actually cross my lips this morning when I picked my copy of The Times up from the mat and saw this headline.

You may recall that the blogs on this site back in 2011/12 were preoccupied with the Health and Social Care Bill (as it then was), and in particular with the need for the royal colleges to man (or woman)-up and call for its withdrawal.

Some of us made ourselves very unpopular with the hierarchy at the RCR, and although we eventually forced an extraordinary general meeting which voted to take a tough line with the government, it came too late. It did however lead to one of our number, Clive Peedell, setting up a new political party, the National Health Action Party, to oppose the changes.

Far more influential groups were also calling for college involvement at that time, but sadly, they met with no more success than we did.

In fact, the Academy of Medical Royal Colleges (AMRC) rolled over under the steely gaze of their political masters and went for ‘continuing engagement’ – a decision reputedly driven by the surgeons. Cynics suggested that this was because any increase in private sector involvement might put more  money into surgical pockets, but I’m sure that can’t have been the case. Whatever the motivation, the outcome was that the government drew the conclusion that the medical establishment had no stomach for a fight.

With a couple of noble exceptions (speaking from memory, the RCGP and the paediatricians, plus the RCN and BMA) this line was adopted by the individual colleges, including my own college, the RCR. We were told that we were politically naive, and that it was better to be in the tent…well, I’m sure you know the rest of the analogy.

This, of course, presupposed that our college officers actually had any influence over the government, whatever the direction of their micturition in relation to the Whitehall tent. In fact, there was already plenty of evidence that their efforts to change the most damaging elements of the legislation were being routinely ignored.

And while I enjoy no contacts with political insiders, other members of the awkward squad had it on good authority that in early 2012, David Cameron was beginning to realise that he had been sold a pup by the swivel-eyed Lansley, and might be open to a concerted campaign from professional bodies to withdraw or significantly amend the Act. That was why the delay in implementing any change in policy by the RCR following the EGM was so frustrating – the window of opportunity was missed.

But then, I don’t suppose that the voice of one relatively small college would have carried much weight, given the supine position adopted by the AMRC.  The rest, as they say, is history. Three billion pounds or so has been wasted on this needless reorganisation, much of it in redundancy payments to staff who were then re-hired to do the same jobs (and many of whom now face redundancy again, no doubt with another pay-off).

So there was a brief ‘we told you so’ moment this morning, but it was soon swamped by frustration and anger. Frustration because the rumours we had heard in early 2012 were clearly correct – Whitehall, and Cameron in particular, were beginning to realise what a can of worms Lansley had opened, and might indeed have been susceptible to an organised onslaught from the medial professional bodies.

Instead, there was a virtual media silence on the medical opposition to the legislation, and we had to listen to Lansley telling the country that the doctors supported his Bill. It would almost be easier, and certainly less frustrating, to be told that we had been wrong, and that there was never any chance of changing political minds.

Well, I hope that George Osborne isn’t the only one ‘kicking himself’ that he didn’t do anything while there was still time to stop the changes. I hope the relevant college officers feel a pang of regret that they bottled it, and I hope that Shirley Williams in particular is deeply ashamed. She had become the focus of our hopes that the Upper House might at least put a brake on the passage of the Act, but no, she meekly succumbed after cosmetic changes its wording, and shuffled through the ‘aye’ lobby.

No-one can take any pleasure from being right about this one, because the damage done to the NHS is immeasurable. Still, I do hope that the royal colleges at least will have learned a valuable lesson. No longer can they be allowed to avoid action in situations like this on the grounds that they are medical charities and cannot get involved in politics (an argument we heard repeatedly as an excuse for doing nothing in 2012).

One of their roles is to safeguard education and quality in their specialty, and when the actions of politicians so clearly threaten their ability to do that they can, and must, act. I hope that the realisation that they could have done something about Andrew Lansley’s madness will ensure that they don’t stand idly by the next time.

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2 Responses to “Health Act: Little pleasure in saying “I told you so””

  1. Joe says:

    Bobs article highlights yet again the failure, by the politicians and the profession to have Andrew Lansley’s Health Act thrown out.
    Many like Bob can truly say ‘I told you so’.
    Permit me also to sound a warning: the extent to which officials and politicians would go to deceptively convince the people of their intentions.
    When Andrew Lansley introduced the Health Act, he had the audacity to claim. “The NHS currently has no legal obligation to improve continuously the quality of care”. Indeed claiming that he was imposing a huge responsibility on himself. What else would you expect of a Health Secretary dedicated to the welfare of the NHS? Audacity is being foolish, but to unashamedly as the Secretary of State to claim be unaware of the Health Act 1999, to justify his Health Reform is to descend to the depths of political depravity.
    I will prove to you that he was more than economic with the truth. I am concerned of using more appropriate words for fear that I may be charged of accusing Mr.Lansley of …..
    Compare his declaration with the definition of clinical governance which evolved from the 1999 Health Act. “Clinical governance is the framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”. Could Andrew Lansley really plead ignorance.
    Morale: Do not be blinded by altruism.

  2. Tom Goodfellow says:

    How much influence do Colleges have on health policy?

    My own College (RCR) has stated, “Most consultant radiologists undertake an excessive workload in comparison with their European counterparts. This workload is considerably in excess of that recommended by the College to be consistent with high levels of quality and the protection of patient safety. An increase in the number of radiologists in training is essential to cope with the existing workload.”

    This was in a document, “Clinical Radiology: A Workforce in Crisis”. The date published? 2002 !!!!

    So in the twelve subsequent years the situation has become much much worse and all representations have been ignored by all political parties.

    Short term thinking and political posturing is all we have had.

    I need to retire…………

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