Bob Bury

Radiologists call for withdrawal of Health Bill

I’ve been to quite a few meetings of the Royal College of Radiologists during my thirty-odd years in the specialty, but never one like the Extraordinary General Meeting (EGM) earlier this week. The EGM was called by the council of the RCR, following a request signed by more than the requisite number of fellows. They were unhappy that the college’s current policy of opposition to aspects of the Health and Social Care Bill had clearly failed to influence its content. They wanted officers to join with the RCGP, RCN and BMA and others in calling for the withdrawal of the Bill.

There was never going to be a large attendance for a meeting called at a couple of week’s notice in the middle of half-term, but it was impressive just how many members had made it, at their own (often considerable) expense. Fears that the attendees would be outnumbered by the platform party were unfounded, and there were 40-50 of us on the floor, so to speak, including a gratifyingly large number of trainees.

There were two motions to be debated. The awkward squad presented a multi-part motion including the key demand that the college should call for withdrawal of the Bill. This was preceded by a ‘mom and apple pie’ proposal from the RCR council, giving them carte blanche to do what seemed best for the college, patients and the quality of the services provided by members.

The first motion was proposed and seconded by Peter Cavanagh and Adrian Crellin, the deans of clinical radiology and clinical oncology. No-one could reasonably vote against it, but equally, it would have been difficult to support this motion and also vote for the second one. As a consequence, the motion was carried by 20 votes in favour, none against, and 24 abstentions.

The second motion started with three sections which welcomed the RCR’s opposition to the Bill; stated that the passage of the legislation would damage the NHS, and that the Bill could not be supported without seeing the Risk Register. Then came the key demand, that the college should call for withdrawal of the Bill, followed by two related clauses calling for the RCR to seek an alliance with the BMA, RCN et al in calling for withdrawal, and that there should be a press conference with those same organisations, making the call for withdrawal public. It was proposed by Clive Peedell, a clinical oncologist, and seconded by Jacky Davis, a clinical radiologist, both of whom have been active, through the BMA and elsewhere, in seeking to get the Bill stopped.

There was then a good debate of the issues. Quite a bit of this spelt out the likely dire effects of the Bill for the NHS and for members of the RCR, most of which was non-contentious. When it came to justifying their current position, the officers really only advanced one argument; namely that a call for withdrawal would result in a loss of political influence which would be damaging to the effectiveness of the college both now and in the future, with Dick Fowler, the warden for clinical radiology, pointing out that there were important debates looming concerning the current under-staffing situation in the specialty.

Those speaking for the motion dealt with this single argument by pointing out that the college clearly had no influence in any case. Successive college bulletins over recent months had outlined the same list of serious concerns over the Bill, none of which had been addressed despite the RCR’s continuing engagement in the ‘listening’ process. One telling contribution came from Professor Peter Armstrong, a former RCR president. He stated that in his experience, influence has to be based on respect, and that, even in Whitehall, you earned more respect by taking a principled stance than by yielding to political pressure to conform. It was interesting that the trainees who spoke, who potentially have more interest in the outcome than old retired types like me, were equally keen for the college to take a firmer line.

When it came to voting, the first three, rather anodyne, clauses were carried unanimously, with the exception of one abstention. The key item, asking the college to call for withdrawal of the Bill was carried by 36 votes to 10, with 3 abstentions. The final two clauses, calling for an alliance against the Bill, backed up by a press conference, were each carried by 32 votes to 15, with one abstention. In other words, a fairly unequivocal result.

So now what? The president, Jane Barrett, had made it clear from the start that council was the body determining College strategy, and while it would be influenced by the outcome of the EGM, it would not be bound by it. Whether it will also be influenced by the electronic poll organised by the proposers of the second motion in the run-up to the EGM is less clear. That had demonstrated an 88% majority of over 600 respondents in favour of calling for the withdrawal of the Bill.

Latest news is that the college will be organising their own electronic poll-frequent calls for which had previously fallen on deaf ears. I shall take the charitable view that they simply wish to be sure of the wishes of members before changing course. Less well-disposed Fellows have suggested that officers will just keep asking the question in different ways until they get the answer they want.

Wording of the question will clearly be every bit as vital as it is for the Scottish independence vote, for example, and initial indications are that the college intend to accompany it with material explaining their position (although it might be thought that the barrage of official bulletins issued since the college was made to take the subject of the Bill seriously had already achieved that end). It is less clear what explanatory material will be included to back up the calls for a change in policy, although there is a suggestion that the minutes of the EGM will be circulated. We would have to hope that those minutes will be a true reflection of a debate which was overwhelmingly in favour of a change of direction-but then, how many people would read them anyway?

I would suggest that we should be presented with a simple choice between the status quo and a call for withdrawal, on the basis that the electorate are grown-ups who are familiar with the arguments. If they insist on including additional material, it should be limited to a Twitter-length contribution from each camp.

Whatever happens, the genie is now out of the bottle. Members have discovered that they can make their views known, and the magic of instant communication means that the outcome of the EGM is already widely disseminated, with both the BBC and Sky news stating-inaccurately but gratifyingly, for some of us at least-that the college has already called for withdrawal of the Bill.

Interesting times, as they say. One thing’s for sure. A group of college officers have never been under closer scrutiny by their members. So, no pressure, then.

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7 Responses to “Radiologists call for withdrawal of Health Bill”

  1. Bob Bury says:

    The following form of words for the survey question has now been suggested to the College:

    The current position of Council is to oppose the bill in it’s current form, but continue to critically engage with the Government.
    Should the College now also call for the withdrawal of the bill?

    This seems to put the choice fairly, and makes the point that calling for withdrawal is an extension of, not an alternative to, the College’s current position.

  2. Bob Bury says:

    However, it transpires that the RCR Council will not even be considering their reaction to the result of any poll until their next scheduled meeting on 23 March—too late to influence events. This is despite a plea from at least one member of Council for an immediate teleconferenced meeting once the results are in. Which begs the question of whether it’s worth bothering.

    And now I really must stop commenting on my own blog.

  3. SonoView says:

    I am as concerned about many of the issues in the Bill as any, and indeed I contributed significantly to the HCSA response during the consultation period (which was based on a full discussion by the HCSA Council members).

    But I may as well put my head above the parapet and admit I wrote to Jane Barrett expressing the view that I believe a vote for complete withdrawal would potentially harm any future influence the College might. If the Bill is passed (and I suspect it will) politicians have a long memory and can get very vindictive.

    They are already peddling the view that the profession is opposing the Bill because of self interest. I accept what Peter Armstrong stated at the meeting, but I still believe that constructive engagement will still be the best way foreward once the sound and fury has died down.

    However I accept that I am currently in the minority.

    Let the stress begin!

  4. Bob Bury says:

    SonoView – it’s good to hear someone putting the other point of view. Neither of us know the answer, but I think the chances of any memory effect being short-lived are good enough that we can afford to take a principled stand (especially since within weeks the President will be dealing with a Secretary of State who owes his or her position to the fact that we opposed the Bill!).

    I was going to say ‘time will tell’, but of course it may not, if the College stick to their guns (or if a repeat poll actually takes place, and the majority share your view). Or the world ends, or something.

  5. Tom Goodfellow says:

    Sono and I are of one mind on this!

  6. Tom Goodfellow says:

    This is how it is going to be played out politically and in the media.

    I have much respect for the passion of my colleagues who want the Colleges to call for complete withdrawal. But this has become a political game rather than an idealogical debate, as evidenced by the PM’s meeting yesterday with BMA/RCGP excluded.

    I think we will find that they are better at politics than we are.

  7. Bob Bury says:

    see my comments on the PRCP article!

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