Dr Blogs

Holding doctors’ representatives to account

After three successive PMQs focusing on the Health and Social Care Bill, I’m sure David Cameron is praying for something else to come along and change the headlines.

As the last vestiges of professional support for Lansley’s reform dissipate, it is all going to come down to political willpower. Cameron cannot afford to lose face so the Bill will happen in some shape or form. And besides, the professional resistance has come too late – to turn back now might be more damaging that going forward.

The Health Bill could well become an electoral millstone for the Coalition. Most people don’t understand it, but if all the woes of the NHS over the next couple of years get laid at its door then it will become a powerful political tool for the opposition. Waiting times are likely to rise with the ‘Nicholson Challenge’ and one way or another the Bill will be blamed.

At least we will get to judge the Coalition at the next election.

But what of doctors’ representatives? I think they’re getting off lightly in all of this. Events like this throw their general ineptitude when it comes to representation into sharp relief.

So many of them have come late to the party. And some have been out of step with their membership all the way.

These organisations – regardless of whether they are a union, royal college or society – should be ‘owned’ by their membership. Their councils should be completely in step with their memberships, something that’s very easy to do in our social media age.

If you contrast how the Royal College of GPs has performed compared to just about anybody else (even the BMA dragged its feet early on) it’s disturbing.

They knew exactly what the majority of their membership thought from an early stage and have been led by a dynamic chair of council who has taken it upon herself to tirelessly explain the issues to a wider audience.

And then there’s everybody else. Hospital Dr blogger Bob Bury has written eloquently on the Royal College of Radiologists’ painfully slow progress towards resisting the Bill.

I can’t believe that the Royal College of Physicians still doesn’t know what its membership thinks yet. It’s got a meeting on Monday to decide whether to survey members. Clinical Commissioning Groups will be authorised by the time they pull their finger out!

(Update: RCP fellows voted overwhelmingly in favour of a survey – and expressed serious reservations with the Bill).

Like the RCP, the Royal College of Paediatrics and Child Health pitched up at the PM’s selective Health Bill summit earlier in the week. Their price for engagement was to be told the Bill is going ahead regardless.

While the leadership were cosying up to Cameron, 79% of its surveyed members were voting for the college to call for the Bill’s ‘outright withdrawal’. Why has it taken until now to find out? How much damage is being done by attending such events, which can be interpreted as approval by the public?

In its press statement, the president says: “All those representing healthcare professionals need to be brought together to thrash out how these areas of consensus can be effectively put into practice.”

Well yes, it’s called leadership, so get on with it. Why wait for the government to set the terms of engagement? Organise a summit for the profession and invite Lansley. Have it in public. Make some PR. Instead we got the Academy of Medical Royal Colleges fudging its way forward.

The Royal College of Surgeons took the blame for that whimper, but at least they’ve been consistent – they support the Bill and will have to live with the consequences.

(Update: both the RCS and RCOG – the other Bill ‘supporter’ – are now holding meetings to discuss their approach to the Bill, watch this space.)

I’m not as antagonistic towards the Health Bill as some commentators, and believe strongly in a more joined up approach to health and social care commissioning, which I feel it enables. But if the will of the profession has been to discard these contentious proposals then isn’t the timidity of its representatives a hallmark of complicity?

All the gerrymandering among the colleges about whether the topic is too political is a smokescreen. If you charge doctors considerable membership fees each year, they are rightly going to expect you to protect their professional interests. Doctors barely understand what their colleges do for them already beyond a vague notion of organising training and exams, and the wishy washy response to the Health Bill is going to do little to address that.

Being a government advisor – which is one of the colleges’ key roles – only works if the government listens to that advice. If they don’t, colleges should express their dissatisfaction and ultimately withdraw from the role. That is not unionised behaviour, and is perfectly acceptable as a charitable representative body.

I would like to think that the leaderships of these representative organisations – executive or elected – will be held to account for their actions, or lack of them. And, if their ‘patch’ suffers, forget the knighthood, their jobs should be on the line.

Bookmark and Share

5 Responses to “Holding doctors’ representatives to account”

  1. jacky davis says:

    Please don’t fall for their argument that it is better to go forward than to drop the bill. The idea that you can make a mess and then use that mess to justify making even more of a mess is bizarre. As my granny used to say – when in a hole stop digging.

    And please give a mention to http://www.callonyourcollege.blogspot.com which has allowed people to organise college EGMs, and which has conducted unofficial surveys when colleges steadfastly refused to conduct their own.

    Otherwise agree wholeheartedly with the sentiments

  2. Brendan O'Reilly says:

    Accountability of medical reps is central and has been avoided for far too long. They get elected and do what they want.

    I think that BMA leaders in particular have a LOT to answer for over many years.

    Thanks for raising this hugely important issue.

  3. Kathy teale says:

    RCoA claiming asking for Bill to be dropped is ” too political”. Absolutely pathetic. We’re asking them to stand up for universal health provision paid for by taxation, not to join the Socialist Party, for heavens sake. It’s like colluding with the school bully in the hope that they’ll leave you alone – usually doesn’t work, does it.

  4. Aseem Malhotra says:

    The author is absolutely correct to state that doctors leaders have been guilty of not representing their members best interests. The profession had an open goal last year to present a united front against the bill when it was introduced but I concur with Jacky Davis that going ahead with the it now will be far worse than dropping it. We have witnessed and are experiencing a far more inferior training system in Modernising Medical Careers that was implemented despite the overwhelming majority of doctors being against it. Although it forced the resignation of the then BMA president Jim Johnson, the consequences of MMC still remain. It is therefore not surprising that the meer mention of the BMA to most grass roots doctors is met with either a quizzical look or one of disgust. There are a few inspirational characters such as Jacky Davis and Clive Peedell, but most doctors are not political and just want to get on with the job. They judge their representative bodies on action not sound bites.

  5. Bob Bury says:

    Agreed Kathy. As we pointed out to the RCR when they used the ‘too political’ argument, there can be few acts more political in nature than rolling over in response to bullying by politicians (and there’s no doubt that our leaders were subjected to extreme pressure when it looked like the Academy of Royal Colleges might be about to stand up to the government).

Post a Comment

Enter this security code

Submit Comment for Moderation