Yesterday the Health and
Care Bill was introduced to Parliament. It follows the
health and
care white paper and an NHS
England consultation.
The RCP is looking closely at the bill and will be working with
its partners to seek amendments where necessary. In the meantime,
RCP president Andrew Goddard said: “We are pleased that the
Health and Care Bill has been published before the summer recess.
It will reassure all parts of the health and care system that
their efforts to better integrate services can proceed as
planned.
“But while we support establishing Integrated Care Systems as
statutory bodies to help enable that better integration, we are
disappointed that widespread health and care sector support for
other key issues has not been taken into account.
“Rather than requiring regularly published assessments of future
workforce needs, with a duty for government to respond, the bill
merely says the secretary of state must describe the system in
place for assessing and meeting workforce needs. This means we
still will not know whether we are training enough people now to
deliver health and care services in future.
“After the past 18 months, during which we have seen very clearly
that our health and care system has no capacity to deal with
emergencies while still delivering routine care, this goes
nowhere near far enough. The NHS is one of our most important and
valued assets. Any other organisation would make regular
assessments of how many staff it has and how many more it needs.
The government has to do the same for our health and social care
system if we want to keep providing the care that patients need
and expect.
“The current system of workforce planning is not working. That is
why the RCP, the Academy of Medical Royal Colleges, British
Medical Association, Royal College of Nursing, NHS Providers, NHS
Confederation and many others in the sector had supported the
recommendation from the Health and Social Care Select Committee
for regular, independent and published assessments of future
workforce requirements across the NHS and social care. It is
disappointing that this widespread sector support has not been
recognised with provisions in the Bill. We hope the government
will reconsider its position on this.
“On health inequality, again the pandemic has starkly highlighted
the extent to which we allow the most disadvantaged in our
society to live with poorer health and die earlier. Taken
together, we believe provisions in the bill will lead to action
by integrated care systems to reduce inequalities in access and
outcomes.
“But we can’t forget that the NHS Act 2006 already says the
secretary of state “must have regard to the need to reduce
inequalities" – and the richest people in our society can expect
to live in good health for two decades more than the poorest.
“It is clear we need to do more than create duties on the
secretary of state for health and care and the NHS. Access to
services and outcomes once someone has become ill are a small
part of the picture.
“Our health and care services are there to try and cure people
once they have become ill, often due to structural inequality –
through poor housing, poor education, low pay, unemployment and
more. We should be more concerned about preventing that ill
health in the first place than about making sure the availability
of cure is equitable.
“That’s why we have been calling for a cross-government strategy
to reduce health inequality, led by the prime minister. Cross
government because policy across all of government has an impact
on health, and led by the PM because it will send a clear message
that this government understands that improving health is central
to levelling up the economic prospects and success of all parts
of the country.
“Finally, the pandemic has also reminded us of the importance of
ongoing high quality research in the NHS. It saves and prolongs
lives, and provides a financial boost to the NHS and economy as a
whole. Rather than simply having to promote research, members of
ICS’ should be required to engage in research and report on their
activity.”
