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RCP reaction to the health and care bill

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.”