Health and Social Care Bill – RCN statement
Published: 19 January 2011
The Royal College of Nursing (RCN) today (19 January) responded to the publication of the Health and Social Care Bill. RCN Chief Executive & General Secretary, Dr Peter Carter, said:
“The stakes could not be higher for this substantial Bill. Nursing staff and other health workers have worked tirelessly to deliver improvements to the NHS over the past decade. Patients have benefitted from decreased waiting times, better cancer and cardiac outcomes, improved access and flexibility of services, as well as more clinical staff. It will be very important that none of the recent improvements to the NHS are placed in jeopardy as a result of these reforms. Of particular concern is the sheer scale and pace of the change at the same time as the NHS is being tasked with saving £20 billion. The RCN is also concerned that fragmentation across the NHS could result in unexplained variations in service, a reduction in collaboration and less sharing of good practice – all of which impact on quality care.
“The RCN will be studying the detail of this Bill and working to ensure nurses’ views are taken into account as the Bill progresses through Parliament.”
Notes for Editors
2. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organizations
3. On Monday 17 January, the RCN and other health organisations wrote a letter to The Times newspaper, setting out some key concerns over NHS reforms. The full text follows:
Radical reform of the NHS in England is expected to come a major step closer this week, with publication of the Health and Social Care Bill. As unions and professional organisations representing the 1.3 million staff who make up the NHS, we are extremely concerned that the Government is not heeding the warnings about key elements of the proposals. We recognise the need to provide NHS services more cost-effectively, but we believe this can and must be achieved without taking unnecessary risks and damaging care.
One of the major concerns is the role that the NHS’s economic regulator, Monitor, will be given to ensure that any willing providers, including NHS and voluntary organisations, and commercial companies, are able to compete to provide all NHS services. In addition, the 2011-12 operating framework for the NHS, published last month, revealed that providers will be able to offer services to commissioners at less than the published mandatory tariff price.
There is clear evidence that price competition in healthcare is damaging. Research by economists at Imperial College shows that, following the introduction of competition in the NHS in the 1990s, under a system that allowed hospitals to negotiate prices, there was a fall in clinical quality. With scarce resources there is a serious danger that the focus will be on cost, not quality.
Enforced competition will also make it harder for NHS staff to work collaboratively in multidisciplinary teams, across organisational boundaries, to create the integrated care pathways that patients want and need, and that will help to make services more efficient.
Furthermore the sheer scale of the ambitious and costly reform programme, and the pace of change, while at the same time being expected to make £20 billion of savings, is extremely risky and potentially disastrous.
Dr Peter Carter, Chief Executive & General Secretary, Royal College of Nursing
Dr Hamish Meldrum
British Medical Association
Professor Cathy Warwick
Royal College of Midwives
Chartered Society of Physiotherapy