Special Bulletin:
EGM and the College's Position

Dear Colleague,

The Health and Social Care Bill for England remains a very high priority for the Royal College of Radiologists. The situation is changing daily so it is important I keep you up to date on progress and on the potential impact on patients, services and the College.

The primary role of the College is as the professional standards organisation across the whole UK including the provision of education and training for both clinical radiology and clinical oncology. There has been widespread agreement across many bodies and all colleges on opposition to aspects of the Bill. Thus far only one medical Royal College – the RCGP - has called for outright withdrawal of the Bill.

The Officers and Council have over many months taken the view that there are significant risks to the future influence and even the viability of the RCR in calling for withdrawal. Maintaining a position of opposition to aspects of the Bill allows us to be part of a continuing dialogue. It is also worth remembering that many aspects of the health service reforms can be implemented without legislation, and indeed much structural change has already started and will not be reversed.

An Extraordinary General Meeting (members and Fellows login required) of the Royal College of Radiologists has been called for Thursday 16 February. The Officers are very aware of an active voice, urging the College to go further and call for outright withdrawal of the Bill. Officers are equally aware of other voices that support the view that withdrawal would be tantamount to political suicide for the RCR. The EGM is the time to hear ALL views in the context of the Resolutions that have been submitted for the meeting. Once again I urge you all to attend.

Officers and Council remain of the firm view that the RCR:

• as a smaller College, must not place itself at risk of isolation and vulnerability;
• must distinguish its position from bodies that have a trades union function such as the BMA, RCN and RCM;
• must avoid being excluded by the Government of the day from meaningful engagement and influence;
• must continue to seek amendments to both the Bill and healthcare reform through constructive dialogue with the Government and others.

To that end our discussions on the Bill will continue and our concerns remain despite the amendments that were announced last week:

• There remains doubt that there will still be a guaranteed comprehensive health service;
• There is still no overriding duty throughout the new system to ensure integration;
• We remain unconvinced that the latest changes to address health inequalities will be effective;
• The amendments do not appear to address EU competition law issues;
• The new provisions as regards education and training and research are good news, but those provisions are weak. There are no provisions to ensure the independence of quality assurance in education and training through the postgraduate Deans.

Alongside this we are still pressing for the release of the risk register by the Government as soon as possible not awaiting the court hearing set for early March.

There are also very specific concerns as regards radiology services:

• Ill thought out competition will lead to destabilisation and fragmentation of services with the loss of many of the efficiencies gained in recent years. The loss of significant, less complex and less resource-intensive work combined with the associated revenue could rapidly make many NHS imaging departments non-viable in the proposed model;
• Fragmentation of the patient pathway. There is a need to have access to all test reports in one place and, for conditions like cancer, a need to ensure standardisation between tests. When patients access multiple providers, there are significant problems with the accessibility and standardisation of imaging protocols and reporting which can lead to an increased number of tests and referrals - exactly the type of inefficiency we are striving to avoid.

It is our stated strategic aim to grow and sustain the influence of the RCR. To do that we always have to find ways to work with the Government of the day – not as a supporter but as a critical friend. It is vital that the Royal College of Radiologists remains in a position to influence and lead on professional standards, training and education of clinical radiologists and clinical oncologists; in particular we have a duty to the particular groups of patients that we serve.

Yours,

Dr Jane Barrett
President