The Medical Royal Colleges play a central role in the shaping of health policy in the UK. Many of these institutions (Royal College of Surgeons or Royal College of Physicians for example) have been in existence for hundreds of years and in that time have walked the corridors of power in Westminster advising politicians about health policy. Often they do not make a song and dance of their influence but do not be mistaken – they have the ears of senior politicians and policy makers and that is why they are key players. Politicians see them as apolitical friends and trusted sounding boards for their policies.
Being a member of a Medical Royal College is often obligatory for doctors to practise medicine at senior levels in the UK. Doctors must pass College examinations to become Members or Fellows. This membership is a prerequisite to becoming a consultant or GP in the UK, but College members often hand over their compulsory annual retention fee and have no further involvement in College policies and politics.
Another important and influential body is the Academy of Medical Royal Colleges (AoMRC) – this is an umbrella organisation for all the Royal Colleges.
During the troubled passage of the English Health and Social Care Bill from 2010-2012 the AoMRC and the individual Royal Colleges played a key role. They analysed and studied the legislation and engaged in the whole process.
Politicians sought advice from College leaders during the Health Bill’s journey. Many dinners were held where the issues were discussed. When the Health Bill was getting into political trouble in 2012 it was clear to many campaigners that the Royal Colleges were not speaking out forcefully enough on behalf of members who were calling for the Bill to be scrapped. Often the Colleges talked of ‘engaging with the government’ or ‘influencing the Bill’ or ‘making amendments work better for us’ – when it was quite clear the medical profession wanted the whole Bill withdrawn. The democratic shortcomings went well beyond Westminster.
In January 2012 I decided that doctors voices were not being listened to and set up a simple lobbying tool using the Survey Monkey software. I asked doctors who were members of a Royal College to sign their name online to a letter asking their College to hold an Extraordinary General Meeting (EGM) to debate withdrawing support for the Bill. To the horror of the College hierarchy, as they dusted off their byzantine rulebook they discovered that as few as 20 names needed to be submitted in order for an EGM to take place. It is interesting to note that some Royal Colleges are now trying to change their rules and make it much harder for ‘ordinary members’ to call for an EGM. Make of that what you will…
The names flowed in and I submitted the respective names to each Royal College and one by one they were forced to hold their EGM. The result was astonishing. Prior to their respective EGMs many of the Royal Colleges had said the Bill was worth engaging with and worth trying to amend and influence. Much to the College dignitaries’ surprise, the democratically formed EGMs one by one overturned this position of engagement, into one of outright opposition. The government went into a tailspin of panic and urgent phone calls were made to College Presidents and threats to remove charitable status from them were made.
Moving to 2013, we now see damaging legislation once more heading towards the statute books. The Tory-led coalition are pushing through legislation that will force competitive tendering onto newly formed CCGs. This tendering process is hugely advantageous to large corporate companies who have massive backroom resources available to them. Local NHS providers will have much less chance in the bidding process as they have very restricted budgets and managerial support.
At the moment the Royal Colleges are once more engaging fully with the legislation and merely calling for amendments, when all can see that outright withdrawal is the only option to try and stop the NHS being parcelled up and sold off quicker than the pre Christmas rush at an Amazon.co.uk distribution depot.
So it is time to resurrect the ‘Call on Your College’ initiative. I have set up a similar online tool to allow grassroots doctors to lobby their College and ask them to call for withdrawal of the legislation. Sitting in an ivory tower will never lead to securing an equitable, fair NHS, free from the ravages of the profit hungry commercial sector. Listening to doctors and staff in the NHS is of vital importance. They know what is happening at the cutting edge of frontline care.
I intend to send the names of the doctors who have signed up online to their respective Royal Colleges a week before the April 24th crucial Lords vote. This will give the hierarchy time to speak to the Lords and advise them of their members’ views.
As Aristotle said ‘In a democracy the poor will have more power than the rich, because there are more of them, and the will of the majority is supreme.’
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