Academy of Medical Royal Colleges drops plan to publicly cricitise bill after 'hard lobbying' by health secretary
Medical leaders opposed to the government's restructuring of the NHS are considering making a last-ditch direct appeal to David Cameron to help ensure the service is not damaged by Andrew Lansley's plans.
Several organisations representing doctors, including the medical royal colleges that speak for GPs and hospital doctors, may seek a meeting with the prime minister in order to voice their concerns.
The idea will be discussed at a summit of the medical establishment on Thursday evening, called by the British Medical Association (BMA), to debate how they should respond to the health and social care bill.
Requesting a meeting in Downing Street is seen as a potential way of airing their concerns following the derailment of plans for all but one of Britain's 20 medical royal colleges and faculties to publicly criticise the bill.
The joint statement by the Academy of Medical Royal Colleges was agreed on Tuesday and was due to be released on Wednesday, but it was withdrawn after Lansley became aware of its imminent publication and began telephoning presidents of the colleges in an attempt to reassure them their concerns would be acted upon.
He promised them that a raft of further amendments to the bill, which the government will publish next week, would soothe their fears on key issues such as the role of competition in the NHS, the reorganised system potentially widening health inequalities and the future responsibility of the health secretary to provide a comprehensive health service across England.
He also voiced concerns that the colleges – professional bodies which by tradition remain strictly neutral in politics – were risking their reputations by taking part in a "political" move.
The academy decided not to publish the joint statement after some of its members, including the Royal College of Obstetricians and Gynaecologists, suddenly withdrew their support. The statement, a copy of which was obtained by the Guardian, said: "The medical royal colleges and faculties of the AoMRC continue to have significant concerns over a number of aspects of the health bill and are disappointed that more progress has not been made in directly addressing the issues we have raised. The academy [is] not able to support the bill as it currently stands.
"Unless the proposals are modified the academy believes the bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high-quality integrated care to patients."
Instead, the academy issued a brief statement saying little beyond confirming that since Tuesday's meeting there had been "extensive discussions with ministers about the detail of our concerns".
Sources close to Lansley said next week's amendments would not involve major changes to key elements of the bill and would instead seek to clarify issues that had proved contentious.
Other Department of Health ministers, and even the NHS chief executive, David Nicholson, and the medical director, Bruce Keogh, joined in with the telephone diplomacy, which one college leader described as "hard lobbying". Lansley was "agitated" at the prospect of the letter, another source said.
Only the Royal College of Surgeons of England had decided not to back the statement, instead welcoming "substantial changes made to the bill as a result of our advice and recommendations". It said: "The bill should be implemented without unnecessary delays as otherwise procrastination, without an alternative cogent plan, will lead to further chaos and be to the detriment of patients."
Ed Miliband challenged Cameron about the increasing hostility among clinicians to his NHS plans during prime minister's questions. "This is a bill nobody wants. It's opposed by the doctors, the nurses and the patients," he said.
Cameron defended plans to increase competition in the NHS. Letting the private and voluntary sectors play a greater role in the provision of state-funded healthcare was "the right thing", he said.
The Faculty of Public Health, which represents 3,300 public health specialists in the NHS, local councils and academia, has joined the BMA, Royal College of Nursing, Royal College of Midwives, Unite and Unison in calling for the bill to be dropped.