NHS reforms: Is support as strong as David Cameron claims?

7 September 2011
"We now see the Royal College of General Practitioners, the Royal College of Physicians and the Royal College of Nursing all supporting our health reforms."

David Cameron, Prime Minister's Questions 7 September 2011 

With the NHS reforms again being debated in Parliament today, Labour Leader Ed Miliband raised the issue in the first round of PMQs since the summer recess.

Yet when Mr Miliband claimed that the Government's reforms lacked support, David Cameron reeled off a list of health sector bodies who apparently backed the bill.

But are they all as onside as the Prime Minister's comments suggest? Full Fact spoke to the organisations themselves to find out what their real position is.

Below follows full statements put out by all three bodies following today's PMQs, so that their position in their own words can be read in full.

Royal College of General Practitioners (RCGP)

Though welcoming parts of the bill, the statement from Dr Clare Gerada, Chair of the RCGP states that her organisation is "extremely worried" about parts of the bill.

"We understand that the RCGP's position on the healthcare reforms was raised during Prime Minister's Question Time today."

"To reiterate our position; the College supports putting clinicians at the centre of planning health services. However, we continue to have a number of concerns about the government's reforms, issues which we believe may damage the NHS or limit the care we are able to provide for our patients. These concerns have been outlined and reiterated pre- and post-pause.

"As a College we are extremely worried that these reforms, if implemented in their current format, will lead to an increase in damaging competition, an increase in health inequalities, and to massively increased costs in implementing this new system.

"As independent research demonstrates, the NHS is one of the most efficient healthcare systems in the world and we must keep it that way. "?

Royal College of Physicians (RCP)

Though a press release put out on Tuesday by the RCP set out ways in which it was felt the bill could be improved, it does not set out particularly clearly whether RCP supports or opposes the bill.

The position is a little more nuanced than that.

In a statement to Full Fact, Sir Richard Thompson, president of the RCP said: 'The listening exercise improved the Health and Social Care Bill, but there are still areas that need to be changed.

"We welcome the mandatory involvement of specialist doctors and nurses in commissioning for this will help commissioning bodies make informed local decisions about patient care.

"However, the proposal that they should be from outside the commissioning area is impractical and will mean that they will lack the local knowledge that should improve decision making."

So portraying the RCP as ardent supporters or implacable backers of the reforms would not be accurate.

Royal College of Nursing (RCN)

Since Prime Minister's Questions the RCN has put out a statement explaining that the organisation still has "very serious concerns" about the financial implications of the reforms.

Dr Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing said:

"The Bill being placed before parliament next week has enormous ramifications for patients and for our members. While we acknowledge that the Government have listened to our members in a number of areas, we still have very serious concerns about where these reforms leave a health service already facing an unprecedented financial challenge.

"The Government has now changed the bill in response to calls from nurses and others, setting out what will happen if providers fail either financially or clinically, amending the language of Monitor's role in competition and ensuring that nurses will be represented on the Clinical Commissioning Group boards. We have also welcomed the government's commitment to maintain a system for professional education and training within the comprehensive health service.

"However, at a time when the NHS needs to find £20 billion in efficiencies, tackle waste, work harder to prevent ill health and deal with an aging population, we are telling MPs that this Bill risks creating a new and expensive bureaucracy and fragmenting care.

"This fragmentation risks making inequalities worse, and preventing health providers from collaborating in the interests of patients. We must avoid a situation where existing NHS providers are left with expensive areas of care while private providers are able to "cherry pick" the services which can be delivered easily. As the Bill enters this final phase, we will be working to ensure that there are checks and balances to avoid these very real risks."


In claiming that the organisations in question all support the bill, the Prime Minister has over simplified the position of all three bodies.

While all welcome aspects of the reforms and changes to the bill that were made as a result of the listening exercise, all three also express concerns about parts of the plan - particularly the Royal College of GPs.

We have put this point to Number 10 Press team and of course will up date when we hear back from them.

Naturally with reforms of this scope it would be suprising if any of these organisations were completely behind every last aspect of this bill, and were not seeking improvements they would consider beneficial.

Which means that trying to portray such groups as solely backers or attackers of the bill isn't particularly helpful.

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