09 July 2024

Royal College of Physicians welcomes new secretary of state for health and social care with an open letter from the physician community

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Dear secretary of state,

Congratulations on your appointment.

The election result of last Thursday gives the new UK government a huge opportunity to prioritise the health and wellbeing of the British people in everything it does.

From now on, your decisions will have a direct impact on the lives of millions of people across the country, many of whom might be going through the worst experience of their lives. They might be living with cancer, have a child recently diagnosed with type 1 diabetes or be caring for a parent living with dementia. They might be waiting for a hip replacement, a lung transplant or heart surgery.

It is now the responsibility of you and your ministerial colleagues to make sure that the experience and outcomes of these patients and their families is second to none.

In April this year, the Royal College of Physicians (RCP) welcomed you to our annual conference, Medicine 2024. In your speech, you talked about ‘a decade of renewal' based on a new 10-year plan for health and social care. Describing a disillusioned and disempowered workforce, burdened by moral injury, living through the worst NHS crisis in history, you pledged to work with clinicians to find solutions and ‘get rid of the stupid stuff’, and on your first day as secretary of state for health and social care, you confirmed that the policy of the Department of Health and Social Care is that the NHS is broken. That patients are being failed on a daily basis, that NHS staff are giving their best, and that it will take a team effort to turn our health service around. And we agree.

You said that change begins now. And we stand ready to help.

Our physician fellows and members work across more than 30 medical specialties, diagnosing and treating millions of people across the UK and globally every day. They provide patient care, train the next generation of medical leaders, and steer groundbreaking clinical research and quality improvement projects that change the world. They are the backbone of the NHS, practising general as well as specialist medicine, using their knowledge and expertise to conduct an orchestra of highly skilled health and care professionals.

But too many doctors feel ignored, disillusioned and frustrated. Our fellows and members are working long hours, covering widespread rota gaps, picking up extra clinics, juggling too many responsibilities. Our early career colleagues are living under intense pressure. Many of them are exhausted and demoralised because they are expected to juggle a heavy workload of acute patient care and specialty medicine, often while studying for professional exams and trying to maintain a life outside of work.

The time for clapping is long past. It is time to act.

The news that you will meet the BMA junior doctors committee this week about industrial action is extremely welcome. We need to get the basics right on working conditions too, with a relentless focus on staff retention. We need flexible working, good-quality hot food in hospitals overnight, affordable childcare, compassionate leadership from employers – while expanding medical school places, increasing the number of postgraduate training spaces to meet changing patient demand, and offering extra support to our locally employed, specialty and international medical graduate colleagues. Reviewing some of the commitments in the NHS Long Term Workforce Plan, for example on physician associate projections, and making sure that doctors are engaged meaningfully in its implementation would be a good start.

The next generation of physicians deserves better and so do our patients. Far too many people are now living with multiple chronic conditions – preventable disease that affects their quality of life and leads, in many cases, to an early death. Day in, day out, our fellows and members see the impact of growing inequalities on our society and on our health service. Something needs to change – because everything affects health.  

Reducing health inequalities and avoidable illness is crucial to reducing demand for health services. And it’s not something the NHS nor the Department of Health and Social Care can do alone. The food we eat, the homes we live in, the money we earn all affect our health and wellbeing. It’s time for a new approach. That is why we welcomed the commitments to tackle the social determinants of health and halve the gap in healthy life expectancy.  

The RCP has long called for a cross-government strategy to reduce health inequalities, and along with more than 250 other member organisations of the RCP-convened Inequalities in Health Alliance, we look forward to learning more about the new government’s mission delivery boards following the prime minister’s press conference on Saturday, and how they will take a cross-departmental approach to deliver change. To create a smokefree generation, the Tobacco and Vapes Bill must be one of the first things your government reintroduces as a matter of urgency – it will save countless lives and, in the long term, reduce avoidable demand on the NHS.

On Friday last week, our National Health Service quietly celebrated its 76th birthday. Many NHS staff may have stayed up to watch the election results, others will have worked the nightshift and seen the coverage as it happened. The NHS is nothing without its people – the doctors, nurses, allied health professionals, porters, administrators, managers, and so many more who keep the wheels turning, day in, day out. We need to look after them as well as they look after our patients.

Our manifesto for medicine sets out our vision for a healthier nation with access to excellent care. Every single one of us looks forward to working with you to deliver the change we need.

Yours sincerely,  

Dr Mumtaz Patel
RCP senior censor and vice president for education and training 
Chair of RCP Council, performing the duties of RCP president