A rush of big changes in health: reflections from month five as President

In his new presidential blog, Russell considers the huge updates in the health world across the UK, and how we can engage with Government to help ensure children and young people remain a priority in the NHS.

Welcome to my new monthly presidential blog, which I hope to use to keep you up to date with key events and my activities working to improve CYP (children and young people) health and support our members. 

It is month 5 in the job! The fervid atmosphere in politics has been very nearly matched by a rush of big changes in health. I spent a lot of July perfecting my non-blinking stare, as I was worried that if I blinked I would miss something big. I did miss the Trump visit to the UK (I was on a small no-internet island off the coast) but I’m sure he took notice of our statement of concerns about US treatment of immigrant children.

A huge amount has happened in the health world - a new long-term financial settlement for the NHS across the UK announced by the PM; a new Secretary of State for Health & Social Care in England; removal of Tier 2 visa restrictions for doctors; the NHS 70th birthday; a new Childhood Obesity Plan... Oh, and a new long-term plan for the NHS in England.

I’ll probably be able to say more about Matt Hancock, our new Secretary of State, in a future blog, as I’ve not met him yet. I hope it provides an opportunity for the SoS to develop a new and positive relationship with the NHS workforce, particularly trainees. Early indications from his first speech suggest this is on his agenda.

A substantial increase in funding

Having a long-term financial settlement for the NHS is hugely important for us – as it signals the end to boom and bust yearly financing and therefore allows longer-term planning. My personal view is that the 3.4% increase is not nearly enough, but I think we should be very pleased to get this level of attention from a Government consumed by Brexit and to have a substantial increase compared to recent years and one that won’t (we are told) evaporate in tough years.

"Of course the devil will be in the detail, and there will be a lot of work to ensure we can influence where the new money goes."

Remember, this is an increase for the whole UK – with the same increase going to devolved administrations as well as to NHS England, and we hope to see this this extra funding invested in health across the four nations. I was lucky (or unlucky!) enough to sit through the PM’s speech announcing the new funding deal, and reflected that our College alongside other Academy of Medical Royal Colleges members could take considerable credit for helping get the deal across the line. We had all done a great deal of lobbying work with Number 10 and throughout government to get this extra money into health, and it was my first experience of being part of a big endeavour that really paid off. Of course the devil will be in the detail, and there will be a lot of work over the next year to ensure we can influence where the new money goes.

I am very concerned that key areas such as public health and medical training budgets were not included in this deal – and I will be working hard to ensure that children and young people’s public health and training budgets get similar uplifts in the next comprehensive spending review (due 2019). 

Being a critical friend

My approach to working with Government has been one of constructive engagement: to be a ‘critical friend’. You need to be in the room to ‘speak truth to power’. If you’re outside the room yelling criticisms, you’ll need more than a megaphone to be heard.

Some of you may feel we should be more critical, but I see no point in isolationist purity. If we work with Government and give credit where credit is due, we will be listened to when we criticise.

An obesity plan that includes our key asks

"We did this carefully, with a clear intention to be inside the tent influencing decisions."

The new Childhood Obesity Plan (Chapter 2), which applies across the UK, is a case in point. We been clear for the last two years (since Chapter 1) that more was needed, particularly on restrictions on junk food advertising and food labelling and promotions. And we agitated with civil servants, ministers and in the press for what we knew was important to protect children’s health. But we did this carefully, worked both by ourselves and as part of a broader coalition (Obesity Health Alliance) and with a clear intention to be inside the tent influencing decisions.

The result was that we believe that we were able to influence what was finally announced – and when the announcement was made in June this year, the new plan included almost all of our key asks. We therefore strongly supported the Plan publicly (how could we not when we got what we asked for) and will be highly active during the necessary consultation period. However, we will challenge where needed if movement from announcement to implementation falters.

CYP higher up the priority list

For me, probably the most exciting bit of news was Simon Steven’s announcement in an interview that children and young people would be a new priority for the NHS England long-term plan. For me this was like manna from heaven, like rain on parched ground – given that my key priority has been to get children and young people higher up the priority list in England to match Scotland and Wales.

As you’d expect, I’ve been talking with NHS England and people at the Department of Health and Social Care and we are working as part of a coalition of charity partners to look at what might go into the long-term plan. I hope to be able to tell you more about this next month.

Celebrating your success

Lastly, I was hugely proud of our members and our young people at the NHS 70 celebration we held at the College in early July. We celebrated the origins of widespread paediatric practice in the UK with the formation of the NHS, heard from young people about their experiences of care and hopes for the NHS and explored the potential challenges of the next 70 years. An appreciative audience heard from speakers including our wonderful past President, Professor Sir Alan Craft and the brilliant Editor of The Lancet Richard Horton (also an Honorary Fellow), with Richard challenging the College to be radical in promoting children and young people’s health. We also had star turns from one of our &Us Network of young people, Thines Ganeshamoorthy, and our beneficiary trustee Jon Foster.

Leaving this celebration to go straight into my first RCPCH membership ceremony in Birmingham (fortunately the President’s gown fits although it was sweltering in this month’s heatwave!), I came away with a great sense of optimism about the future of our College.

Till next month,