Royal College of Physicians of Edinburgh

Comment on the House of Lords Committee on the Long-term Sustainability of the NHS report

Commenting on today’s (Wednesday 5 April 2017) report of the Committee on the Long-term Sustainability of the NHS, Professor Derek Bell, President of the Royal College of Physicians of Edinburgh, said:

“Today’s report is wide ranging, addressing the key issues which are affect our NHS now and will continue to do so in the coming years.  These include a lack of resources, workforce challenges and the need to improve the prevention agenda. This College continues to call for the Government to set up a working group involving the Royal Colleges, healthcare practitioners, patients, the public, and politicians as a matter of urgency to find solutions to alleviate the pressures faced across the NHS in England.

“Undoubtedly there will need to be changes to ensure a sustainable healthcare system by 2030. A partial solution is significantly greater financial investment into healthcare. However, even if this were forthcoming, it would still not be enough without greater system changes.

“The Committee is correct to conclude that short- termism exists in the NHS and in social care. Longer funding cycles are needed to avoid this to avoid this, and any end of year effects. Many attempts to reform the NHS, particularly in the community, have resulted in excessive efforts to re-group, re-package and re-design services which consume time, effort and funds only for a new cycle of reform to begin a few years later. There is an over-emphasis on appearing to reform rather than sustaining and improving existing services for the long term.

“The stated ambition to reduce reliance on the acute hospital sector should not be pursued to the detriment of the quality of patient care. We must not allow patient safety to be compromised by the implementation of this approach without clear, established evidence that the care of patients outside acute hospitals will be as safe and effective as hospital care. We support shifting care closer to home but not at the expense of quality.

“The report notes the value of the workforce and the importance of strengthening workforce planning, and we welcome the recommendation that this be tackled as a matter of urgency. A similar exercise is already underway in Scotland. We also look forward to hearing more about proposals to change the training and education of the health and social care workforce. This College is committed to ensuring that medical training and education is the best it can be as this ultimately leads to better and safer patient care.

 “The College has worked to improve public health for nearly 350 years, and we concur with the Committee’s conclusion that failure to protect and enhance public health spending is short-sighted and counterproductive. The costs of obesity to both the NHS and patients are high, both financially and in terms of preventing avoidable diseases such as cancer and type 2 diabetes. While we would support the Committee’s recommendation to implement a nationwide campaign on the issue, other policies such as reducing pack sizes and implementing taxes must also be considered in the short term.”


Contact 0131 247 3658

Notes to Editors:

  1. More details of the inquiry, including the transcripts of evidence received, and the call for evidence, can be found on the Committee's webpage
  2. The evidence submitted by the College can be found here
  3. A letter from the Royal College of Physicians of Edinburgh, the Royal College of Surgeons of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow to the Prime Minister suggesting a working group on the NHS in England can be found here