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The road ahead

This is an extraordinary time to become president of England’s oldest medical royal college because the recent publication of the health white paper Equity and excellence: liberating the NHS signals one of the most radical re-organisations of the NHS, says Sir Richard Thompson

As expected, almost every part of the NHS will see significant change if the proposals are implemented. One of my first priorities as president will be coordinating the College’s response to the white paper and ensuring the views of our fellows and members are heard in Westminster and Whitehall.

As physicians, we shall grasp the opportunity to be involved in the changes, using our collective knowledge and experience. The test for these proposals will be how far clinical integration is genuinely facilitated by the reforms rather than hindered. We shall also be hoping that members and fellows will start to build links and work closely with our GP colleagues to ensure that our expertise from acute and chronic care is fed into the commissioning process.

European Working Time Directive

Another key issue for the RCP over the coming months is the European Working Time Directive. As well as playing an active role in the European Commission's recently launched impact assessment of this Directive, we have been promoting the key findings of RCP surveys and studies that have confirmed the inflexibility of the application of the current Directive, as much as the limit in hours, has had a significant negative impact on the continuity of patient care and on the training of doctors.

While recognising that a return to a culture of long hours is not safe, desirable nor appropriate to the current intensity of the work upon today's acute physician, the RCP believes that this inflexibility urgently needs to be addressed, in particular the regulation of on-call work. It has really damaged the provision of care in the acute medical specialties and we shall press for it to be modified.

Public health

The College has a long tradition of engagement with public health issues, particularly tobacco, alcohol and obesity. I am committed to continuing our work in these areas, and have a particular interest in obesity. We need far more research into the psychological aspects of our obesity crisis. We need to know why people continue to lead unhealthy lives despite all the evidence and develop ways of encouraging and persuading people to take better care of their own health. This is not just a personal health issue - the government, working across all departments and sectors, can play a major role in supporting and enabling a healthy society. In my first few months, I shall be consulting experts in the field to discuss where we are and how best to go forward in combating this epidemic.

I shall also be revisiting the issue of recreational drugs and their effects on people and society, examining with the Royal College of Psychiatrists, progress since our 2000 report Drugs: Dilemmas and Choices and how we can use our fellows’ expertise in this area.

Social determinants of health

Another issue which requires action from the College and across society is that of the social determinants of health. The inequalities in health that persist today in the UK are not inevitable. All sectors have a role to play in reducing the gap in health between the richest and the poorest in our society. A recent RCP policy paper, How doctors can close the gap, which was launched at an RCP conference, calls upon doctors to act, involve themselves and advocate for programmes of action to tackle the social determinants of health and reduce health inequality.

All doctors must embed the social determinants of health into their day-to-day practice and work to increase awareness amongst their colleagues, policy makers and the wider public of the factors contributing to inequity and inequality in health. I shall be promoting all these ideas throughout my presidency.

Leadership

I believe that at least part of the high profile failures in hospital care is due to the inability of health professionals to take the lead in setting everyday standards of kindness and humane care right across every part of their hospitals and when they try to change things their careers are damaged. I want all our fellows and members to do more and the College will encourage and support them to provide the whole care that they would wish for themselves.

Sir Richard Thompson is the new president of the Royal College of Physicians

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