The government may have sought to avoid difficult issues in medicine, such as the role of physician associates, in the King’s Speech yesterday, according to leading doctors.

King Charles delivered the speech to Parliament on behalf of the government – but one senior GP warned of “notable omissions.” There was widespread praise for one significant measure – Rishi Sunak’s plan to phase out cigarette smoking. The King also spoke of the implementation of the NHS Long Term Workforce Plan and the delivery of plans to cut waiting lists.

He also affirmed that the Government will press on with decreeing “minimum service levels to prevent strikes from undermining patient safety”. This angered the British Medical Association, which also criticised the workforce plan for heavy reliance on clinical associates to tackle the doctor shortage.

The Royal College of GPs questioned whether there would be legislation on the regulation of associates. This has become controversial as many doctor organisations object to it being done by the General Medical Council. There was also criticism of the failure to deliver a promised Mental Health Act.

RCGP chair Professor Kamila Hawthorne said: “A number of notable omissions in the King’s Speech are disappointing. There was no mention of the anticipated regulation of physician associates, expected later this year, to provide much-needed clarity on the role and to assign formal responsibility for their work – or a merging of the specialist and GP registers to reflect the parity of esteem that GPs have with doctors working elsewhere in the NHS. It was also concerning to see the Government fail to introduce reforms to the current Mental Health Act, something that has consistently been promised in their manifestoes, to improve the care our patients with mental health conditions receive.”

British Medical Association deputy chair Dr Emma Runswick said: “The Government today showed it has the wrong priorities for the NHS. Instead of presenting ways to support and expand the medical workforce it has chosen to repress it and devalue it. Instead of trying to fight the very experts it needs to fulfil their pledges on waiting lists, the government should be listening to them and working with them. We encourage all doctors to respond to the Government’s consultation on this Bill and tell them just how misguided the current plans are. The fight is by no means over.

“By forging ahead with its workforce plan the Government also commits1 to plans for the General Medical Council to become the professional regulation body for physician associates and anaesthesia associates. These plans are shortsighted, ignore the concerns of the medical profession, and will create yet more uncertainty for patients. At a time when there is growing concern among the medical profession and patients about some physician associates exceeding their clinical skills and knowledge, we are deeply concerned that these plans will create further confusion for patients between the roles of doctors and those who do not have medical degree and are not qualified doctors.”