Jeremy Hunt “declares war” on hospital consultants – and shows he cares more about politics than patients

Yes we do have a problem.

There is no doubt that people admitted to a hospital as an emergency on a Saturday or a Sunday  are statistically more likely to die than people admitted during the working week. The difference varies according to the type of emergency and the individual hospital but on average it is large – up to 16% higher on a Sunday.

We know something about the cause. Patients admitted at the weekend are sicker on average so a difference could be anticipated. There are fewer emergency admissions at the weekend and one would expect that the missing emergencies are the less ill ones who can wait until Monday.

But even after accounting for this the differences remain. If you look at hip fractures, which happen in equal numbers every day of the week and always needs immediate admission to hospital the historical death rate in some trusts is 10% higher for patients admitted at the weekend and it is known that this difference can be eradicated by operating immediately to repair the fracture rather than leaving patients for the next working day list.

Nobody would argue that the quality of care for emergencies should not be the same every day of the week and few would claim that it is currently.

So what is the problem with Jeremy Hunt’s ultimatum to the medical profession this week?

Yes, it is his job to encourage consultants to work weekends in order to improve quality of care. What he should have done was engaged with clinicians of all disciplines in a discussion to decide the best approach and then made efforts to facilitate implementation of the plan and to mobilise the necessary resources.

What he actually did was launch a high profile attack on the whole consultant body, making best use of a scandal hungry media and with little regard to the facts. The assertion that 6000 patients die each year because consultants refuse to work weekends is disingenuous and wrong. I am a hospital consultant and have never come across a colleague who has used the terms of the new contract to avoid working weekends. All consultants in emergency specialties do weekend work as a routine.

He accused doctor of being overpaid and lazy – putting their best interests above that of their patients. Talk of a big pay rise in 2003 is a bit irrelevant when we have had a pay freeze for the last four years and the promise of the same for four more years to come (and a bit ironic when politicians have just awarded themselves 10%).

In my own organisation every ward is visited by a consultant every day of the week and this has been the case for the last 5 years.

We do this as an extra duty over and above our job plans but are paid very little for it. The on call supplement for consultants is between 2 and 8% of the basic salary depending on intensity so works out at an hourly rate not much above the minimum wage.

Mr Hunt’s plan – to force us to do shift work and have days off in the week rather than weekends – will add very little to patient care over and above what we do now, but will be hugely disruptive for our family lives. Most consultants are in middle age with partners and children who are at home only at the weekends. Taking consultants off the wards during the week when the rest of the multi-professional team are present makes no sense.

A consultant alone can add little without the support of the rest of his team. We need physiotherapists, OT, pharmacists, juniors doctors, radiographers, pathologists and the rest. If you look in a hospital staff car park at the weekend you will see 75% of the spaces empty – but many of the cars that are there there will belong to consultants. Proper 7 day working with a full team of people, not just a consultant, will need a massive investment of cash and a huge recruitment drive. This will not happen quickly and probably never under the current government.

Why would Jeremy Hunt take on the BMA in such a high profile way?

So the ultimatum to the BMA this week was bound to be rejected because it completely unworkable and pointless. Mr Hunt is not stupid – he must have known this.

I can only conclude that this attack on senior doctors had the PRIMARY purpose of trying to discredit them and reduce their status in the eyes of the public. He needs to do this because he knows what the government has got planned for the NHS – commercialisation and gradual progression to an insurance based system – and he also knows the consultant body will be amongst the strongest opponents of this. He is getting in his retaliation first. This is all about politics and nothing about patients.

So what if this is a political act – he is a politician after all? Consultants are grown-ups and they should be able to take it. Maybe so, but there are consequences to these high profile spats. Patients hearing the scare stories will be frightened and their experience of care will be damaged. Staff will be further demoralised and care quality could actually be worsened.

Political games of this sort can cause real harm to real people.  By picking a public fight to score political points he has demonstrated cynicism, callousness and a lack of respect for the NHS and the British public.

He should apologise for the pain and suffering his actions will cause NHS patients and staff and if he had an ounce of conscience he would resign.

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54 comments

  1. Shame on him, a consultant & all the staff supporting them, r not dealing in 2 nd hand cars, they are passionate about the quality of a human beings life, consultants r there from birth 2 death, in order for them 2 do their job 2 the best of their ability it is important they have enough time off 2 b physically & mentally fit, we are honoured 2 have a NHS and the only way that will continue to exist & flourish is if the power of decision was removed from the suites & handed over to the consultants, doctors & nurses, they are the only people qualified to understand how the NHS runs & ultimately what the patients need!

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      1. If you actually open your consciousness and actually read then review the area of homeopathy, even better experience it you will not be so keen to bombard your self with synthetic poisonous drugs. It is proven psychosocial factors have a profound effect on your physical health, or do you think all I’ll health is caused by disease? I speak from experience on many levels

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  2. We now have a situation where 90% of newly qualified Doctors have no intention of working in Primary Care, Emergency Medicine and Mental Health, indeed 30% intend to emigrate, 30% of younger GP’s are also considering emigration and 85% of GP’s over 50 are considering taking early retirement, we don’t train enough Doctors , have cut Nurse training. Pretty clear that the Government are intent on the destruction of the NHS and intend introducing the American System, with all that implies. They forget, are unaware or simply don’t care that the Public Sector workforce is the most highly skilled and educated part of the UK’s workforce and their skills are in demand , they are voting with their feet and leaving in droves, leaving whole areas close to collapse.

    Liked by 3 people

    1. I wholeheartedly agree with these remarks. I was a nurse for 40 years and have watched the changes, not always for the better in recent times.

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    2. I note that this blog/ article didn’t mention Nurses,! now nurses in my opinion . Of which I’m untitled to if not slightly biased but should not invoke any negative replies, do over half of the care for patients, picking up the, at times carnage that is left behind by certain members of the team. It is nurses that advise inexperienced DR’s, chase DR’s sometimes to finish/chase up care and point out potential issues / results or changes in condition etc. Nurses do many (actually 80% ish) of what used to be skills performed by the DR’s. I would like MR Hunt and any other MP to come and work with me. It is also down to many nurses to muddle their way through the disaster that is caused by a body that have absolutely no knowledge, or experience of running, organising and maintaining an organisation like the NHS where human lives are only seen in binary code

      Liked by 1 person

    1. They’ve been playing with people’s lives all along – think police and ambulance services to name but a couple.

      The transparency of it is what disgusts me. You can pick out the planted political stories immediately if you scan through the Daily Mail website.

      Haven’t got the stomach for it if I’m honest. Dirty grubby little paper.

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  3. Last week London Underground workers were being slated in the press for striking over a radical change to their work/life balance. The reason they went on strike was not because they were opposed to 24hour tube services or wanted more money but was simply because their managment had refused to consult them over the changes and instead gone ahead and tried to force them through. Almost the exact same thing is happening now with doctors (with the same type of language being used ‘greedy’ etc). It will be interesting to see if the press and public reaction towards doctors should they take any kind of action against these plans is a strong as it was towards the underground staff who stood up for themselves.

    Liked by 4 people

    1. London underground workers get paid more than teachers and nurses and do sweet FA!!! Diddums beause they weren’t consulted – they are the most over-paid workers in the UK, and we should all be concerned that drivers who sit in computerized engines receive £60K a year!

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  4. The Tories hope to profit from it so suddenly they pretend to care about the number of people dying and give you the figure. As soon as it comes to giving numbers of how many people have died within six weeks of having their benefit stopped the Tories say it is a morbid request and go running to the Information Commissioners Office to appeal and block, it using taxpayers money to do so.No mention of what an avoidable situation it is or any regret.
    A petition has been launched after the Department for Work and Pensions (DWP) blocked the publication of statistics showing how many people have died within six weeks of having their benefits stopped.

    More than 18,000 people have signed the Change.org petition in under a week after the DWP appealed a decision to release the sensitive figures.

    After a freedom of information request, the Information Commissioner’s Office (ICO), an independent authority set up to uphold public information rights, agreed that there was no reason not to publish the figures.

    Liked by 4 people

  5. I just do not get Hunt’s logic, if he expects consultants to work at weekend then yes he will obviously need to have all the back up services running too, so unless he is going to employ thousands of more staff to cover days in the week when such staff will need time off, so how will he do this without depleting services in the week?

    As others have said, is this not a ploy to being in more private provision which we all know is surely their ultimate aim and has been since 2010! No I will rephrase that, it has been their aim since the creation of the greatest social achievement for the people of this country. Bevan knew that they would oppose it and destroy it if they could when he said … ‘The NHS will last as long as the people have the faith to fight for it.’

    Liked by 1 person

  6. Having lived in Dubai I can tell u Private Healthcare means you are lucky to walk into a clinic when a GP is present. Most consultants will chose to specialise in one area so who ever is in can’t help you. The GP you wanted , they have most days off. Normally most times you’ll have to go somewhere else because you need to be seen that day to get treatment and to get a sick line for work. You’ll have to pay for the appointment and depending on who you see that would be up to £100. They won’t know what’s wrong with u so they’ll write you a ‘shopping list’ of medications to buy that u don’t need up to £25 and a days sick line at extra cost if u are really poorly but no more than a day another £25. I had no choice but to work in 50 degree heat and dust with a sealed up nose and bad asthma. I went 3 months out there with what I now know is allergic rhinitis. my nose was completely sealed up and I had nasal drip. I came back went to the NHS was seen the same day! and they knew I needed a simple Steroid spray within seconds! i paid £3 for my spray over the road and my appt was already covered so no other costs to me that day! I would not need a sick line for work to be off a couple of days. I am the kind of person who becomes sick frequently and having to splash out hundreds of pounds every few weeks is senseless and for misdiagnosis from part time GPs. On the happiness scales America comes last and the reason is ppl can become homeless having to pay private healthcare bills and then claiming it back on their insurance provider my work which only covers certain things I might add. Mental health was not covered by mine so I also had to go to a private hospital out in the city where they had a Psychiatrist this cost £60 for the appointment £150 for tests on my thyroid to rule that out and £25 for medication these costs had to be monthly as I needed regular sessions for anxiety and depression. Although the psychiatrist I found was very nice and approachable he was very far into the city and expensive. In the UK I saw my regular GP up the road from me for ‘free’ and paid only for the cost of my medication which was £7. In the UK we have access to GUM specialist to deal with very complex parts of the body and any day of the week for ‘free’ or should we say prepaid by our taxes and NIs. there are NO costs to me that day!!!! Just imagine a world where all your family bills amount to the first and not the second figures in those two scenarios and you have to pay for anything specialist treatment like a Gyaeno it would be another couple of hundred pounds you will see how valuable and crucial to our everyday lives the NHS is. Only the Tories could live in a world where hundreds of pounds a month is fine on medical bills. In Scandinavia they pay higher taxes (50%)than us for the same kind of systems we have in the UK and they are the happiest nations on earth -statistical fact. They trust their governments will look after them and they won’t get sick and end up on the streets because they can’t pay horrendous American type bills. Don’t vote conservative. Campaign against their ridiculous plans to fold the NHS. Stop the madness. Once the NHS is wiped out it will be impossible to re-establish it! imagine being elderly and the amount of times u need to go into hospital or even past middle age; a fall-cut head, a stroke, gall stones, heart attack, dementia, a broken bone, cancer of any kind, imagine the bills on a monthly basis then! Because that’s how often things happen to us and often there are overlaps between one illness and another and thank goodness with the NHS we have prepaid for all of these things to come. As a young working professional the NHS going from this country would see me moving to one where it is in place. It would be one major reason to move on to another European country.

    Liked by 1 person

  7. This group of ministers relies entirely on spin and obfuscation. There is no evidence to support many of their policies, and where conflicting evidence exists they bury it (see the NHS Risk Register that’s still not been published despite huge demand and a Court of Appeal ruling ordering them to do so).
    They talk about mandates, but they certainly don’t have one when it comes to their plans for the NHS. I’ve just left the ambulance service where I worked as a paramedic in a largely rural area. I’m in a mess physically and mentally as a direct result of the pressures of our working conditions.
    The job itself is rewarding but challenging, and we all accept that. What we don’t accept is that it’s ethical to cut costs while pretending not to, and to heap so much pressure onto people who naturally work above and beyond the call of duty that they collapse under the strain. That’s what’s happened to us. Even the young paramedics are cracking.
    Our patients suffer too, as we spend time on silly calls, miss breaks, drive hundreds of miles, and become shattered and sluggish. Ambulances often aren’t available for emergencies because they’re tied up on silly 111 calls. This is anything but ‘efficient’ and the term ‘efficiency savings’ makes me scream.
    That’s the root of the problem – the current ridiculous definition of ‘efficiency’ is couched purely in financial terms. Where consultation occurs, it’s at great expense and involves a team of outsiders who don’t have the faintest idea what’s going on. There needs to be a debate, exactly as this excellent piece argues. But Hunt isn’t interested in debate, nor evidence, nor in speaking to those who do the front-line work. He doesn’t wish to know and it suits his purpose to lump us all in as lazy, non-hardworking-people who have a cushy life at the expense of patient care. We are all undeserving of fair pay and decent terms and conditions of employment.
    If community services (GPs, community nurses, local beds, social services, mental health services et al) had not been savagely cut many of the emergency admissions to hospitals would not be happening. More ‘efficiency’ in action.
    The point of this government is that it always blames the workers, whether professional or not. It’s busy divesting itself of all responsibility for this through its programmed of shrinking the state to the point where there’s hardly a need for government. This is what devolved power is about.
    We are all grown ups who know where the problems lie, yet nobody will talk to us.
    Surely the mass failures of private companies who’ve taken on NHS contracts should act as a red flag? Circle, Serco, G4S, NSL and co have all failed spectacularly to be efficient and make a profit, yet the outsourcing continues, to the same companies who are supposed to have some magic wand which makes them able to care for the 5000, Jesus-like, with a loaf and two fishes.
    I despair.

    Liked by 1 person

    1. Well said wwc, just so sorry you have had to leave your profession and are suffering as a result of the pressure and I hope you recover. I have nothing but admiration for you guys and gals on the front line doing your best in challenging circumstances.

      I have been campaigning for our NHS for some years now and do what I can to raise awareness about what is happening , because sadly some of the public are still unaware and sleep walking into a disaster. It is ingrained in people’s psyche that the NHS will always be there, they take it for granted. One young person said to me it would be better if it went private until I told her how much it would cost, they are clueless.

      Liked by 1 person

      1. The public are completely misinformed and are putting they’re vexation at the wrong people, in a litigational age no body is firm enough to say “. Right this is the mess we are in. What do we want to achieve? How can we do it without penalising the people that work hard to support Their funds? What are the common issues? How can we achieve this? They have to find the balance and remember why they are, where they are in society!!!

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      1. The public are completely misinformed and are putting they’re vexation at the wrong people, in a litigational age no body is firm enough to say “. Right this is the mess we are in. What do we want to achieve? How can we do it without penalising the people that work hard to support Their funds? What are the common issues? How can we achieve this? They have to find the balance and remember why they are, where they are in society!!!

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    1. I think you need to take into account the job description . Much more equal and attainable but the fundamental care is given by Nurses and if they want efficiency they need to reward the staff to keep them motivated and retain the nurses. Trouble for us all is people that are professionals with live knowledge of what is needed and how it can be achieved should be up with them making decisions. How can you understand and run an organisation whose core principles are to deliver care that is safe, cost effective and efficient centred around the patients choice”. They set the standards yet won’t invest as money is handed the wrong way. How do you think us Nurses have coped all these years? With rearranging our lives around our shifts, missing out on many special moments. Our roles are not understood, it I is multi-complex. Why shouldn’t We all work 7 days a week No-one single employee is better than the next. They could consider reshuffling the banding according to experience and skills while live on the job. The recruitment may improve a bit and money could be saved!

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      1. We are supposed to be working on a common goal,,,,,,,,, the Patient, You knew what job you were going into I’m sure some go in it with the right intentions . They find out how hard it is yet stay as they don’t want to disappoint family, or fear wrath, some enjoy the status but forget why they are in the job. There are many reasons the NHS is in a quandry

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  8. I agree with most of what you said till it got near the end when you listed all the people you need to help you in your team weirdly completely missing out nurses??? Who looks after the patient then!! BTW we are also on a pay freeze n get paid a hell of a lot less than hospital consultants but are just expected to get on with it! Boo hoo!!!!

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  9. I agree that this attack on the consultants is a purely political manoeuvre on behalf of the conservatives because they already know what they want ie privatisation ,commercialism private health insurance etc because the conservatives have all got thier own personal investments in the companies which will put bids for N H S service provision, most of the conservatives have wealth, they r born into wealth they have always paid if they needed health care cos they believe its not good if its free they have no concept of how people without wealth live or what thier needs are ,they also see that they can increase the wealth they have via privatising our beloved N H S WELL I SAY AND SO DO OTHERS BUGGER OFF COS U ARE NOT HAVING OUR BELOVED N H S AY ANY PRICE GOT IT!!!.

    Liked by 1 person

  10. I am a public hospital consultant in Queensland, Australia.

    Around 18 months ago we had a similar problem with our then Health Minister who wished to force over 3500 onto unfair contracts which, in our view, would have seriously affected patient care.

    The right-wing government took full advantage of its well oiled spin machine, and portrayed us as money grabbing, not caring about patients, and in some cases fraudulent.

    We mounted a response, and a large proportion of us made it very clear we would not be prepared to work under such conditions. It is illegal for medical staff to strike here, so we had only one option. We submitted resignation letters to our union, which would have been delivered to government had they refused to negotiate. The government said they’d bring in doctors from overseas. You can’t replace even a quarter of the workforce that quickly.

    The mass resignation strategy worked for us, and preserved our right in the new contracts to practise medicine as we see fit; not as a government bureaucrat demands.

    It is worth noting that the government picked fights with a number of professional bodies, believing itself to be untouchable due to its massive parliamentary majority. At the state election this year they suffered a massive swing against them and lost office.

    The new government is in the process of returning our contracts to what they were before this whole debacle started.

    Talk to your colleagues in Queensland. You can win this.

    Liked by 3 people

  11. This is a good blog.
    I was involved in the doctors’ strike in 1976 and Barbara Castle was similarly implacably opposed to the workforce. Some politicians believe that the best relationships are those based on acrimony, distrust, and constant criticism, that somehow this gains loyalty, commitment and the wish to go an extra mile.
    Well said Stephen.

    Liked by 1 person

  12. The PM has taken a 10% wage rise because he’s worth it but insist that public sector are not worthy. Fire service pension robbed. They are dismantling everything about this country that we should be proud of.

    Liked by 1 person

  13. This guy has no Clinical or Medical experience what so ever.

    He was part of the political expenses scandal

    He believes in homeopathy

    He wants to privatise the NHS so negative propaganda is his way of doing this. Once NHS is gone then what? Will we have better roads? Bigger schools? More police or fire fighters? Less poverty? I don’t think so!

    I’m an ODP and I too work around the clock. I work along side consultant anaesthetists and surgeons who work the same days and nights as I do. We’re part of a medical emergency team and trauma. I’ve been working on shifts where a single operation lasted 18 hours. We were all there from start to finish and we come back and do it all again. It’s needless to say that this man is detached from the reality of what it’s like to work in the NHS on the front line. It’s a selfless job but we choose to do it and do it with a smile too. Hands off the NHS!

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  14. Can I ask those who have negatively commented about this topic – were you actually at The Kings Fund to hear Jeremy Hunt’s speech? No, its plainly obvious you weren’t. I was. I heard every word, in its correct context. I sat in there with the press and was horrified to hear reports on Radio 4 just minutes after, picking out emotive elements which were highly misrepresentative and clearly engineered to whip up fury. I shouldn’t have been surprised.

    The bottom line is that the NHS cannot sustain itself any longer the way things are. An institution set up for a smaller population who was culturally very different in the 1040’s needs to have a massive overhaul if it is to survive. That is a huge job and needs us all behind it if we want an NHS to call on. The NHS was not slated, it was praised. Consultants are not worse off, their hours don’t increase, it is just a different way of working and only affects new contracts anyway. So stop the bellyaching, roll your sleeves up, help out (firstly by looking after yourselves better and being mindful how much YOU are costing the NHS) and start talking positive. If you could be bothered to find a transcript of the speech (or it might even be available on The Kings Fund website by now), just listen and get behind him – whatever political leaning you are. He’s not just trying to do this for Conservatives you know – it’s for us all. And it goes beyond what happens in the hospital……but I suggest you just do a bit more research yourself and then eat humble pie.

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    1. It was not after the speech that the headlines came out – it was in the morning before the speech. The remarks hit the headlines because they were fed to the press deliberately to get those exact headlines. It was a misjudged deliberate attempt to undermine the hospital doctors in an attempt to help negotiations with the BMA.
      It clearly backfired but you cannot blame the press for repeating what was in the press release.
      My point that playing politics with the NHS is harmful to patients – the main thrust of my article – still stands.

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    2. Jeremy Hunt deals in spin. If he likes the NHS so much, why then is he (secretly) moving towards a privatised model which evidence shows is wasteful, expensive and inequitable? The NHS would be fine if it were funded properly. The massive cuts to social care and mental health and so on have left the rest of the system lurching from crisis to crisis, and the staff at breaking point. Hunt never acknowledges the causes of this NHS crisis, but he’s adept at spouting discombobulated and meaningless statistics.
      Either Hunt doesn’t understand the consequences of his own coalition and Tory NHS and Social Care policies, or he’s deliberately concealing the evidence and the causes. Either way he’s wholly unfit to be in charge. Conveniently, however, the Health and Social Care Act divested him of the responsibility to provide healthcare for the population.
      It’s you who needs to do some research I’m afraid.

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    3. Actually, no, Catherine, it doesn’t just apply to new consultants. If existing consultants choose to stay on the old contract, they will be denied access to any future pay rises. I have 20 years plus to go to retirement – so I have no choice. Hunt’s proposals will force me to take a substantial paycut or work at least 3 extra hours per week, which will wreck my childcare. I do emergency medicine – the proposals are going to force people like me to emigrate, and then who’s going to look after you when you’re sick?

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  15. I have never worked in the NHS but value the service provided and always will.
    Hunt is a very stupid man and is playing a very dangerous game that will affect every single person living in the UK.
    I for one do not want to revert to the time before the NHS where only those that could afford it had accsess to any medical support. The NHS is the envy of the rest of the world ,lets get the support of all those that care and show Hunt he cannot privatise the NHS.
    I am very confident that as soon as people realise what his intentions are their response will be more than enough to nip this in the bud.
    What is need now is more articles like this, some good press about the NHS rather than the rubbish Hunt promotes solely to advance his privatisation plan.

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    1. The government should be warring with themselves seeing as they are the ones making all the crap decisions it’s called mass bullying!!!

      Sent from my iPhone

      >

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