A year ago – though it feels like a lifetime – Jeremy Hunt went to war with doctors in a speech urging us to “get real” because the cost of our unwillingness to work weekends was 6000 avoidable patient deaths every year.
These days, his “weekend effect” schtick is conspicuous by its absence. One imagines he’s finally cottoned onto the fact that the public never bought his more lurid claims about junior doctors effectively allowing patients to die through their obsession with so-called Saturday ‘overtime’. Even the authors of the academic paper Hunt quoted warned its readers it would be “rash and misleading” to assume excessive weekend deaths were caused by NHS staffing patterns.
But for a politician, as we know, reality is as elastic as the spin allows – and no-one does spin quite like our Health Secretary. A case in point is the curious front page story from last week’s Telegraph. The newspaper marked new doctors’ first day of work in the NHS with the exciting news that Hunt’s year long dispute with junior doctors hadn’t damaged recruitment at all. In fact, the gaps in our hospital rotas remained firmly fixed at around a mere 1 in 10 nationwide.
Cause for celebration? Well, let’s just put that another way. Jeremy loves a good aviation analogy (which I find ironic, considering my pilot husband believes if he were forced to work under Hunt’s punitive new contract, the fatigue levels would “turn his plane into a lethal weapon”). So let me ask Jeremy this: would he really feel comfortable travelling on an airline in which 1 in 10 pilots were missing? Worse – in which the remaining skeleton crews were forced to cover their missing colleagues’ duties as well as their own? No, I didn’t think so.
This it precisely what is happening right now in every hospital up and down the country. And it is putting your lives at risk. I was passed information this week about a hospital unit in which 12 junior doctors normally cover the inpatients, yet a week after new doctors took up their jobs in the unit, 6 of the training posts remain unfilled. The Trust is now scrabbling to find locum doctors to make up the 50% shortfall. This isn’t inconvenient, it is potentially deadly: tired doctors make mistakes and, no matter how effective our clinical skills, none of us can be in two places at once.
So just why isn’t the medical establishment taking the government to task on this? A few of the medical Royal College presidents – Jane Dacre of the Royal College of Physicians, Neena Modi of the Royal College of Paediatrics and Child Health and Simon Wessely of the Royal College of Psychiatrists, for example – have publicly challenged Hunt on doctor understaffing. But where are all those other luminaries who purport to care about patient safety? Lord Darzi, Sir Bruce Keogh, the GMC, Health Education England? They all piled pressure upon junior doctors to try and dissuade us from our all-out strike (anyone would think their interventions were coordinated) yet now their silence is deafening.
Meanwhile, some hospital Trusts seem to be doing everything in their power to exacerbate the dangers of Britain’s missing doctors by driving even more of us away. In what other profession would it be acceptable to start a new job without: (1) a contract, (2) a salary, (3) a rota and (4) any information whatsoever about the nights, evenings and weekends you are about to be working? This is the contempt with which some Trusts are treating their juniors right now. One doctor’s Facebook post (below) perfectly encapsulates how her treatment at the hands of her Trust is incompatible with childcare and life in general. No wonder we are quitting the profession we love:
More fuelled up to fight this contract than ever after the past week. I started at a new hospital last Wednesday – but was only given the rota just over a week ago and have been told it’s wrong so will likely be changed. Have only been given 6 weeks of it anyway. It is based on the new contract, so the hours are awful. Next week I’m on 8am-8pm every day except Friday and, in a couple of weeks, I’m on call 9am-9.30pm four times in the space of seven days (this is just the regular medicine on-call rota, not A&E or anything). So, I have had one week to sort a babysitter for most days next week, which I still haven’t managed (my partner is a nursing student and on placement, so can’t help). I have asked for a copy of my contract – which apparently isn’t available yet. I have asked for my wage – and they have said they don’t have this information yet.
So. I am working with no contract, no idea of my income, no proper rota, and insufficient notice of shifts to get reliable childcare. What I can see of the rota is awful – with lots more evening work than I have ever had to do before, so I will be paying a fortune in childcare. But they give a random rest day every so often, so overall they can argue my hours aren’t excessive. If this is a sign of things to come with the new contract, it will be impossible for anyone with children to work it unless they have family picking up most of the childcare (mine, unfortunately, live in a different country so not possible). So what happens next?
Jeremy Hunt wants you to believe all is rosy on the NHS frontline. So rosy, in fact, that there’s absolutely no problem stretching existing services across seven days, not five. I’m afraid that is wilful blindness on his part. It is he who needs to get real. Because if he doesn’t, the self-proclaimed patient safety champion will find himself presiding over unsafe staffing levels of such severity that patients will die on his watch. The government’s unfunded, unstaffed “truly seven-day NHS” is a vacuous yet deadly soundbite. What is truly reprehensible is that Jeremy Hunt and Theresa May lack the candour to admit this.