‘7 days’ – Contrived Chaos & The Department of Health

UnknownI read recently an interview that Mr Hunt, Secretary of State for Health, gave to a newspaper. The problem, as they called it, is that nobody in Downing Street ‘expected the BMA…to sabotage’ the Conservative’s ‘7 day NHS’ election manifesto. This is certainly not true. In the run up to the general election the British Medical Association (BMA) launched their own ‘No More Games’ campaign with the sole aim of pleading with our political leaders to desist from using our NHS as a political football. Following on from this, they repeatedly asked the Government for clarity with respect to what their reputed ‘plans’ for a ‘truly’ seven day NHS were. Mr Hunt famously referred to his plans as many as eighteen times in one speech and in August when plans had yet to materialise, Dr Mark Porter, Chair of the BMA, took out a entire page newspaper advert simply to ask the question ‘When will the Prime Minister define what he means when by a ‘truly seven day NHS’?. I think if we can safely assume anything, it’s that Downing street absolutely had the foresight to know that discontent was coming.

The conflation of contract proposals with plans for a ‘7 day service’ continues however to be deeply distressing for junior doctors. On the day the BMA strike ballot result was announced, Mr Hunt actually gave an entire interview to ITV news while hardly referring to any of the junior contract issues at all (if you don’t believe me, read it). He repeatedly talks about having more doctors at the weekend; without any plans to actually employ more doctors. In one interview he went as far as to say that the proposals would mean more consultants at the weekend. Which is of course impossible, given we are talking about contract for junior doctors alone. He repeatedly talks about statistical excess in deaths as if they were de facto ‘preventable deaths’; a pitfall which Sir Bruce Keogh himself warned him against. It seems that the longer the junior contract row depends on the media, the more likely it is to be engulfed by 7 day service rhetoric. Genuine negotiations are required to give the BMA a chance to unravel the spin.

To add further to this frustration of course, when Mr Hunt does actually talk about the proposals, he dresses up a firmly neutral pay envelope as an 11% pay rise and talks of ‘perverse incentives’ to work outside rostered hours. If you ask a doctor what their incentive to work longer hours are, they will tell you it comes down to a sick patient in front of them and a regard patient safety is not perverse.

Some might say that the Conservative party had no intention of ever defining what their great plans were and how they would be funded. Now of course they feel obliged to deliver something and conflating the issue of junior doctor contracts with the ‘7 day service’ hot potato is rather a convenient scape goat. If they promise a contract that doctors know is unfair and unsafe, it is a doctor’s duty to resist it. If they make the public believe the junior doctor contract proposals are actually the answer to their mythical ‘7 day service’ then perhaps they won’t have to find the money to deliver something that works. Realistically of course, given the £2.2 billion pound deficit expected at the end of this year alone, can they be expected to find the money at all? In the end, junior doctors will be seen as resisting service improvements that weren’t existent to begin with.

Scrolling through the interview further, it is hard not to notice that Mr Hunt is described as ‘savaging’forcing’ and ‘lambasting’ junior doctors. I don’t expect that Mr Hunt has attributed these words to himself, but any reflective leader would surely be disappointed to hear himself described in these terms. The same article goes on to refer to the ‘cajones’ of our male secretary of state of health, while calling his female junior doctor adversary a ‘cheerleader’, but I think that’s a topic for a entirely different day.