Response to MP on Junior Doctors strike

AudlemOnline publishes this article as an alternative view of the issues behind the Junior Doctors' Strike action (see the earlier article here for the contribution from our MP, Antoinette Sandbach). Jeffrey Price tells us that "I do some volunteering at Leighton hospital where I come into contact with junior doctors so I understand their enormous dedication and commitment."

Let's start by remembering that it was Jeremy Hunt who in 2010 blamed the Hillsborough tragedy on 'hooligans', presumably thus including those who died. I think this suggests that he is quick to jump to conclusions; is a man who has little interest in evidence and a man who is indifferent to the feelings and opinions of others. This is exactly what he has shown during the doctors' dispute.

The initial motivation for Hunt's crusade was a superficial, largely unsubstantiated piece of research into death rates in relation to days of admission to hospital. Even Hunt's own Conservative colleague, Sarah Wollaston MP, described his point about weekend mortality rates as 'spin'.

The weekend care point is ridiculous as his argument is based on when patients were ADMITTED to hospital not when they died. The research was about what happened in the 30 days after the admission. If someone was admitted on a Saturday, but died 29 days later on Monday, this was seen to be significant. Statistically, it is pretty dodgy being admitted to hospital on a Wednesday, evidently (You have been warned).

So, this research was not about patients dying at the weekend at all. Moreover, of course, under our system, patients who are admitted on Saturday or Sunday are more likely to be seriously ill. If not, they and their doctors would wait until Monday.

Interestingly, similar statistics about weekend admission mortality rates occur in other parts of the world with completely different systems to ours. The research made no link whatsoever between death rates and staffing levels and,of course, ironically, the one group of people who are in hospitals at the weekend more than any other group are junior doctors.

Because of the allocation of training posts in the North West, our junior doctors at Leighton could be seen to work even harder than in other similar hospitals: they deserve more from their MP.

The BMA have repeatedly denied that the only sticking point in the negotiations concerns Saturday pay. It, of course, suits Hunt to turn this into a mere pay dispute. Yet, part of the dispute is certainly about pay (though not a pay increase).

I am surprised that so many people in England and Wales would be prepared to take a 15 – 40% pay cut and feel it is wrong to object. (Of course, as an MP, Ms Sandbach has not had to suffer such a reversal, quite the reverse in fact).

This is not just concerned with weekend rates but also changes which will adversely affect part-time workers and those leaving to have children. The Government has admitted that this contract affects women more than men but, presumably like Ms Sandbach, deems this acceptable.

It seems strange that a contract which ostensibly offers a 13.5% pay rise also includes pay protection for three years. If the contract is so advantageous why do doctors need 'protection'? This ,of course will not apply to those who qualify in three years' time. It is a very strange way for a CEO to act, in a time of acute staff shortages, to worsen the pay and conditions of his most skilled employees and to drive them away.

Applications for medical schools fell this year and Jeremy Hunt is the best recruiter ever for the Australian health service. The Conservative MP, Sarah Woollaston, mentioned above, admitted that her daughter and her daughter's husband plus six of their friends, all doctors, have recently moved to take up positions in Australia.

The most serious aspect of this contract is the effect it could have on doctors' working hours. Just try to work it out. Jeremy Hunt wants to expand the NHS into a full 7-day service. Nothing wrong with this. However, no extra medical training places have been provided, the current system of full 5-day provision plus cover at weekends is under extreme pressure and there is currently a chronic shortage of doctors in A&E, paediatrics and psychiatry.

Hunt has no intention of increasing funding or providing extra doctors and nurses (despite a recent report saying the current system requires 70,000 extra doctors and nurses to match the provision in other OECD countries. There are currently 20,000 nursing vacancies in England and Wales and over 90% of hospitals cannot maintain their own safety standards of nursing numbers on wards). He does not propose to employ more ancillary staff, essential to provide a full service for the extra two days.

He says that the contract will reduce doctors' working hours yet, interestingly, one of the points he was totally intransigent on was his insistence on the elimination of fines for hospitals that made doctors work dangerously long shifts. Does this go with reducing their hours?

The information above surely illustrates that what he is proposing is mathematically completely impossible unless doctors work dangerously more hours to provide the 7-day system (unless he intends to close hospitals during the week).

Why would a group who have a record of not striking, who have for several years now accepted, largely without complaint, 1% pay deals in steadily worsening working conditions when private sector rises have been greater, suddenly object to a seemingly advantageous contract? It doesn't make sense does it?

Unless, of course, they understand the contract removes important safeguards about the doctors' working hours which in a time of significant staff shortages in many areas of the underfunded NHS is very dangerous for patients.

I do not want to be treated by a doctor who has been working non-stop for 18 hours because the hospital management cannot find anyone to do the next shift (which at a time of acute shortages made worse by Hunt is more common). Currently, hospitals are fined if they do so; under the new contract they can insist that he/she continue with some feeble register of occasions their only punishment.

Finally, some hope for junior doctors: the private company appointed by Iain Duncan Smith to assess fitness for work is currently advertising junior doctor posts for disability assessment at £72,000+ per year for a 37 hour week! This is about twice the amount they get for working in a hospital and for far fewer hours. So we cannot afford to pay junior doctors to treat sick people but we can pay them handsomely to shaft the vulnerable!

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