Doctor's strike.

[DJ Barry Hammond]

Why? It's an accusation from the government. That is the claim they are making.

 

Still didn't really answer the question either, is it an extra 11,000 (with mitigating circumstances) or not?

You could on the flip side ask the government to provide trialled evidence that the new contract proposals have an effect on their findings?

[Guest MattP]

You could on the flip side ask the government to provide trialled evidence that the new contract proposals have an effect on their findings?

 

If we had a government minister on the forum I would.

[DJ Barry Hammond]

If we had a government minister on the forum I would.

well the simple answer is the government hasn't done anything of the sort have they?

[Alf Bentley]

This comment from a consultant in response to Matt's "Guardian" article seems to give a good overview:

 

"I'm one of the consultant surgeons that Jeremy C thinks needs to be coerced into working more at weekends. I currently spend 1 in 6 weekends in my hospital, often operating in excess of 10 hours a day and I'm available for the entire 48 hours if needed. This is of course on top of the 48 hour week I work Monday to Friday. There are 6 consultants who do what I do, so we divide the weekends up between us. If he wants all 6 of us in, like the rest of the week, we would be working every weekend. If he wants just 2 of us in every weekend we would have to work 1 in 3 weekends. I'm afraid that's not a realistic or reasonable prospect and I couldn't handle that for long at my age (50) if it was imposed. 
There is no doubt that the level of medical cover at weekends is way below what we would like it to be. So is the level of nursing care, physiotherapy, portering, midwifery, admin staff, radiology technicians, theatre support staff, operating department assistants, lab staff and access to social services. I am frequently exasperated by my inability to get anything done in a timely fashion when working weekends. The reason for this is not that any of these groups of staff are lazy or unwilling to embrace positive change . It's that there simply aren't enough of us. Nor, it seems, is there the resource to pay for it.
We struggle to provide an adequate service Monday to friday with "full" staffing (ignoring the large number of unfilled posts in my hospital). Extending this from 5 to 7 days is an increase of 40% (minus what is already there). That is going to be very expensive. The NHS is already massively underresourced compared to most other developed countries and with an increasing and more elderly population with ever higher expectations of the health care they want, it is only going to become more costly to provide. I see no evidence that this government is willing to provide the resources needed for 5 day working let alone 7 days.
One final point. Hunt constantly conflates the so called 'opt out' of weekend working in the consultant contract with poor outcomes at weekends. I'm not sure whether this is because of his ignorance or mendacity. Probably both. To be clear: the opt out is related to routine working, the poor outcomes at weekends that he likes to quote are related to lack of emergency cover. At present I can decline to undertake a routine operating list of varicose veins at the weekend. But I cannot (and do not) decline to operate on emergencies. The 'opt out' clause is a red herring" ".

[Bryn]

Why? It's an accusation from the government. That is the claim they are making.

Still didn't really answer the question either, is it an extra 11,000 (with mitigating circumstances) or not?

Mitigating circumstances You're looking a study being used to claim a causal link and you're dismissing an explanation of the figures which goes against your viewpoint as mitigating circumstances?

I haven't seen the raw data but I've no reason to believe that raw number is false. No industry relies on raw, non-peer reviewed raw data to make earth shaking changes. You can't take raw data before it's even published and reviewed and used it to dock a profession's pay in blame.

There were approximately 14.5% more days of patients in the "weekend" data set in comparison with the control "weekday" group which had 15% fewer deaths. That sounds a neat stat doesn't it? Equally bollocks without proper critique of the evidence.

Worth noting that the authors declared no competing interests but the study was commissioned by the Health Secretary.

[Guest MattP]

This comment from a consultant in response to Matt's "Guardian" article seems to give a good overview:

 

"I'm one of the consultant surgeons that Jeremy C thinks needs to be coerced into working more at weekends. I currently spend 1 in 6 weekends in my hospital, often operating in excess of 10 hours a day and I'm available for the entire 48 hours if needed. This is of course on top of the 48 hour week I work Monday to Friday. There are 6 consultants who do what I do, so we divide the weekends up between us. If he wants all 6 of us in, like the rest of the week, we would be working every weekend. If he wants just 2 of us in every weekend we would have to work 1 in 3 weekends. I'm afraid that's not a realistic or reasonable prospect and I couldn't handle that for long at my age (50) if it was imposed. 

There is no doubt that the level of medical cover at weekends is way below what we would like it to be. So is the level of nursing care, physiotherapy, portering, midwifery, admin staff, radiology technicians, theatre support staff, operating department assistants, lab staff and access to social services. I am frequently exasperated by my inability to get anything done in a timely fashion when working weekends. The reason for this is not that any of these groups of staff are lazy or unwilling to embrace positive change . It's that there simply aren't enough of us. Nor, it seems, is there the resource to pay for it.

We struggle to provide an adequate service Monday to friday with "full" staffing (ignoring the large number of unfilled posts in my hospital). Extending this from 5 to 7 days is an increase of 40% (minus what is already there). That is going to be very expensive. The NHS is already massively underresourced compared to most other developed countries and with an increasing and more elderly population with ever higher expectations of the health care they want, it is only going to become more costly to provide. I see no evidence that this government is willing to provide the resources needed for 5 day working let alone 7 days.

One final point. Hunt constantly conflates the so called 'opt out' of weekend working in the consultant contract with poor outcomes at weekends. I'm not sure whether this is because of his ignorance or mendacity. Probably both. To be clear: the opt out is related to routine working, the poor outcomes at weekends that he likes to quote are related to lack of emergency cover. At present I can decline to undertake a routine operating list of varicose veins at the weekend. But I cannot (and do not) decline to operate on emergencies. The 'opt out' clause is a red herring" ".

 

An excellent response. Well worth reading.

[Rincewind]

Interesting. A tory MP defects to Labour because of Hunt's handling of the junior doctor's dispute. His wife and some friends are junior doctors so he has a different perspective and knows first hand what is happening.

 

http://www.newhamrecorder.co.uk/news/politics/east_ham_conservative_defects_to_labour_over_junior_doctors_dispute_1_4444149?utm_source=Facebook&utm_medium=Social_Icon&utm_campaign=in_article_social_icons

[Alf Bentley]

Interesting. A tory MP defects to Labour because of Hunt's handling of the junior doctor's dispute. His wife and some friends are junior doctors so he has a different perspective and knows first hand what is happening.

 

http://www.newhamrecorder.co.uk/news/politics/east_ham_conservative_defects_to_labour_over_junior_doctors_dispute_1_4444149?utm_source=Facebook&utm_medium=Social_Icon&utm_campaign=in_article_social_icons

 

 

Deputy Chairman of a Tory constituency association, not a Tory MP, Ken. It's the Labour bod, Timms, who's the MP.

[Rincewind]

Deputy Chairman of a Tory constituency association, not a Tory MP, Ken. It's the Labour bod, Timms, who's the MP.

Sorry misread. He is still a Tory at heart though and may not be welcome at the association's diner and dance knees up.

Considers himself 'socially conservative' whatever that is. At least he has some principles.

[DJ Barry Hammond]

Eye, but he's polish as well so I'm sure the Tory's could spin this a certain way

[Jon the Hat]

One imagines many any doctors are Tory voters. doesn't mean they are going to agree with Mr Hunt.

[Bryn]

An interesting, highly emotive blog post.

http://outofmybrains.org/2016/03/02/no-beds-2/

Is there any chance we can change the silly name of this thread to something more appropriate"

[Bryn]

This is another deeply concerning aspect of our careers which is running parallel to the strikes and hasn't had any coverage.

 

http://www.54000doctors.org/judgments/employment-appeal-tribunal.html

 

A registrar in Lewisham blew the whistle on systematic bad practices (exactly what has not been disclosed because of legal proceedings) and alleges he was mistreated by Health Education England subsequently. The claims regarding his treatment do not appear to have been refuted. Rather, the legal process was regarding who exactly  has employer status and so to whom laws regarding whistle-blowing protection apply.

 

Junior doctors are actually hired on multiple short term contracts through their training which gives flexibility to move us from trust to trust to allow us to get a wider breath of training. Obviously being on short term contracts do have a lot of disadvantages in regards to job security. Whistle-blowing laws do not apply to the trusts because they are short-term employers. HEE have career-long responsiblity for organising training posts, revalidation and the like and have the power to revoke our ability to train. In this case specifically, HEE have been able to argue that they do not have sufficient responsiblity for our employment, despite that short description of their direct role in employing, training and revalidating us, for whistle-blowing law to apply to them either, meaning we literally have no legal protection if we are discriminated against for drawing attention to systemic malpractice in our trusts. This was described in court as "a conscious decision of parliament".

 

http://www.newstatesman.com/politics/health/2016/02/how-government-leaving-whistleblowing-doctors-twist-wind

[Bryn]

Which hasn't stopped our newspaper of ****ing record publishing this awful headline this morning on a seperate issue on which Hunt has actually demonstrated a modicum of understanding.

[DJ Barry Hammond]

And we thought this was over!

Junior Doctors have rejected the revised and union backed 'final' contract offer! Dr John Marrow-win-ey (can't be arsed to look up the spelling) who had been leading the negotiations on behalf of the BMA has understandably resigned following the verdict from the union.

[Darkon84]

What was the split? I overheard something on the radio and I think they said 44% voted in favour of accepting the contract, and 56% voted against it. They've obviously closed up some ground, surely they can't be too far off.

 

With such a close result this time, you know what this calls for on behalf of those who voted to accepted it, don't you? A PETITION! Yayyyyyyyyy!  

[DJ Barry Hammond]

What was the split? I overheard something on the radio and I think they said 44% voted in favour of accepting the contract, and 56% voted against it. They've obviously closed up some ground, surely they can't be too far off.

With such a close result this time, you know what this calls for on behalf of those who voted to accepted it, don't you? A PETITION! Yayyyyyyyyy!

Word is, Hunt isn't willing to accept the democratic mandate because if you include those that didn't vote, only 40% rejected it - so it seems anyone can play this game of twisting results.