The letter that shows even Jeremy Hunt doesn’t believe changing junior doctors contracts will improve weekend care

Letter-from- the-Secretary-of-State-for-Health-to-the-Chair-on-seven-day NHS hospital services-page-001

Jeremy Hunt’s most recent letter in which he never mentions junior doctor contracts. An omission or an admission?

Junior doctors have been saying for months that they already work 24/7 and changing their contracts won’t improve patient care. It now seems even the Secretary of State agrees with them…

Four days ago, Jeremy Hunt wrote a letter to a fellow Conservative MP, Dr Sarah Wollaston, trying to explain the ongoing media kerfuffle about the ‘7 Day NHS’, and why it’s so important it needs to be tackled.

This is all fairly standard behaviour. Jeremy Hunt is the Secretary of State for Health. Dr Wollaston is Chair of the Health Select Committee, and the most influential M.P. on health matters outside the Government. It makes sense that they would communicate on a fairly regular basis.

He starts by explaining the 10 clinical standards that NHS England describe for 24/7 care. He explains that four standards are most important. These are:

  1. Consultant presence during initial treatment decisions
  2. Regular consultant review
  3. Access to diagnostic tests
  4. Consultant-led interventions

He then sets out his evidence for why these changes are important. He lists 15 studies that have apparently found worse health outcomes during the weekend than on weekdays. He lists a number of proposed reasons for why this might be, including the possibility of sicker patients being admitted at the weekend.

One group of people he doesn’t mention are junior doctors. Not even once. However he does mention their senior colleagues, the consultants. In fact, he mentions them a lot.

Letter-from- the-Secretary-of-State-for-Health-to-the-Chair-on-seven-day NHS hospital services-page-003
 

The importance of consultant presence at the weekend is mentioned 5 times in one page alone.

 

 

With no less than 10 mentions in what amounts to 3 sides of A4, Jeremy certainly seems to think that changes to how consultants practise their jobs are necessary to stop substandard care.

He’s also quite keen to mention improved access to diagnostic tests (4 mentions) and to suggest improvements to community and primary care services (2 mentions).


 

For those of you wondering if Hunt mentions his ‘20% increase in stroke death at the weekend’ line, yes he does. He then promptly mentions that the implementation of Highly Acute Stroke Units (HASUs) has reduced this figure dramatically. In his words, ‘this clearly demonstrates the link between seven day services and reduced mortality rates.’

And in my words, ‘and it was all achievable under the current junior doctor contract, as are all your other suggestions to improve weekend care.’

Given that Mr Hunt clearly knows what needs to be done to improve weekend care (and its not junior doctor contracts), and has admitted as such, it’ll be interesting to see if he continues to peddle the nonsense that junior doctors don’t work: at all/enough/with enough ‘vocation’ (delete as appropriate) at the weekend when he pops back into the spotlight again.

Doctors of all grades and specialities want to help make all care, including weekend care, better. The implementation of HASUs shows that where problems exist, the NHS can pull together to change them.  What won’t change them is antagonising all the junior doctors to the point where half of them don’t sign up for speciality training, and quite a few of them never come back.


 

Click here to read the full text of Jeremy Hunt’s letter 

If you’re a junior doctor, medical student or anyone at all who cares about how the junior doctors who work in our NHS are treated, email jdcchair@bma.org.uk and make the subject “FAO: David Dalton & Clare Panniker”. The negotiating teams want to know your views and they want to know them ASAP!

 

 

 

 

 

 

 

 

 

 

 

 

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