Reminder: Jeremy Hunt met media execs eight times between October and December

This post originally appeared on WestminsterWorld.com. I’ve republished it now as by the end of this week I’m expecting replies from the Department of Health on 20 Freedom of Information requests. These requests covered these meetings and other meetings between Jeremy Hunt and his junior ministers that seemed of interest.


Jeremy Hunt had eight meeting with senior media figures between October and December, a period that coincided with escalating industrial action by junior doctors.

Jeremy Hunt, the UK Secretary of State for Health and Dr. Mark Davies, Director of Clinical and Public Assurance at the Health & Social Care Information Centre, visited the Kaiser Permanente Center for Total Health for a tour, given by Bernadette Loftus, MD, Mid-Atlantic Permanente Medical Group, Kim Horn, President, Kaiser Permanente, Mid-Atlantic States, and Phil Fasano, Chief Information Officer
UK Secretary of State for Health Jeremy Hunt and Dr. Mark Davies visit the Center for Total Health. Credit: Ted Eytan

These media figures included: Fraser Nelson, Editor of The Spectator; Amol Rajan, Editor of The Independent; Tony Hall, Director-General of the BBC and Tony Gallagher, Editor of The Sun.

Additional meetings are known to have occurred with the editorial teams at BBC News, The Daily Telegraph, The Mail on Sunday and The Daily Mail. Hunt also attended the BBC Proms twice with his wife, courtesy of complementary tickets on both occasions.

Hunt’s eight media meetings over three months contrast sharply with a total of zero meetings over the previous nine months.

The meeting and hospitality were revealed in the latest release of ministerial gifts, travel, hospitality and external meetings from the Department of Health. Exact details of who was at the meetings and what was discussed have yet to be revealed. Westminster World has sent Freedom of Information Requests asking for further details of the meetings.

 

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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!

 

 

 

 

 

 

 

 

 

 

 

 

What Health Professionals Should Pay Attention To In Parliament This Week

Like all weeks in Parliament, there is quite a lot on. Even massive nerds like me struggle to care about most of it, but there are always a few nuggets worth paying attention to. Here are the things healthcare professionals should be paying attention to.

Monday 30th 

The Health Select Committee will release their report on childhood obesity. This report will make uncomfortable reading for Health Secretary Jeremy Hunt, given the recent furore over the proposed sugar tax and the ongoing crises of junior doctor contract talks and NHS finances. The report will probably generate an ‘action plan’, health professionals will be interested to see if it’s up to snuff.

Tuesday 1st

The Health Select Committee will interview the potential new head of the Care Quality Commission (CQC), Peter Wyman. He has held a few interesting roles over his career. A bit of digging reveals the following:

  • He is a senior advisor to Allbright Stonebridge Group – a company that advises multinationals on business strategy, or in blunter terms, a lobbying group.
  • He is a member of the board of Companies House. This group oversees businesses in the UK.
  • He was previously president of the Institute of Chartered Accountants, and a senior figure at PriceWaterhouseCoopers.

It is a little surprising that the Government’s preferred candidate  to oversee the quality of healthcare is a man with ongoing interests in business. Hiring Wyman would open them up to further criticism about their desire to further the links between the NHS and private business interests.

Friday 4th

A bill designed to make off-patent drugs cheaper will get its second chance in Parliament. It will take a miracle for it to even be talked about as 11 other bills have to be voted on before it. It has such a late position as it was blocked on its first day by Alistair Burt, Minister for Social Care, who spoke for nearly half an hour to stop it passing.

 

To be honest, a lot less of interest to healthcare professionals in Parliament this week than most weeks. Though the upcoming junior doctors strike, and the ongoing NHS financial crisis, will ensure health and politics don’t stray too far apart.

Hypocritical Hunt AGAIN avoids Parliamentary emergency

Jeremy Hunt has once again avoided answering an urgent question in Parliament, the second time he has done so in as many months.

Today’s question on junior contracts came just over 24 hours after junior doctors overwhelmingly voted for industrial action.

Whilst the first ever vote for strike action by Britain’s doctors might sound like a big deal to most people, Jeremy Hunt decided against attending today’s debate on it. It was left to  junior minister Alistair Burt to answer the questions out to him by Heidi Alexander, the Shadow Health Secretary, and other MPs.

Mr Hunt avoided a question on NHS finances on the 12th October 2015,  and here’s what I wrote then:

“Urgent questions are the parliamentary equivalent of a heart attack. They are serious, don’t happen that often and are granted only if there’s no other way of asking for the information you want.

 

Given that Hunt is continuing to say he’s open to negotiations, one would expect him to take the chance to discuss the contracts in Parliament. Mind you, you’d also expect him to take up the offer of fresh contract talks.

In fairness to him, there was the small matter of the worst ever NHS financial crisis to deal with today. However if his excuse is that he’s got too many crises to deal with at once then there will be very little sympathy for him in the world.

There has long been a feeling amongst junior doctors that Jeremy Hunt is either incompetent at his job or deliberately messing things up. This feeling is not helped by the fact he appears to do his best to avoid any kind of honest debate.

If he continues to avoid debate over important issues, you can only help but wonder before this total lack of trust starts to carry over to his political masters.

NB: The full debate can be viewed here. Scroll down on the right-hand side to 11:00 to ‘Urgent Question – Junior Doctor Contract’.

3 Charts That Should Convince You Doctors Are Being Poorly Treated

For those living under the proverbial rock, junior doctors are very angry with Jeremy Hunt. So much so, they are threatening strike action.

Over the last few weeks, there’s been a lot of information coming from both sides of the dispute. Everything has got quite complex.

To help ease any confusion, here are three charts based on government documents. They help explain the changes junior doctors are facing.

1. Basic Hours Are Increasing More Than Basic Pay

change in basic pay_edit.fwThe original review into junior doctors pay gave four options for social hours pay (A, B, C, C+). These are shown in the chart above, along with Jeremy Hunt’s most recent offer.

Jeremy Hunt’s heavily publicised offer of an 11% rise is actually less than all four of the original options.

It is important to note that whilst social hours pay is increasing by up to 19%, social hours are increasing by 50%. This effectively means junior doctors will lose most of their antisocial hours pay without being effectively  compensated by a rise in social hours pay.

2. GP Trainees Are Facing Up To A 31% Pay Cut

gp_trainee_pay_edit.fw

Currently trainee GPs are paid a supplement to make their pay equal to doctors in hospitals. This is done in order to make general practice a more popular career path.

The proposed contract would remove this supplement, which can be up to 31% of a trainee GPs pay. This would make general practice less attractive at a time when it is already suffering from a recruitment crisis.

‘Flexible Pay Premiums’ have been proposed to replace the original supplement. These premiums can be adjusted over time depending on recruitment and retention. This theoretically means that if GP training slots were consistently filled in one area, the pay premium would be lost.

The reasoning for replacing a pay supplement with a pay premium which has an identical raison-d’etre is not given.

Overall, this means trainee GPs face the possibility of a future pay cut not because they deserve one, but because their employers have managed to find the necessary amount of employees.

 

3. Saturday Will Become A Weekday

sociable_hours.fw

Junior doctors are expected to work whatever shifts are given to them any day of the week. Currently, Mon-Fri 7am-7pm is classed as sociable time and paid at a basic rate.

The proposed contracts would change sociable hours to Mon-Saturday 7am-10pm (a 50% increase) and would make working a Saturday evening identical to working Monday morning.

Shifts during antisocial hours are paid at a higher rate. A decreased amount of these shifts will mean a decreased overall pay packet. This will be especially true for jobs which work lots of nights and weekends such as A&E, anaesthetists and obstetricians.

In summary, doctors are facing more weekend work for less money. Some will have less annual leave. Some of those training to be GPs face losing nearly a third of their income. They will get a maximum 19% increase in social hours pay for an increase of 50% in social hours.

Most people would be willing to strike over such draconian measures. Many have struck over less. Very few would expect those who look after the nation’s health on a daily basis to be so poorly treated.


 

There was originally another chart here describing annual leave changes.

After some confusion, it turns out that annual leave varies a lot by area and by experience. The original chart has been removed to avoid confusion. 

The proposed changes will give doctors 25 days annual leave, rising to 30 after five years of service. In some areas, this will be a decrease; in some areas, it will mean no change.

Health and Politics: This Week’s Agenda

This is the first in a weekly series of posts that aim to explain what our politicians are doing about health-relates issues. 

Published each Sunday, these articles will look at the Parliamentary agenda for the week ahead. This series aims to clarify what events are happening, which ones matter and why you should care.

Monday 16th

The Public Accounts Committee (PAC) is looking at the management of adult diabetes services in the NHS. The PAC looks at how government departments spend their money, and is widely respected. It can drag anyone in front of it for questioning, and doesn’t always treat them nicely when they get there.  This session’s victims include Simon Stevens, the head of NHS England

It’s usually pretty scathing in its reports, and recently eviscerated the Government for its handling of Kids Company, a charity which collapsed into financial ruin despite huge grants from central government.

This session, and its report that’ll come out later, won’t produce any changes in law. However, it’s evidence carries a lot of clout and influences many future decisions on policy and management.

Tuesday 17th 

The monthly pantomime that is Health Questions, where for three hours, Jeremy Hunt and his junior lackeys will avoid answering questions from other MPs.

A disappointing set of questions this time around, as at least six look like they’ve been tabled just to give a chance for Jeremy Hunt to hear how well he’s doing (despite all evidence to the contrary).

There’s still a slight chance of something interesting happening though. Things to look out for include:

  • The inevitable row over junior doctor contracts
  • Quite how badly the Government answers a question on the availability of off-patent drugs, given that a heath minister Alistair Burt, blocked a bill that would’ve made such drugs cheaper just two weeks ago.
  • The likely spat between Phillip Davies and Jo Cox over hospital car-parking costs. Davies infamously blocked a bill that would have made hospital parking cheaper for visiting carers.
  • Ministers trying to appear informed about genomic medicine, and the genetic issues around first cousin marriages.

Wednesday 18th

The House of Lords is having a chat over dinner about improving stroke care. In what is delightfully called ‘Dinner Break Business‘, peers get to chat about whatever issues they feel are important whilst everyone else is having food. These debates can get quite technical and detailed, and generally are a lot more informed than Commons debates.

Thursday 19th

Backbench MPs have organised a debate on ‘A New Cancer Strategy’. Backbenchers are those who don’t hold senior positions in the government or opposition.

David Tredinnick, Parliament’s very own witch doctor, was involved in getting it organised. Tredinnick is famous for believing surgeons don’t like operating in the full moon as blood doesn’t clot properly, so there’s potential for some very wacky ideas to get thrown about.

Almost as equal a nutball is the previously mentioned Phillip Davies, MP for Shipley. Davies’ claims to fame include being Parliament’s biggest producer of hot air and for getting in a recent argument over whether to debate International Men’s Day.

Davies got his way but will be talking in Westminster Hall. If the Commons chamber is the Premiership, Westminster Hall is the Vanarama League. Seems about right for as silly an idea as International Men’s Day. It’s a great shame that the very serious topic of male suicide is being discussed alongside it.

Friday 20th

Despite many members returning to their constituencies on Thursday, apparently the House of Commons thinks Fridays are great times to discuss new laws. Specifically, they debate Private Members Bills, which are introduced by normal MPs, rather than the Government.

Unfortunately, these bills can be ‘talked out’ by MPs who think they’re a bad idea. Basically, this involves chatting enough nonsense so that there’s no time to vote.

Phillip Davies, who by now is seeming like a thoroughly disagreeable human being, does this quite a lot.  Ideas up for debate include:

  1. Introducing compulsory emergency first aid education to secondary schools
  2. Increasing provision of independent mental health advocates in England
  3. Making service commissioning more equal towards those with mental illness and learning disabilities
  4. Increasing provisions for mothers, and expecting mothers, with mental illness

Unfortunately, if the first aid bill uses up all available time, then every other bill can be blocked by just one MP shouting object. If this happens, bills get shoved to the bottom of the debate pile for next time and have no practical chance of becoming law. This might be the single stupidest thing in Parliament, which is quite impressive given the intelligence of some of its occupants.

The Lords are also debating a bill which will give more money to mesothelioma research. A commendable idea, but it won’t ever happen, unless an MP in the Commons decides to pick it up.

Gay conversion therapy – going the way of the lobotomy?

Surgeons preparing to perform a lobotomy, 1941
Surgeons preparing to perform a lobotomy, once thought to be a promising procedure (1941).

50 years ago, the sight of surgeons preparing to perform a lobotomy would not be uncommon. 17,000 Britons were lobotomised for various reasons – including homosexuality. Despite huge step forwards in LGBT rights in the UK, gay conversion therapies are still on offer. On November 3rd, MPs will debate whether to send these therapies the way of the lobotomy.

Gay conversion therapies, according to their supporters: “might be able, with help and support, to achieve some degree of change in orientation.” However, medical professionals and LGBT activists say that there is no evidence for the therapies.

The debate has been called by Conservative Mike Freer, MP for Finchley and Golders Green. In a piece on Politics Home, he said: “The practice of ‘conversion’ therapy has no place in our society, no place in our health care system or in our schools. Ban it”

Mr Freer is well-known for his campaigning on same-sex issues, and revealed he was gay to his fellow MPs whilst debating same-sex marriage.

The debate is scheduled for 4pm in Westminster Hall. While the debate will not cause a change in the law, Mr Freer hopes that event will spur politicians into future action.