The speech by Jeremy Hunt, our erstwhile Health Secretary has caused undue stress and anger among the health professionals, particularly consultants. He claims the consultant do not work over the weekends! I am not sue where he got this information from. I was operating last Saturday and counted not less than 11 other consultants working in the theatres along with number of junior doctors, nurses and allied professionals. This did not include those working in A&E, path lab, radiology etc.
He has taken a poorly performed study which only looks at gross statistics without taking into account the numerous variables which affect mortality for any admission. McCartney M in his paper (BMJ 2015;31:h3575, 6th July) unfortunately does not take into account the type of illnesses. Patients with milder illnesses are less likely to call the doctor or attend the emergency services at weekends, so there are fewer admissions and the average severity of illness is probably greater.
Prof Barer, Consultant in Stroke Medicine at Sunderland Royal Hospital has written a letter in the latest BMJ (1st August 2015) where he points out “Acute Cerebrovascular disease is the biggest single contributor to the excess of weekend deaths.” The Gateshead Stroke register shows a crude death rates of 15.5% for weekday admissions and 17.5% at weekends. There were 36% more admissions with “suspected stroke” during an average weekday than a weekend. Often the weekday admissions included higher proportion of TIA (Transient Ischaemic Attacks) and Stroke Mimics with a much lower mortality rate. The register also shows that the strokes were “milder” during weekdays.
Instead of looking for causes of increased death rates during the weekends using standardised models, the secretary of health has used on flawed study to back his claims. If we start to change our treatment modalities based on such an example, the outcomes for our patients would be disastrous.
Mr Hunt has been bombastic about his claims and statements during his speech of 16th July. He claims that he wants to change the NHS to a more “human service.” Such statements have been made by politicians in the past and the service has veered gradually towards a Manager driven service than a clinical driven service. This has caused a top heavy service lead by managers with little or no knowledge of the clinical nature of the NHS. More often than not the service is treated in the same format as a car spare part factory. It has become a numbers driven service with managers deciding on the priority of treatment. I have had patients crippled with severe arthritis cancelled by managers to allow Bunion surgery to take place purely because they “came first”!!!!
He claims that he understands Doctors and in the same speech commands “We are ready to impose a new contract if negotiations are not successful within six weeks.” He must have taken the words straight out of Stalin’s workbook!
The online petition (https://petition.parliament.uk/petitions/104334) now has has more than 200,000 signatures. As Mahathma Gandhi once said to Lord Curzon, “It is time you left,” it is time Mr Hunt left and allowed someone else with a better understanding of the health service to take over the mantle of Health Secretary.
Prof Barer ends his letter by saying “It is time to show that policy can be based on reliable evidence rather than political expediency.”
1. Basing seven day working on evidence not expediency, Prof D Barer, BMJ2015;351:h4061
2. Skirmish over seven day working, Mark Newbold. BMJ2015;351:h4082
3. Petition calling for health secretary’s resignation exceeds 200 000 supporters
4.McCartney. The Zombie Statistic behind the push for seven day working. BMJ2015;351:h3575