The Best Way To Privatise The NHS?

Posted on 29th March by whatthebleepdoc

How would you privatise the main thing that makes most people proud to be British?(1)

Start by putting yourself in the shoes of the current Health Secretary. You have helped write a book recommending the privatisation of the NHS with you stating “our ambition should be to break down barriers between private and public provision, in effect denationalising the health care in Britain.”(2) You have a cousin who was previously MP for South West Surrey and Health Secretary who may have helped you get the same positions; she is now a director for the private healthcare company Smith & Nephew and before that, for BUPA.(3) Now let us presume that you want to privatise the NHS, what would you do?

What would you do first?
Public announcement of privatisation would see public outcry, and once the public were against you, you’d probably lose your job as Health Secretary. Public support is KEY!

How to Privatise?

“The standard technique of privatisation: defund, make sure things don’t work, people get angry, and you hand it over to private capital.”(4)

When the NHS doesn’t work you will need to aim the public anger towards the healthcare employees failing to deliver the service. You will need to concentrate on feeding stories to media to help spin and support your campaign to land the blame at the feet of the healthcare professionals.

Defunding the NHS by directly reducing the amount of money given to healthcare is too public and will get heavily scrutinised. If you find a way to stretch services without additional funding, it will have the same impact. It will make sure services across the board fail.

Choosing a Service to Stretch.

You will need to pick a service that will get public support. The obvious choice would be emergency care services, as everyone wants the best emergency care possible, but what would you stretch with this service? You can’t make people have more accidents or more heart attacks to strain the services and the service is already 24/7.

Elective services are currently supplied 5 days a week. Why can’t you have the hospitals doing knee replacements and hernia repairs 7 days a week? Surely the public will support extending these elective services to 7 days a week? You can also build your campaign around a ‘7 day NHS’ to blur the lines between emergency and elective services which will help you build support.

You will have to change the contracts with all the healthcare professionals so you can stretch the current elective workforce over 7 days, and make these contracts cost neutral to provide an unfunded new service.(5)

Choosing a Profession to Target

You don’t want to take on all the healthcare professionals at once as this will unite them, and they could block your plans. So you need to take them on one at a time, but which professionals to start with?

1. Nurses have to do some of the hardest and dirtiest work, and on a modest wage. It would be hard to take nurses on first if they don’t agree to your contract and they will most likely have overwhelming public support.

2. Consultants would be easier to portray as greedy, money hungry doctors, however they also have a lot of power they can leave or decide to retire early and they are difficult to replace. 

3. Junior doctors are a group of people, doing quite well at life and not getting a bad salary. They are reasonably young and impressionable that you should be able to manipulate and once they have taken the contract you will be able to push it onto consultants, nurses, paramedics, healthcare assistants, lab technicians, cleaners, administration staff and all the other healthcare professionals.

Would you privatise the NHS any other way?

Jeremy Hunt could not have predicted how proactive junior doctors were to standing up to his contract(6) and to proceed to take industrial action. He couldn’t have predicted the public getting behind and supporting junior doctors throughout the process, but don’t believe that Jeremy has made a big mistake. He has planned the best way possible to privatise the NHS, he’s currently just hitting a feel bumps in the road.

 1. http://nhap.org/the-nhs-remains-the-thing-that-makes-most-people-proud-to-be-british/ 

 2. https://whatwouldvirchowdo.files.wordpress.com/2015/09/direct_democracy___an_agenda_for_a_new_model_party.pdf 

 3. http://www.smith-nephew.com/new-zealand/about-us/who-we-are/our-board/

 4. https://politicsbitesize.wordpress.com/2013/10/11/debunking-the-defunded-nhs/

 5. http://www.itv.com/news/update/2016-02-11/can-junior-doctors-contract-really-be-cost-neutral/

 6. http://www.whatthebleep.co.uk/

Mr Cameron’s Post-Budget, Pre-Strike World

Posted on 20th March by doctoroxforduk

Here we go again. A week overwhelmed by fallout from the disability benefits debacle, ended with a barely-registered pipsqueak of news: that the BMA voted last Friday to escalate its industrial action.

No more 48 hour strikes for junior doctors. Next time will be a step change, a cranking up of the pressure. Whatever form this escalation takes, the prospect for patients is bleak. The government, hell-bent on imposition, flat refuses to lose face by climbing down. Meanwhile, the BMA is ramping up retaliation on every front: judicial, industrial and public relations. To borrow the marshal language of which Mr Hunt is so fond: two tribes, back at war, with patients still stuck squarely in the middle.

The longer this dispute endures, the more people are asking: ‘what on earth are they still fighting so bitterly about?’ Confusingly, the answers provided by both government and BMA have patient safety at their core, yet are framed within two radically different narratives.

The government insists this is a pay dispute in which the key sticking point is overtime on Saturdays. For them, the broader narrative – the entire raison d’etre of contract reform, no less – is honouring an election manifesto pledge to deliver a ‘truly seven day NHS’, thus protecting patient safety at weekends.

The BMA’s narrative is in flux currently. Until last month, its messaging was hampered by its acceptance of the government’s precondition that delivery of new seven day services must occur within the confines of a ‘cost-neutral envelope’. The new junior contract, in short, could cost no more than the old one, despite delivering new weekend services. That, with hindsight, was a tactical blunder. It meant inadvertently colluding with the government spin that you can somehow provide seven days for the price of five. It also gave the government free reign to frame this dispute as hinging on minutiae: overtime, Saturdays, quibbles.

As of last month, however, the BMA junior doctors’ committee voted to reject the principle that a new seven day NHS can be delivered ‘cost-neutrally’. Its narrative now hinges on the fact that a ‘truly seven day NHS’ is not possible without truly seven day staffing. New doctors are needed to provide new weekend services, not merely the same ones stretched more thinly.

Forget pay, forget Saturdays. What really puts the fear of God into grassroots juniors like me is the sheer, ignorant audacity of a government insisting we can deliver new, all-singing, all-dancing seven day services with a mere re-jigging of our shift patterns. That smacks of utter obliviousness of what life is actually like on the NHS frontline right now. We have nothing, just nothing more to give. Hospital overstretch is already dire, a real and current danger to our patients. Short-staffing blights every doctors’ rota. And unlike aviation where, if an airline pilot loses their co-pilot, the plane will immediately be grounded, in medicine the junior doctor is invariably forced to shoulder their missing colleague’s workload – on top of their own. Crippling for doctors, potentially lethal for patients.

We oppose this contract, in short, because we cannot endure being stretched more thinly still, and we will not permit our patients to be endangered by that over-stretch. Even the Department of Health’s own data demonstrate that at least 4000 more doctors are required to deliver safely a seven day NHS.

So where do we go from here? Would putting temporary brakes on imposition really be so hard for the Prime Minister? Having been accused this week of picking the pockets of the disabled while lining the purses of those rich enough to benefit from cuts in capital gains tax and higher rate interest tax, Mr Cameron’s assertion that “we are all in this together” is looking increasingly shaky. First the tax credits climbdown, now disability benefits. Driving bullishly on with imposing a seven day soundbite backed up with neither evidence nor funding may yet prove to be his third misjudgment of the mood of the nation.

It seems pretty simple to me. Either Mr Cameron is serious about delivering a seven day NHS, or he’s not. Either he demonstrates precisely how he will fund and staff his ‘pledge’, or he needs to back off doctors until he’s done so. Just as doctors practice evidence-based medicine, so too do governments owe electorates evidence-based politics. When we have hard, public data on the costs and staffing requirements of seven day services, then – and only then – can we negotiate a new contract fit for purpose. The onus is entirely on you, Mr Cameron.

The Government Aren't Listening. Time To Make Them.

Posted on 13th March by JuniorDoctorBlog

The junior doctor contract dispute has taken its toll; eight gruelling months, three major protests, four days of strike action, and 54,000 angry, articulate, dedicated individuals.

We have staged sit ins, delivered giant books, set up fake betting shops, supported two hugely successful choirs and one Christmas number one, created fashion lines, and even collaborated with a Time Lord or two. We have become our own investigative journalists: uncovering dubious research practice, revealing departmental incompetence and lies, and documenting tragic cases of the government’s spin causing real patient harm. We have become our own researchers: revealing flawed data, misrepresentation of statistics and huge holes in the government’s ‘evidence’ arguments. 
We are not giving up anytime soon.

Why are we doing this? David Cameron and company would have you believe we are grabbing for a payrise, grabbing for free weekends and better perks. Many of you know by now this is simply untrue.

What we are terrified of is an imposed contract, unmodelled, uncosted, and unbelievably unsafe. The NHS is on its knees- the knock-on effect to recruitment and retention alone, not just for junior doctors but all NHS staff, could collapse the entire service.

So what next? How can we make a government listen to our concerns.

This. We, a group of patients, doctors and NHS staff, are proud to announce the initiation of a second independent judicial review into the junior doctors contract. We are not the BMA- they have challenged the government as an employment dispute, on equality grounds.

We are challenging them over patient safety- patients who are concerned an already underfunded NHS cannot cope with the government’s insistence on ‘7-day’ services without additional funds or additional doctors. We have huge gaps in cover already-60% increase in rota gaps for doctors, 50% increase in agency nurses in a single year. 9/10 junior doctors have said they will resign if the new contract goes ahead. Even if 1/10 actually leave- for locum work, abroad, pharmaceuticals, or even simply stop being doctors- the system will crumble. Then the nurses, the pharmacists, the AHPs, the consultants, the GPs will undergo the same.

We have instructed renowned Human Rights and judicial review specialist law firm, Bindmans LLP, to investigate the legality of the decisions of the Secretary for Health. We will ask for a wide-ranging review into the impact on staffing, costing and the evidence for need and benefit of imposition. We will force the government to finally listen, and come up with the so-far missing evidence to back up months of wild claims and false promises.
At the very least we will see the necessity, and take the time to consider the biggest gamble in the history of the NHS. At best, we may finally prove that the DoH and government have been peddling smoke and mirrors, and find the real reasons for the underfunding, the enforced contracts, the increased privatisation. Most importantly, we may avert catastrophic patient harm.

What can you do to help?

We are not an organisation- we are simply individuals who care deeply about the future of the NHS. We are crowdfunding our case here, at CrowdJustice. Follow us on Twitter and Facebook as #JustHealth. We are off to a great start, but need at least £100,000 or more to fund such a complex and important legal action. We will possibly need more to keep going, and it will be only your support that will make this possible.
For years I have ranted on about trying to save our NHS. Many of you agree, but ask “what can I do about it?”
This. You can do this.

We can save our NHS. We must.

Juniordoctorblog.com

 

The Demoralising Hunt

Posted on 10th March by Clinoncdoc

I am a junior doctor striking for the third time in only a few months, but I do so in despair. We have heard every junior doctor apologise repeatedly for the cancelled operations and clinics and repeatedly re-iterate that we would not be on strike given the choice. This is not junior doctors towing the party line, but truly how we feel. 

It is no secret the majority of doctors get a kick out of helping people. Yes, there’s an attraction to the intellectual challenge in a dynamic landscape often on the cutting edge of technology, but it is contact with patients that drives the vast majority of doctors. We are people-pleasers. Perhaps more than most other professions, doctors’ thrive on a positive public opinion and sense of value. It is confirmation that as a profession, we are keeping our patients happy and safe. I still get a buzz when I know that my actions have directly contributed to my patients’ wellbeing. Working in the emotive field of cancer, that feeling can sometimes be overwhelming. Perhaps part of it is for my ego, but my drive remains singular – I always want what’s best for my patients. 

So imagine my despair when Jeremy Hunt and David Cameron decide to make wholesale changes to how I deliver care without having modelled, costed, or staffed their punitive contract. Neither the Government nor NHS leaders have any idea of what it will cost to implement the ambiguous ‘7-day NHS’. On the back of £22 billion in cuts deemed ‘efficiency savings’ the reality is the money just is not there. The Government’s own risk assessment state that this contract cannot be ‘cost-neutral’ without impacting care.

Sample rotas provided by NHS Employers had doctors cycling frequently between night and day shifts, often with only 1 day in-between to try to adjust. Experts have reviewed these rotas and deemed them inherently unsafe as they will lead to jet-lagged doctors at risk of making mistakes. The rotas also don’t encourage continuity of care (being seen by the same doctor or team throughout the week). This will have a huge impact on patient safety and satisfaction.

There is a shortage of 6000 doctors and 23000 nurses in this country. Mr Hunt is not magically creating the required number of professionals to staff his ‘7-day NHS’. Rota gaps are ubiquitous. In the coming months, my own department will be searching for 3 locum registrars to ensure emergency cancer-care is safely staffed. The Health Service Journal has reported some Trusts cutting nightshift cover due to substantial vacancies (one Trust  was down 18 general medical registrars) Demanding the same number of doctors to do more for the same pay is not only unfair, but inherently unsafe.

What has hurt me the most, is how my own Health Secretary has used inflammatory and often military language in this process. He has said that I lack vocation when I regularly stay hours beyond my rota at no extra cost to ensure patient safety. I have gone 13 hours without so much as a meal or bathroom break for my patients. I have routinely missed birthdays and weddings. I have come in on my time off to prepare for clinical exams because my trust did not allow me enough training time. Doctors jeopardise their own health and wellbeing for the benefit of their patients. To then be insulted by our own health secretary is damning.

Mr Hunt has frequently used military language to describe me. I have been called a militant and he had no qualms about using his ‘nuclear option’ of contract imposition. Somewhere in this debacle, Mr Hunt has forgotten that I’m neither an anarchist nor a terrorist. I’m a geeky member of society that has studied exceptionally hard to get the grades required for Medicine. I left university with a personal debt of £50,000. I continue to study, attend courses and take post-graduate exams (all at my own expense) to further improve the care I deliver to my patients. Mr Hunts language has left me despondent. Do all my efforts and sacrifice not count for something?

Mr Hunt has painted me as money-hungry deviant. He suggests that I work unnecessarily long shifts to earn ‘danger-money’ – a term that no junior doctor has ever heard or used. He suggests that the industrial action is all about ‘saturday-pay’. I never asked for a pay-rise, and I certainly am not striking to get one. For Mr Hunt to publicise such a notion means he simply has not listened to my concerns. Worse still, he is actively attempting to spin public opinion against me through lies and manipulation.

It is clear Mr Hunt will go to just about any length to denigrate junior doctors in this ‘battle’. Recently, Mr Hunt used the Paris attacks to score political points against junior doctors.

The media have certainly played their part. The rightwing media have lambasted junior doctors in recent months. We have been vilified for taking holidays and drinking alcohol and unfairly been labelled ‘Moet medics’. We are repeatedly called money-grabbing. Mr Hunt’s influence over certain media outlets is well known, and it’s appalling that my own health secretary would go to such lengths to denigrate me in pursuit of political points.

For a group of professionals who thrive on being liked and valued, Mr Hunt’s method has been catastrophic. With morale at an all time low, and recruitment and retention of doctors in crisis, his handling of this debacle has alienated an entire generation of doctors who may no longer go the extra mile.

It has never been more apparent that Mr Hunt’s rare kind words about ‘valuing junior doctors’ are nothing more than lip-service. Mr Hunt has been caught on camera running away from a junior doctor trying to raise his concerns. He recently moved a public meet-and-greet to a secret location for fear that junior doctors may attend.  Mr Hunt has repeatedly refused to meet junior doctors face-to-face, declining all invitations to a television debate with doctors. 

For a man who’s door is always open, it is impossible to find the door.

Find me on Twitter: @clinoncdoc

 

Junior Doctors On Strike - On The Digital Picket Line

Posted on 10th March by Josephine Neale on PsychSite.

I am a junior doctor.

As a CT3 in Psychiatry, I have spent five years as a junior doctor. I will spend at least another three years as a junior doctor in training, probably longer depending on the route I take through specialty training.

Today I am junior doctor on strike. I feel proud and strong, but at the same time I feel guilty and deeply saddened by what we have come to. Here's why.

Image from www.bbc.co.uk

In September 2015, when I first heard talk of industrial action. I was on-call for the first planned strike in December, providing emergency cover, so the decision of whether to strike or not was made for me. I was secretly glad not to have had to make such a difficult decision. The strike was called off. I breathed a sigh of relief and hoped that negotiations would resume and industrial action would just fade into the background.

I couldn't believe it when talks broke down so soon, in January 2016. I admit, I buried my head in the sand. I felt extremely uncomfortable with joining the fight against an employer that gave me a job, gave me a salary and gave me the career I had dreamed of. I didn't fully understand the arguments on either side. I was frightened, confused and terrified of losing my job. Doctors had not been on strike since 1975. For a caring profession, it seemed such an aggressive act. On the 12th January, the day of the first strike, I went into work.

Where I was working at the time, there was no picket line to cross, no angry junior doctors to confront me on my way in to the building. It wasn't about losing pay. I just didn't know what to think. I have family members who have been involved in industrial action in other industries and I have witnessed the terrible fallout of this. While I was frightened of the pressure to strike, I was also ashamed as my colleagues from other professions looked silently stunned when I entered the office.

I didn't tell any of my friends about my decision not to strike. I only told two other doctors, and one of those was my consultant. Some of the changes in the new contract didn't seem that bad. My fear was that we were digging our heels in without compromise. I had struggled to understand the nuances of the current contract, let alone the endless possibilities of the new one. I started a new job in February 2016 and was faced with yet another day of industrial action. I felt torn by my loyalty to my employer and my loyalty to my colleagues, who stood outside with their placards as I persisted with my day-to-day work. I felt guilty about leaving colleagues overstretched and unsupported. I just could not convince myself that strike action would resolve anything.

However, when I did more listening and reading over the weeks, I found that actually, with industrial action taken so far, the contract proposition has changed for the better.  It has been extremely difficult to obtain accurate information about the disagreements - and I am referring to both the government and the BMA when I say that. Neither side has handled this perfectly. What doctors really want is for the negotiations to restart in order to resolve all of the disagreements safely. What we're really angry about is how much uncertainty is left in the new contract and the way it has been imposed. You can read a basic explanation here about how we got to this point.

Image from www.bma.org.uk

So here I am today, I am on strike.

Some will wonder why it took me so long to get here. I would argue that I am now more confident than ever that this is the only way to have the voices of junior doctors heard. No-one wants to be on strike but we have been backed into a corner. I still feel torn and confused, but we cannot have overtired doctors making mistakes. Some will wonder why I am not out there in the cold and the rain shoulder-to-shoulder with my colleagues on the picket line. I thought about picketing at the hospital where I work. I considered going to the hospital near where I live. I am hugely grateful to those who have picketed, but I thought I could reach more people on the digital picket line. According to healthcare social media site symplur.com, over 38,000 people used the hashtag #JuniorDoctorsStrike yesterday. Please help us spread our message.

The contract might actually be better for some specialties. With 56 different different specialties and thousands of different rotas up and down the country, it is near impossible to get one contract to suit all. But for the majority, the unwritten contract is unsafe. We need certainty about rota design, we need guarantees that we will be adequately rested. We need reassurance that steps will be taken to improve recruitment of junior doctors, instead of frightening them off with more hours for no more pay. We need details of how non-resident on-calls will be paid, we need guarantees that we will not be switching from day to night shifts like yo-yos. We need funding to be allocated so that a seven day service is not paid for by simply stretching a five day service.

Doctors don't mind working odd hours - quite frankly we expect it. People get sick all at times of the day and night. But we would at least like fair compensation for all the family time we miss, for the weddings and birthday parties we can't attend, for the Christmases we spend with our patients rather than our partners and children. The government will tell you they have offered us a 13% pay rise, which we have rejected. They forget to tell you this is to replace the 20-50% 'banding' top-up which most doctors receive for out of hours work.

I am striking for all those doctors who have missed out on family time. I am striking for my friend Anna, who did a PhD in the middle of her medical degree and now, while trying desperately to further scientific research as a doctor, risks being punished financially for taking time out to pursue academic work. I am striking for my friend Fiona, who works tirelessly as an Accident & Emergency doctor, already has one of the most antisocial shift patterns I have ever seen and needs the guarantee of a safe and well-staffed rota so that neither her nor her A&E department collapses.

I am striking for all those doctors who have fallen asleep in the middle of a shift from sheer exhaustion. I am striking for all those doctors who have stopped training in a specialty they love, a National Health Service they love, or even a country they love, because they can no longer cope with the demands placed on them. I am striking for the future trainees who will have to work on a contract we have negotiated for them.

Image from www.bma.org.uk

Doctors are intelligent, kind and compassionate. We are highly trained to treat you with the best evidence-based practice. We are highly trained to analyse statistics from medical research. Doctors are not money-grabbing, champagne-swilling gluttons. My email inbox is topped up on a daily basis with offers of more money for fewer hours in the private sector. But we love and believe in the NHS and what it stands for. You trust us with your lives and rightly so. Please trust us when we say the new contract is dangerous - for doctors and patients.

The BMA website has further information on how you can support junior doctors.

There are more strikes planned. For everyone's sake, I hope they don't happen. I hope we can reach meaningful negotiations before then. We are one profession. We stand together.

The Battle For Our NHS Is Nearly Over. And We Are Losing.

Posted on March 8th by Junior Doctor Blog.

Be kind, for everyone you meet is fighting a battle you know nothing about.
Wendy Mass, The Candymakers

There are secret battles going on all over the country right now: battles to keep teachers, fire fighters, police officers in work, to protect the rights of disabled people, and save children from poverty. The NHS is quietly becoming a war zone all by itself; there are battles to stop stripping student nurses of their bursaries, to stop A&E and maternity closures, to keep community pharmacies open, to challenge consultant contracts, to keep GP practices open, and the most publicly of all; to halt the imposition of the junior doctors contract.

These battles are secret not by our choosing- I have colleagues who have done nothing but work themselves to the bone for the last eight months to try to get the word to you- I hope you were listening. Many mainstream media outlets were not. The uphill struggle to even dent the public perception from the governments spin machine has been titanic. I still think we haven’t got even halfway there.

This isn’t about weekend pay or hours, it’s a little about unsafe staffing and a lot about dangerous underfunding of the national health service. What it’s mostly about is challenging a government set on dismantling the free at the point of use service of the NHS.

Since 2010, on every recordable measure the NHS is failing: waiting times, staff retention and recruitment, funding ‘deficits’. If you want to get really simple: death rates are up. Let me reiterate that- since 2010/12, after fifty years of steady decline, death rates in the UK have started to rise. More people are dying. THIS is the result of a financial crash and a Tory government ‘not letting a good crisis go to waste‘- pushing an ideology of public sector sell off and shrinking of government that is the core of conservatism.

You might think they’ve gone too far- I do. So does Prof Don Berwick, the Nuffield Trust, the Financial Times and the Kings Fund to  name a few. The deficit is £97 billion, the national debt is £1.6 trillion– there is no ‘balancing of the books’. Austerity was a great lie. This is a government of PR, not policy.

Now circle around to the junior doctors’ contract dispute. The contract is a means to provide lucrative cheap elective weekend work at the cost of safety to patients during the week. There are no more doctors to provide these services. The National Audit Office and Cass Business school said these changes ‘posed a genuine risk’ and may ‘breach employer duty of care’.

Why would David Cameron do this then? Because for twenty or thirty years successive governments have tried to privatise health in the UK: the head of the NHS is an ex-US health care executive, Virgin own many NHS community services ALREADY in the UK, the former Health secretary now works for a private health consultancy, £1.5 billion pounds of private contracts linked to companies of sitting MPs. Still don’t believe me? Here is the plan- from 1988 Britains Biggest Enterprise by Oliver Letwin, current Tory advisor and strategist. Here is the plan revisited in 2005- Direct Democracy, co-written by current health secretary Jeremy Hunt.

The plan is to drive down terms and condition, create an unworkable and unsafe NHS, and then in a crisis- roll in private companies. As they say- ‘never let a good crisis go to waste’. While people, other normal human beings will suffer; your families, grandparents, uncles and aunts.

That is what this fight is about. The battle for the NHS has raged for thirty years, and you mostly had no idea about it.

I have colleagues who spend all their own time organising, campaigning, giving interviews, challenging the government to show us we are wrong; and thus far all we are met with is lies and spin. Colleagues who have taught themselves law, economics, public relations, journalism, song-writing. These men and women are all working doctors, nurses, physios and AHPs- saving your life as a day job, trying to save your health service from home.

We are doctors who want to do our jobs; to protect the health of our patients. We are fighting because banging our heads against the wall just isn’t enough anymore.

We will fight them in the courts.  The BMA is launching a legal challenge to the contract. It will force the government to legally show us that they will not harm patients, that they will not create further crisis in the NHS, that they are doing as they say, and acting in the best interests of patients. We know they are not.

We will fight them on the streets. Join us on the picket line on March 9th and 10th March. Show them you value the service and staff of the NHS. Come and talk to us at Meet The Doctors events. Find out more here.

We will fight them in Parliament. The NHS reinstatement bill has its second reading on the 11th March- it challenges the legality of privatising the NHS and the market that encourages private takeover, at huge public cost. Write to your MP and tell them you support this bill. https://speakout.38degrees.org.uk/campaigns/685

The fiercest battle is sometimes one you never heard of. Don’t let this one be – join us in our fight to save our NHS. To paraphrase a superb junior doctor on social media; “in two decades time you can tell your kids the reason there’s still an NHS is because twenty years ago you stood up for it”.

Stand up.

Juniordoctorblog.com

Omnishambles? It’s far worse than that.

Posted on February 29th by Junior Doctor Blog.

It’s been a long week for the NHS in politics. The week opened with the announcement of further doctors strikes, three 48-hour emergency care only periods in two months, plus the launch of a legal enquiry into the imposition of the contract.

Jeremy Hunt’s and David Cameron’s argument  goes like this;

“Studies show we have excess death on the weekend because we do not staff our hospitals properly. We need to create a ‘7-day’ NHS to fix that, and this junior doctor contract is needed to do so. We are putting £10 billion into the NHS to achieve this.’

The government has spun a tight narrative over the last six months- but this week it began to unravel.

Firstly the most quoted ‘study’ it emerged last week was shown to the DoH and Jeremy Hunt before it was verified and published; a serious misdemeanour for both ministers and ethical research. David Cameron missed the point at PMQs, mixing up two studies from different years as ‘estimates’, and continuing to misrepresent both. Interestingly he claimed that the Freemantle study arose ‘based on a question asked by the Health Secretary of Sir Bruce Keogh‘. Did the Prime Minister just intimate the government commissioned its own research?

Staffing hospitals is a major issue it would seem- but not at the weekend, throughout the week. During a DoH public accounts committee meeting it became apparent that due to overzealous ‘efficiency’ targets trusts were told to reduce staffing. When this became unsafe they hired agency staff to fill the rotas leading to the £2.8 billion deficit this year

NHS chief executives are also concerned that trusts prioritise ‘quality’ over ‘costs’. In healthcare I think most people would do the same.

On top of this the BBC reported a 60% rise in vacant posts for doctors and a 50% rise for nurses in two years. With so little staff do the department of health think it safe to stretch the NHS to a ‘7-day’ service?

Well it would seem they haven’t thought about it at all. In the same PAC meeting it emerged the Dept of Health have no formal strategy for ‘7-day’ services; they don’t know how much it costs, they don’t know how contract changes will achieve it and they don’t know the impact it will have. That sounds very dry so let me characterise that.

You go to see your doctor feeling tired. She says “you have cancer and we must start treatment straight away.” You are rightly upset.

“How do you know?” You ask.

“Well there are significant ‘data gaps‘ in the judgement, it’s not just scientific fact you know, and we need ‘certainty‘ going forward so, yeah. But we must start treatment straight away- I don’t know how much it costs, what the treatment is, and it’s probably very damaging. To be honest, I have no idea. I’m ‘flying blind’ on this one, but I’m going to impose this treatment anyway, because I’ll get sacked if I don’t’.

So where did this contract come from, if the DoH hasn’t actually done the work that demonstrates its necessity?

In a great article that looks into its origins Steve Topple reveals a group of hospitals proposed taking advantage of a (disappearing) excess of doctors in training to drive down pay and conditions. The originators of that work now hold high level positions in the NHS administration.

Lastly, the money. The NHS needs £30 billion to maintain current standards by 2020. The government chose to make £20 billion of cuts to services and put in the least funding rise in the history of the NHS- 0.9%/year. This is the £10 billion in every Tory quote- that was only ever going to (try to) keep the lights on. Cameron thinks it will pay for a 7-day NHS, despite no one knowing what that will cost, and Hunt is paying for a ‘paperless’ NHS, 7-day services and who knows what else. The £20 billion in ‘cuts’ is already creating huge deficits in care- the £2.8 billion ‘deficit’ this year in trusts is a direct consequence of this political decision. Despite the governments insistence- the NHS is dangerously underfunded.

In a speech to the King’s Fund, Professor Don Berwick, US healthcare expert and former government patient safety advisor, agreed;  “I know no nation that is seeking to provide healthcare at the level that western democracies can at 8% of GDP, let alone 7 or 6.7. That may be impossible.”

Meanwhile the NHS crumbles- in a stage managed fashion as private companies come to collect. This is #cams7dayscam, and far from being an omnishambles it is a controlled demolition.

We need to make it clear to sitting MPs that this is a disaster that we will hold them personally accountable for, an issue that will make or break their political careers for years to come.

The NHS is nearly done- record waiting times, record deficits, record staffing gaps, record low morale. It needs more money and better leaders. We are desperate to get this message out: if you want the NHS to survive you must fight for it, because David Cameron and this government are going to destroy it if you don’t.

Join us on the picket lines March 9th and 10th.

Juniordoctorblog.com