Meeting Jeremy Hunt

Posted on 20th April 2016 by Alex Murray on MurrayHealth

As assignations go, this one could have been like a date with the devil. An hour in a room with Jeremy Hunt? For many of my 53,000 junior doctor colleagues, this might be their worst nightmare.

Actually, the reality was rather different.

Last night I met Jeremy Hunt in the heart of the parliament buildings. I was one of the two doctors who were invited from outside the Department of Health to talk. Why were we outside the DoH you ask? A group of junior doctors launched the peaceful indefinite protest 8 days ago now to highlight Jeremy’s unwillingness to return to negotiations over the junior doctor contract. An empty chair with his name sits beckoning for resolution.
So on my day off I turned up at 9 am to wait for a chance to talk.  The support from the public, MPs, civil servants and the BMA has been overwhelming.

His advisor and secretary turned up at our protest around 17:30 and asked if we wanted to talk to Jeremy.  I did not feel rushed to go meet him but there was a definite – ‘now is the only good time’ feel. As we walked up the steps to his parliamentary office, I carried the weight of 53000 doctors hoping he’d change his mind about imposing his contract.

Was I nervous? No. I genuinely wasn’t. And the reason is this: I don’t care anymore how it started, the whole ‘he said/he said’ arguments between the BMA and Jeremy, which I can never verify because they occurred behind closed doors. Nor do I care about which point was the sticking point in negotiations. Do I want a pay cut? No. Do I want to do more night shifts? Definitely not. I know the NHS is a political bargaining chip but I even don’t care at this stage which government is tinkering with it. What matters is the patients. We need a solution, a repair and – to go one further – an improvement to the relationship between junior doctors and Jeremy Hunt. Because only in that way will we break this deadlock.

What was most striking during our meeting was the disconnect, the mismatch. We both said we want to protect patients and improve services. He trusts and respects Bruce Keogh and David Dalton, yet we junior doctors on the frontline know they are outdated and no longer have their finger on the pulse of the NHS or the lives of junior doctors. He seems to genuinely believe his new contract will save lives at weekends, we know that – contract or no contract – we simply do not have enough doctors as it is.  We are papering over the cracks in the NHS with goodwill. There are so many rota gaps I get daily emails from multiple hospitals asking for locum cover. He says he will hire another 5000 doctors, we know these ‘extra’ doctors just don’t exist. And if they did, what on earth would make them want to come work in England, where a contract is being forced upon them?

We had a civilised conversation, not a slanging match, and I asked a lot of questions, about staffing levels, safety, funding, statistics interpretation and how we came to this impasse.  Nothing new was said but under-running this discussion was the feeling that he believes what he says, though we know some, if not most of it is flawed.

Jeremy Hunt may think he is doing the best thing for us, but myself and the 53,000 doctors in uproar over this know that contract imposition is far from the best thing for our patients, us, or the future of the NHS.

So I asked the ‘what if’ question. What if you could have anything in exchange for removing imposition? His reply? ‘Nothing’.

Is there really nothing he would ask for in exchange for removal of the imposition and to work with junior doctors?
And so, sadly, the peaceful protest outside the DoH goes on in the hopes of future negotiations.

I stand for my patients and for my colleagues but, if Jeremy genuinely stands for improving the NHS, surely we should be on the same page? What would it take, Jeremy? Call me naïve, but I stand by this: it is never too late for us to find a solution together if the imposition is removed. The olive branch is there to take up. Let us pick up a clean slate and move forward together: what would it take, Jeremy?

Alex Murray
Junior Surgeon

73% Of Junior Doctor’s Want Full Walkout, after Jeremy Hunt Imposes Contract!

Posted on February 22nd by What The Bleep

73% Of Junior Doctor’s Want Full Walkout, after Jeremy Hunt Imposes Contract!

In a recent poll of junior doctors 73% of doctors want the next strikes to include a full walkout as the government continue to impose an unsafe contract.

Jeremy Hunt responded to the last junior doctor strike by stating imposition of the contract for August, and now with time running out and the BMA planning the next strikes, junior doctors have voted in a recent poll of over 504 doctors across Facebook and Twitter and online poll, with almost three quarters voting in favour of a full walkout. 

Whatthebleep‏@whatthebleepdoc

Should our next set of #juniordoctors strikes include a full walkout? #juniorcontract

73%

Yes - 369

19%

No - 96

08%

Not Sure - 39

(votes collated across social media and online poll)

There is overwhelming public support for the junior doctors who put the blame at Jeremy Hunt’s door, and comments from those doctors voting No/Not Sure raised concern that they may lose public support if there is a full walkout, however what the public need to know is that junior doctors have support from their senior colleagues who will stand in on the emergency cover during a full walkout, and although a full walkout will cause disruption it will not effect patient safety. Well known evidence has famously shown that mortality actually drops when doctors strike.

Overall this is not a decision taken lightly by doctors, but with a government not listening and not responding to the last strikes junior doctors need to turn up the pressure on the government if striking is going to be successful.

NHS Morale Should Be Our Biggest Priority

Posted on February 13th by Dr Gagan Bhatnagar on the clinoncdoc.

The Government has bulldozed ahead with the imposition of a junior doctor contract against the advice of every professional medical body in England. Of the 20 NHS chief executives that supposedly backed his imposition, 14 have stated that they in no way supported this extreme action. It is worth considering that if the Government can just impose a contract of their own accord without agreement of the other party, what is to stop them from changing their mind in the future only to impose another contract?

The crux of the contract debacle is simple, the Government and NHS Employers are looking to extend services to 7 days on a 5 day (elective care) budget. Emergency care already runs 7 days a week, 365 days a year. Mr Hunt is not proposing to increase the pool of doctors to achieve this, so he will be stretching an already over-stretched workforce more, for the same pay-packet. The simple solution: If you would like to extend services, fund and staff them appropriately. Indeed experts suggest an extra 38,000 doctors would be required to safely staff a 7-day NHS.

This debacle comes on the back of a build up of frustration within the NHS workforce over a number of years. Increasing demands, real term pay-cuts for over a decade (ignoring DDRB advice for annual pay rises with inflation), staffing shortages, no recognition of the need for rest and breaks, and no support for those in training has left junior doctors (and other healthcare workers) at breaking point. The workforce now feels under-valued and demoralised. The dissent that followed asking doctors to do more for less, was inevitable.

Senior officials within the NHS have acknowledged the demoralisation of the workforce over a number of years. I place the blame, not only with the Government, but NHS Employers. They are directly responsible for looking after their work-force, but in the pursuit of appeasing a relentless Government hell-bent on ‘efficiency savings’ and ‘extension of services’ without extra funding, they have failed their employees. Employers have failed to listen to junior doctors and have failed to engage them, all the while increasing their requirement for service provision and depleting their training time. Doctors are expected to train in the little free time they do have (often coming in on their days off, just to gain experience), pay exorbitant fees for mandatory exams, courses, and medical licenses for the benefit of the Trust and patients.

The same can be said for nurses that are ever being stretched thinner due to cost-cutting. Recent studies show that mortality was significantly improved when nurses are responsible for 6 or fewer patients. However, this is rarely the case in most hospitals. Indeed recently the Government attempted to bury safe-staffing guidelines. The Government and NHS employers are hardly champions of patient safety.

It is little surprise then. As working conditions and morale have deteriorated over the last decade, the medical profession has found itself in a serious recruitment crisis. In recent years, one third of A&E doctors have left. Last year half of Foundation Doctors did not apply to specialty, a drop of some 25% from a few years prior. Across the board, fewer doctors are choosing to continue their training in the NHS due to poor working conditions. Even more worrying is a drop in medical school applications by 13.5% since 2013 which has been linked to the continuous negative publicity.  These numbers are catastrophic.

In a capitalist society where value is measured in coin, pay is certainly part of the issue. It is worth clarifying that junior doctors have never asked for a pay-rise. The government justifies huge bonuses for bankers and chief executives to recruit and retain the best but the same does not apply for doctors, nurses, or teachers. Fundamentally, this debacle is about feeling valued and respected and thereby retaining your doctors to provide the best care possible. The persistent devaluing of bright, highly skilled and motivated staff over a number of years has lead to this crisis which will ultimately be to the detriment of patients.

Unfortunately the actions and words of the Health Secretary have not helped morale which has received severe backlash on social media. Mr Hunt has called doctors militant and lacking in vocation (#MilitantMedic, #LackingInVocation). He has suggested junior doctors don’t work weekends (#ImInWorkJeremy). He has claimed our motivations are monetary (#DangerMoney). He is closely linked with the smear campaign by Murdoch media (#MoetMedics). He has continuously lied and misrepresented scientific data, and when answers are demanded of him, he shirks his duties by failing to attend urgent questions in parliament (#TheJeremyHunt, #TheHuntHunt).

Mr Hunt has failed to meet face to face with a junior doctor in over a year, and has been caught on camera actively running away from a junior doctor on Sky TV. Furthermore, he has cancelled meetings with the public for fear of confronting a doctor. If his actions were right, he should have no difficulty justifying them to doctors face to face. This is not a Secretary of State that instils confidence or boosts morale. As the single biggest contributor to loss of morale in recent history, there was a distinct irony when Mr Hunt requested an inquiry into why doctors’ morale is so low.

Morale may seem an abstract concept to measure, but it is clear that it has never been lower in the NHS. As it continues to plummet in the face of contract imposition, doctors may vote with their feet, leaving the NHS in further turmoil. Improving the morale of staff should be the single most important item on the itinerary for NHS Employers, and they should begin by stopping the meaningless lip-service and demanding the Government retract this imposition and find a way to demonstrate how they truly value their doctors.

Dr. Gagan Bhatnagar MBBS BSc (Hons) MRCP

Clinical Oncology Registrar in Oxfor