Andrew Lansley has not gone into my good books. He presided over the widely-derided Health and Social Care bill – the biggest top-down reorganisation of the NHS in its history – in direct contravention of the Consevative Party’s manifesto and in spite of a complete lack of evidence that it would improve anything.Hmmm. He also received £21,000 pounds from the director of Care UK (a private healthcare company that benefited strongly from Lansley’s reforms), and introduced significantly more private healthcare into a supposedly-not-private National Health Service. Fortunately, Andrew Lansley is now gone. Unfortunately, his replacement, Jeremy Hunt, appears so far to be as bad, if not worse.
Jeremy Hunt was reshuffled into office as the Health Secretary in September 2012, still under a shadow of suspicion over his (mis)handling of a sizable bid for BSkyB from Murdoch’s NewsCorp. Andrew Lansley, having attracted votes of no confidence from both the Royal College of Nursing and the British Medical Association, as well as enough negative publicity to last several lifetimes, was quietly moved to Leader of the House of Commons.
Hunt came under fire almost immediately for his belief that the public should fund homeopathy on the NHS and for having previously co-authored a book suggesting that the entire institution should be dismantled. Why you place a man who has literally written a book on why the NHS shouldn’t exist in charge of said NHS is an interesting question for another time.
Hunt has been involved in a few spats since then – a false claim that foreign nationals using the NHS came at a cost of £200 million (when official statistics place it at £33 million), backing a regression in abortion limits from 24 to 12 weeks, and presiding over the worst winter for the NHS ever (with one hospital even erecting field triage tents in the car park simply to deal with demand). The latter point, I admit, is more an illustration of the result of the Conservatives cutting of healthcare spending over many years rather than Jeremy Hunt’s specific failure, but it is specifically Jeremy Hunt’s responsibility (despite Conservative attempts to remove that clause from the Health and Social Care Bill 2012).
Speaking, however, of specific failures by Jeremy Hunt brings me neatly on to the current furore. Hunt has picked out hospital consultants as lazy, money-grabbing targets within the NHS and has, in combination with a epically-misquoted scientific paper, given a firebrand speech in which he declared that unless the BMA agreed to his demands he will impose a new 7-day contract upon doctors within six weeks. The contract he proposes has many faults, but the one I take most issue with is the change in definition of ‘anti-social hours’.
Currently, ‘normal hours’ are defined as 08:00 to 19:00 Monday to Friday. Working shifts within these times attracts no anti-social hours pay, which seems perfectly reasonable. Hunt wants to redefine ‘normal hours’ as 7am-10pm, Monday to Saturday. I don’t know about you, but ‘and evening with your family/friends’ and ‘an evening when you finish work at 22:00, get back at 22:45, scoff some food and go to bed’ do not seem compaitable in my eyes. Certainly working for no additional pay on Saturdays and calling it ‘normal hours’ seems harsh (and equivalent to a 15% pay cut: a stark contrast to MPs 10% pay rise). Jeremy, not content with that, cutting pay for extra hours worked (stating we should use our ‘professionalism’ to justify working without pay), and demonising consultants, then really stepped over the line. He criticised doctors for not working weekends, for not being vocational enough, and told them to ‘get real’. That was a mistake.
Doctors work weekends, and we do it because it is our vocation. Not because we have no friends or family to see; no weddings to attend, no hobbies to enjoy, but because we care for our patients.
We work lots of weekends – I work three weekends in every 5. It’s not just junior doctors, either: there are consultants in every hospital, every weekend – lots of them. The #iminworkjeremy hashtag was started on Friday and became a fully-fledged grassroots campaign within hours. Letters from junior doctors – incandescent, furious letters – were shared tens of thousands of times. A petition on change.org (which currently stands at over 75,000 signatures) was rapidly superceded by a parliamentary petition to debate a vode of no confidence in Jeremy Hunt (which has accrued 68,000 signatures in under 24 hours so far). There was criticism of Hunt’s lack of understanding of the difference between emergency and elective care, and what this means for mortality rates. There was criticism of the chronic lack of funding for emergency care – for the supoort staff over the weekend whose absence makes additional weekend consultants redundant. There was no explanation from Hunt about where the funding for all these consultants would come from, and who would cover the weekdays they were taken from. In fact, the only response from Hunt I’ve found so far is a tweet thanking doctors for working the weekend and saying that means they need a new contract. Not. Good. Enough.
With regard to the pay cut, some of the letters rightly pointed out that after 9 years of training and working, a doctor earns as much as a tube driver does on day one. Other comparisons were drawn with pret-a-manger managers and various other non-life-or-death professions whose pay is generally equal or higher than the pay for doctors of various grades. It was pointed out that doctors would be paid more under a private healthcare system – it should speak volumes that doctors know this, but do not support private healthcare. Why? It would be worse for patients, and even after all the media hatred, the political slander, and the fact that (certainly in A&E) we are insulted and sometimes assaulted daily, we do care.
There’s been a smattering of coverage in national news – but only a smattering. Nothing in the Murdoch press on the front pages of their websites, a small article hidden on the BBC website, and a feature on the Guardian from the initiator of the #ImInWorkJeremy campaign. Various small pieces elsewhere. A disappointment.
I hope against hope that even that disappointment will be enough. I realise that this may be unrealistic; I realise the the government is unlikely to listen – there is, after all, an awful lot of precedent for that. I don’t even think that firing Jeremy Hunt will be helpful – what I hope for is that he takes a moment to listen. Takes a moment to learn what would actually be useful in hospitals, from people in hospitals, as opposed to arbitrarily picking things to slander. Most of all, I hope the government realises that the NHS can’t take more cuts, more efficiency savings, more streamlining. It needs more funding. More nurses, more doctors, more porters and radiographers and lab technicians – and certainly it needs those people at the weekends. Ironically, about the only thing that isn’t needed at the weekend is more consultants. Jeremy Hunt needs to understand this. If he loses his job in the process, so be it. If he doesn’t, and if he doesn’t learn from his errors…well, you might get to live the reality of a country where the NHS is consigned as a failure to the history books.
At least, a failure in the books that Jeremy Hunt co-authored, of course.