Hugh Byrne is an NHS hospital consultant in London.
Jeremy Hunt’s speech on 16th July had vision, insight and a dose of reality. The rather predicable storm of outrage amongst doctors has mostly been confined to social media. Their ill-judged responses are a protectionist reaction to a single aspect of his speech: the section that took on meaningful seven day service provision. A Twitter and Facebook campaign using the affronted #ImInWorkJeremy hashtag started, and it was this campaign rather than the substance of the issue itself that became the minor news story. The public, who are the service users, aren’t impressed. I’m ashamed that other important insights in the speech into the way the health service could be run, and some harsh realities about the actual harm caused to patients by the way it is run, have been largely ignored by my reactionary colleagues.
The majority of the tweets are from junior doctors, and if these were removed there would be very few tweets left in circulation. Seven day working is about improving senior input and leadership, and mostly applies to consultants who don’t currently undertake any meaningful weekend work, but juniors and irrelevant consultants alike waded in without thinking and publicly criticised their employers. Most will not have read or listened to the speech in its entirety, and of course there are rational counter arguments to each and all of their histrionic claims.
The previous, less noisy, medical media storm occurred when the Secretary of State correctly pointed out the hard reality that we effectively kill or maim several hundred newborns a year through poor standards of care. The midwives of Facebook chose to take this as a criticism of their individual work rather than an acknowledgment of the difficulty of their jobs in the wider setting. It is a reflection on the fact that the majority of NHS staff vote for the Left that they chose to respond through personal attack rather than logical argument.
The current campaigners now threaten to continue until Hunt resigns. I hope that they can afford this because there will be no repeat of the loss of Lansley, who also truly understood the machinations of the health service. At that time we overestimated the power of unions like the BMA. The resulting strike was laughable, and exposed the BMA’s weakness as a trade union.
I’ve said before that this dilution of their power is because they also try to be a public health body, but their efforts in this regard could be described as being of a barstool standard, if they weren’t too sanctimonious to be found sitting on one. An example of this is their recent proposal of a big government 20 per cent tax on fizzy drinks, which was echoed by Simon Stevens, the NHS CEO (who has a Labour Party background). Perhaps a lesson in simple economic history pitched at their ideological level is needed.
The BMA, and its equivalents for nurses and midwives, the RCN and the RCM, are on the HMRC list of memberships required to function in one’s job, and so subscriptions to them attract tax relief. I would argue that every medical speciality already has their own Royal College to oversee their clinical practice and that there is no need for the BMA beyond a pure trade union role. Conversely, it seems that a lot of nurses and midwives seek advice from UNISON when they feel they need to, so the RCN and RCM should perhaps limit themselves to clinical matters rather than trade union issues.
The #iminworkjeremy hash-tag should surely have read “I’m at work”, but that error of syntax says a lot: yes, doctor, you are indeed ‘in work’ – in well-paid employment in a country that has little or no unemployment amongst medics. Before you idly threaten to leave for New Zealand, please be reminded that they have exactly the same number of doctors per head of their much smaller and relatively homogenous population. Your ready replacement will come from the UK medical school whose places are completely oversubscribed or from abroad – and there can be hundreds of applicants for one UK midwifery training place too.
Some of the more sanctimonious tweeters added that they worked long hours (paid work of course, and subject to the European Working Time Directive), that they stayed on sometimes to see a task through and that they “really cared” about their work - but there isn’t a job on earth where that all doesn’t apply.