Phil Taylor is a Conservative activist in Ealing.
You might think from listening to the junior doctors over the last couple of weeks that the idea of a seven day a week NHS is some kind of weird Tory idea. It isn’t – but it is the way we are going.
Politicians always try to reduce arguments to simple ideas in the hope of finding a nugget that will lodge in the minds of the public and help them to win the argument. In this case, I don’t think the Government has done a very good job of explaining its seven day a week proposal. Indeed, in the Guardian, Dr Hannah Mitchell, Andrew Mitchell’s daughter, has been saying disobliging things about the Secretary of State, including: “The Health Secretary is not even clear on what he means by a seven-day-week NHS.”
So where did this seven day notion come from?
Even back in 2008, the Darzi Report – Lord Ara Darzi’s High Quality Care For All – said that “personalising services means making services fit for everyone’s needs, … when they need it.” He then cited the example of providing 24/7 brain imaging and thrombolysis delivered by expert teams for stroke patients.
In my own area, North West London, the consultation on their Shaping a Healthier Future in 2012 referred to “properly maintained and up-to-date hospital facilities with highly trained specialists available all the time.” It also said that this “means making sure that centres of excellence, such as the hospitals in NW London, have access 24 hours a day, seven days a week, to the best doctors, equipment and back-up.”
In October 2014, before the last general election, Simon Stevens, the NHS chief executive published his Five Year Forward View, the document that was essentially a manifesto for a publicly funded health service in the 21st century. He talked about: “Ensuring that hospital patients have access to seven day services where this makes a clinical difference to outcomes. “
So the idea of moving to a 24/7 model didn’t just come out of thin air. It is what the NHS leadership are trying to move to. This is not surprising, really. People are ill 24/7 and we need to move to servicing their needs 24/7.
Sure, the doctors would like to keep premium rates for antisocial hours, but there simply isn’t enough money to offer this. Their dispute has now resolved down to the rate of pay for Saturday working. It is a straight industrial dispute about pay, and high falutin rhetoric about patient safety, privatisation and all the rest is just that.
Both my parents have had recent extended hospital stays and both felt that their care was put on hold over weekends and public holidays, as the hospitals went quiet over the weekend. No consultants, no physiotherapy, no drug changes, etc. This needs to change.
The junior doctors have been talking about seven days a week elective surgery as a means of rubbishing the new contract. They know this is not the point of the changes. They have been talking about 24/7 emergency cover, but that is not the point either. There are lots of patient experiences that could be improved by providing clinically appropriate care over the weekend.
The junior doctors’ argument that it will take 40 per cent more resources to be more flexible at the weekend is nonsense too – there won’t be 40% per cent more illness just because you better match the supply of service to the 24/7 incidence of illness.
The Five Year Forward View is a manifesto for making a state health service viable in the 21st century. Stevens is asking the doctors to get with the programme. The doctors think that by calling Jeremy Hunt names they can change the subject. If Hunt really wanted to destroy the NHS, as the junior doctors are claiming, then he wouldn’t be trying to get this deal. The fact he is shows that he is committed to making the NHS work as a public service – however painful that process will be.