A row over whether hospital consultants should be required to work on weekends has descended into farce, with both the Health Secretary Jeremy Hunt and the doctors’ union the British Medical Association (BMA) repeatedly telling each other to “get real”.
Hunt used a speech to the Kings Fund to lay down an ultimatum, giving the BMA six weeks to negotiate a new deal on pay and working hours or face having one imposed on them by the government. Highlighting statistics which show that 6,000 people die needlessly each year because of hospitals’ failure to provide a seven-day-a-week service, Hunt pointed out that patients are 15 per cent more likely to die if admitted on a Sunday than on a Wednesday, The Times has reported.
“No one could possibly say that this was a system built around the needs of patients,” he said. “And yet when I pointed this out to the BMA they told me to ‘get real’. I simply say to the doctors’ union that I can give them 6,000 reasons why they, not I, need to ‘get real’.”
The BMA council chair Dr Mark Porter has hit back with a statement of his own, calling on the government to lay out plans for how the changes will be funded:
“More than 80 per cent of the public believe that doctors alone cannot deliver seven-day services without proper support, yet the health secretary makes no mention of the extra nurses, diagnostic staff, porters, admin staff – the list goes on – that would be needed to deliver the same high level standard of care patients deserve seven-days a week.
“So, I say again to the health secretary, get real and show us what you mean.”
Current terms for hospital consultants, agreed by the Labour government in 2003, grant hospital consultants an average full-time equivalent of £118,000 plus the right to opt out of non-emergency work outside the hours of 7am to 7pm on weekdays.
Those who agree to work nights or weekends can negotiate higher rates of pay, an option that 71 per cent of doctors take up, earning up to £200 an hour, according to a 2012 report by the National Audit Office.
Although the government can’t change existing contracts, they can alter the terms of new contracts – and it is this that Mr Hunt has threatened to do if the BMA don’t come up with their own solution. Mr Hunt said:
“I have yet to meet a consultant who would be happy for their own family to be admitted on a weekend, or would not prefer to get test results back more quickly for their own patients.
“Hospitals like Northumbria that have instituted seven-day working have seen staff morale transformed as a result.
“No doctors currently in service will be forced to move onto the new contracts, although we will end extortionate off-contract payments for those who continue to exercise their weekend opt-out.”
Whitehall sources have proposed a plan which involves performance related pay incentives, and variable allowances based on doctors’ individual work patterns. They insist that the plan is cost neutral, and that doctors will not be forced to work extra hours which may compromise safety.
But the BMA has insisted that Mr Hunt is taking a simplistic approach. They say that moving consultants onto a seven day a week schedule would involve also moving all the infrastructure, in terms of support staff, onto the same schedule, which they claim will cost more.
“Today’s announcement is nothing more than a wholesale attack on doctors to mask the fact that for two years the government has failed to outline any concrete proposals for introducing more seven-day hospital services. The health secretary has questions to answer. How does he plan to pay for it? How will he ensure there isn’t a reduction in mid-week services or fewer doctors on wards Monday to Friday? Yet again there are no answers,” Dr Porter said.
He added: “Doctors support more seven-day hospital services and have repeatedly called on the government to outline how they will fund and staff them. Despite whatever the health secretary may claim, his simplistic approach ignores the fact that this is a much broader issue than just doctors’ contracts.”