I'm in work Jeremy. Are you?
Contrary to recent comments from health secretary Jeremy Hunt, consultants are not fat-cats who prefer playing golf on a Sunday to treating their patients, says Drew Payne
On the weekend of July 19-20, Twitter was alive with the hashtag #ImInWorkJeremy as NHS staff tweeted that they were working that weekend. They told of busy shifts, early starts and listed the other staff they were working with, including consultants.
This was a direct challenge to health secretary Jeremy Hunt and his latest plan for a seven-day NHS. Listening to Mr Hunt lately, you would think the NHS runs on skeleton staff at weekends, wilfully putting patients’ lives at risk. The #ImInWorkJeremy tweets painted a very different picture.
Mr Hunt’s argument has been that if you are admitted to hospital at the weekend, you are 16% more likely to die than if you are admitted during the week, and 6,000 people a year die needlessly because of the 'poor' healthcare at weekends. And whose fault is this? Why, it's the fault of hospital consultants according to Mr Hunt, for their 'refusal' to work weekends.
Writing in the BMJ,Glasgow GP Margaret McCartney neatly took apart the 16% statistic. This figure comes from a 2009-10 study of English hospital admissions, with patients followed for up to 30 days after admission. During this time, there were 14,217,640 admissions and 187,337 deaths. This equates to a death rate of 1.32%. Of that 1.32%, there was a 16% increase in death if the patient was admitted on a Sunday. This means that there is a 0.2112% increased risk of death for all patients admitted on a Sunday, not 16%. Also, there is no evidence for why there is this increase - it is not just because the senior consultant was at home that day.
As for the 6,000 deaths a year caused by 'poor' care at the weekend, this figure comes from an unpublished study, meaning no one can analyse the data, the study, its findings or even what the study was about. We can’t check this figure because no one knows where it came from, making this a breathtakingly dishonest use of statistics.
But these criticisms don’t seem to have stopped Mr Hunt, who is now threatening to push through this reform with or without the support of NHS staff. He is also painting a prejudiced and out-of-date picture of consultants as fat-cats, more interested in playing golf than seeing their patients on a Sunday afternoon. This isn’t true, but it gleefully appeals to the tabloid newspapers and makes good headlines. It also plays into the old image of the bullying consultant who nobody dares to question.
The truth is that many consultants are already working weekends. The 2003 consultants contract, the one Jeremy Hunt wants to rip up, says that senior doctors can opt out of weekend work only if their work is non-emergency or urgent. But they are still expected to be on call.
So why does Mr Hunt want to change this? Call me paranoid, but I fear that there is another agenda behind his plan. Consultants have been very vocal opponents of current changes being imposed on the NHS, especially the Health and Social Care Act 2012. Is this an attempt to silence them and break their perceived power? If so, what for? More contracts in the NHS? More privatisation of the NHS?
Hunt’s actions are certainly confrontational, and his talk of lazy doctors and consultants putting patients at risk is not helping anybody. This is not the behaviour of someone who wants to negotiate and improve patient care.
So what was Mr Hunt’s reaction to #ImInWorkJeremy? On Friday July 19, he posted a picture of himself on a hospital ward on Twitter. In the background, patients’ names and details were clear for all to see, so he breached patient confidentiality.
I was working last weekend, and I tweeted #ImInWorkJeremy both days. I was late leaving on Saturday and Sunday because of the volume of my workload - and where was Jeremy Hunt? He was enjoying the start of his seven week summer holiday.
About the author
Drew Payne is a community nurse in north London.
Follow Drew on Twitter at @drew_london