Tim Farron has commented on today’s strike over shift patterns, patient safety and pay.
Tomorrow’s strike is the result of the Government’s serious mismanagement of negotiations with junior doctors. Healthcare professionals, patients and the public have been let down.
Throughout this process, the Government seems to have focused more on political point scoring than engaging with junior doctors in a respectful way which recognises that they are dedicated public servants, who work extremely hard, caring for people in need.
The Government must urgently resume talks with the BMA and stop their megaphone diplomacy. Our NHS and everyone who relies on it, deserve much better than this.
Junior doctors are notoriously overworked and have not been on strike since 1975 so I am not surprised that they enjoy majority public support in this dispute.
While the NHS is already a 7 day operation to a great extent, it does seem reasonable to me to seek to extend this. While the mortality statistics behind this move have been debunked, it is well understood that the service at weekends is not as good as during the week. And hospitals are reluctant to schedule more doctors to work at the weekends if it costs more than working during the week, hence the impetus to change the contract.
To make this wizzo idea a good idea that benefits patients overall, all the government would need to do is ensure that doctors are not overworked and subjected to unreasonable shift patterns, and that medicine remained an attractive career even to people who would like to have some time off at sociable hours. Hence the dispute.
* Joe Otten was the candidate for Sheffield Heeley in June 2017 and Doncaster North in December 2019 and is a councillor in Sheffield.
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25 Comments
Who identifies an “unreasonable” shift pattern. Looking at the governments proposal it does not seem unreasonable to me. Nothing is ever perfect. I am not sure what the Doctors are so upset about, lot of what they say through their spokesmen seems to be hot air and a smokescreen. The proposals seem to be an effort to change things for the better, but the Doctors seem to have dug themselves in. almost to a point where to give an inch is seen as a disaster. I suspect if the system was given a six month trial period it would then be generally accepted, after a bit of tweeking.
Can anyone point me to a site which gives details of the hours which doctors are expected to work? I know that hours may change from week to week, but what is the work pattern? We hear of 60 to 70 hour weeks, which is a lot more than the 35-40 which most people work. This can only lead to tiredness and potentially to mistakes.
Whatever happened to ACAS? Weren’t they involved at one stage? Didn’t both sides agree to abide by their recommendations? If not, they should have.
Back to the ‘dispute’. We clearly need more doctors and nurses. These need paying for. So, if there’s no alternative, let’s ALL pay a little more for health care.
The reason that it’s the first time that doctors have been on strike since whenever is that Governments usually cave in to any and every demand from the medical profession and either throw money at it or, if the money’s not there, instead throw them some outrageous and irrelevant ‘public health’ bone, such as a display ban on cigarettes or (wait for it) a sugar tax; which benefits public health not one whit but annoys the public and makes a lot of pharmaceutical lobbyists very happy. In this respect (only) , doctors are like Tube drivers; they use the vital nature of their service; the fact their consumers have pre-paid and monopoly position to ensure that providers’ interests prevail over payers’. I agree with Tim: back to talks is the way forward but can we not allow the wool to be pulled over our eyes as to where the *public* interest lies.
Tim is correct , but a word or two in the other direction would be justified .My personal conviction is, in the medical profession , fire , and police services , as with the military , in a modern , humane democracy , no matter how wrong footed or ham fisted the government policy or attitude , strikes are not acceptable , ever . Marching , campaigning , interviews , giving us all the sense of their argument , all these accomplish so much more . Yes , doctors are overworked , but we need many more of them .Putting patients second , is a second rate practice. We expect little from tories on health , we expect more from doctors.
@David Blake
Most junior doctors work an average of between 40 and 48 hours per week, mostly at the higher end of that range but this would likely go up under the new contract. One of the changes being proposed is to revoke the rule where hospitals have to pay doctors more when they make them work more than 48 hours a week – under the proposals they’ll be able to make them work as much as they like. This means that a lot of specialties which currently work long hours or a lot of out of hours would end up working longer and more anti social hours for less money. They’ll also no longer be paid (at all) to be on call unless they actually need to be called in – which is problematic because time on call isn’t actually time off, you need to be contactable, have childcare in place, and be within a set distance of the hospital.
A lot of the ideas in the proposed contract are actually quite good in themselves (e.g. paying people for the amount of out of hours they actually do rather than using the banding system, where the people who work the most out of hours lose out) but the government’s inflexibility on issues like the above has made any kind of reasonable negotiation difficult – everyone’s backs are too far up.
I don’t support the strike. I’ve looked at the new contract and considering we have a big budget deficit I don’t think it justified a strike.
A nurse strike can cost patient lives, never mind a junior doctors one.
I don’t agree with the new contract, but I think strike action will be taking this out on the patients.
I know the public supports it, but I can’t given what I’ve read and my own experiences of the NHS.
@Laura
“Most junior doctors work an average of between 40 and 48 hours per week, mostly at the higher end of that range but this would likely go up under the new contract. One of the changes being proposed is to revoke the rule where hospitals have to pay doctors more when they make them work more than 48 hours a week – under the proposals they’ll be able to make them work as much as they like.”
But wouldn’t that be caught by the European Working Time Directive?
Gosh, judging by some of the comments here, I thought I had inadvertantly wandered into the online Daily Mail;s BTL commenters.
Shaun,
I constantly listen to the BMA representatives and their political supporters, but really am no clearer as to what the core issue is. I am beginning to suspect it is one of holding the line at all costs, no change and some doctors seemingly on a seemingly emotional kick, with reason and common-sense second place.
Up to now governments have seemingly caved into the BMA, somewhere there has to be a change.
Shaun,
I confess that I have listened to several BMA representatives and am still no clearer as to what the core issue is. There was one on the Daily Politics this morning, at the end I was just frustrated apparently listening to a lot of flowery talk but nothing specific or concrete.
Perhaps it is time for the Doctors to join the Police, Prison and other emergency services operating a scheduled 7 day week without the double treble time payments.
Shaun – agreed. I haven’t been reluctant to criticise Tim Farron in the past, but in this instance all credit to him. I had the misfortune to attend A&E in the early hours over the weekend. The junior doctor was clearly exhausted and on a couple of occasions forgot what I had just told her. These are people making life and death decisions. It’s all very well saying they should not go on strike but what else should they do when the Government just do not listen. The performance of Hunt on the media today has been appalling, insulting and inflammatory. He talks about patient safety as if he cares and the doctors have no regard for it. Well I know who I’d rather trust on the subject.
Is it patients safety and then what does this actually mean in real terms?. It can mean different things to different people. Is it money, some Doctors say no, others say that it is, others say it is a bad contract without saying what is good, bad or indifferent, then the weekend working issue, what is so wrong with this, it is just bringing them into line with other public emergency services. When you move away from the emotion I become really bemused, trying to understand the real and actual grievance. I say this as someone who was on strike myself a few years ago, but that was quite specific, no waffle, no talking around the edges, it was pay. Even on the Daily Politics today it was the same, nothing really concrete, nothing really tangible.
I support the strike but the BMA and Junior doctors are in it for themselves and the voice of the patient is lost in this dispute. My kid has had type 1 diabetes for a year and despite the junior doctors saying they work 7 days a week and the NHS is a 7 day a week organisation, on 0 days out of 365 has my son seen an endocrinologist. The NHS is not fit for purpose, many of the exhausted junior doctors now will be extremely wealthy consultants and registrars later, doing private work using public facilities and trained by the public purse
… later and the people who ultimately lose out are the patients and other healthcare professionals, especially nurses who do the heavy lifting.
Alistair , why support the strike ,having made such a personal , concerned , statement , the strike makes no sense?! If you have experienced such a poor service you should complain . I feel for you , I have experienced a poor service for years with a partner who suffered in a car accident . The NHS has a lot going for it but is not the romanticised wonder many think it is , it should , in outcome , be judged as any other service is , in which case it would be found wanting . Because the government gets it wrong and are criticised accordingly , this is no excuse for this strike , that is not daily mail politics as is so flippantly mentioned in this thread , it is humane concern for patients. (Comment edited to remove name-calling) The answer to exhaustion is more doctors , but working in patterns and shifts , yet of availability of cover seven days a week ! I have seen the tv appearances of doctors on several programmes , and like Theakes , on this thread , I am decidedly unimpressed !out of all the comments I remain baffled at the support for strikes , what happened to a Gandhi or DR. King spirit of publicising a cause and putting a message to , us all ,we the people . Maybe , unlike those heroes the cause here is not worth our support , if we barely understand it , and we being the political wonks !!!
heakes 12th Jan ’16 – 4:54pm………..Shaun……….I confess that I have listened to several BMA representatives and am still no clearer as to what the core issue is…..
If you are confused by the BMA
I watched a) Department of Health adviser ‘gagged’ in Sky interview on junior doctors’ strike where his DoH ‘minder’ intervenes to stop Norman Williams being questioned about health secretary Jeremy Hunt’s reluctance to go on television…
and b) The BBC ‘interview’ with Jeremy Hunt….
If that is what passes for government clarity then no wonder the BMA/junior doctors are confused..
The Tories promised 7 day hospitals. It is clearly their responsibility to deliver it. Hunt’s first attempt was/is to coerce doctors to change their employment contract to deliver their political promise. The BMA is certainly not a Trotskyist organisation. the 98% of doctors who voted to strike aren’t stupid sheep and understand the issues. Could it be that meeting the doctor’s demands might cost money? Could the Tories be trying to deliver a promise on the cheap at the expense of the Doctors? I don’t know but the best indicator of Hunt’s incompetence is the promise to fine Trusts for excessive doctor working hours. Surely the fine would impact on the Trust funding and hence to that available to patients??
@Laura – “One of the changes being proposed is to revoke the rule where hospitals have to pay doctors more when they make them work more than 48 hours a week – under the proposals they’ll be able to make them work as much as they like. This means that a lot of specialties which currently work long hours or a lot of out of hours would end up working longer and more anti social hours for less money.”
There is much misleading information being put about, I suspect much is actually being put out by the BMA, for reasons given by others, they expect the government to give in to their emotive demands. Take the above, yes one of the issues was that currently the the fines levied on a hospital when it makes junior doctors work more than 48 hours a week, get paid to the doctors – so where is the incentive for doctors to push back and work less than 48 hours? hence the change being proposed wasn’t to not fine hospitals but to change who should be receiving benefit from the fines.
Moving on to the ACAS negotiations, there is clearly two different views being put out about how the negotiations have been going and which party is currently refusing to turn up to ACAS and continue the dialogue. I suspect the BMA are generating a lot of misinformation, and are being slow in their negotiations (they’ve not been seen at ACAS nor given a date for when they wish to have further negotiations), because they perceive it to be in their negotiating interest, to delay negotiations, and there is little the government can say or do to show that it is the BMA who are currently the bad guys…
This isn’t to say that the government has or is doing a particularly good job, just that the news is being very carefully managed and orchestrated.
I am a reader of your paper, which I like for the ability to think out of the box.
For this reason I quickly will try to suggest a different perspective on the Junior Doctors contract issue.
I believe that the patients mortality statistics are the usual Government spin to manipulate the public opinion: the classic scaremongering strategy. (like increasing the military expenses by emphasizing the terror threat).
In this case the through objective is to rapidly achieve the NHS targets before the next elections by utilizing the actual hospital infrastructure to the maximum: fully operational hospital for longer hours and 7 days a week.
This simply save money and time .. and it make good sense. But the hospital need to be manned as well. New personnel should be trained and recruited. Time and costs could be reduced by asking the new doctors to work longer hours for the same amount of money, renegotiating a package that sounds like a pay rise.
The public opinion is taken on board and the doctors become the villains.
The question is: is this right or wrong?
Some readers are commenting already that they work unsociable hours for much less. But the issue could have larger implications if the doctors contract would become the example of the way the ideology of the free market is diminishing the workers’ rights. Where does fairness ends? Is the Government playing people against each other? Who is the real gainer?
I profoundly dislike the patronizing rhetoric of politicians. Unfortunately, the media prefer populist stories too: everybody has to earn their living. But it would be nice if this sort of “house Parliament” pantomime would be replace by a better rational approach to problem solving. It might be that we become better people.
Kinds regards
Angelo
Isn’t the 7-day a week issue due to the disconnect between front-line medical care and ancilary services? For example, doctors and nurses vs radiographers, porters etc
“Isn’t the 7-day a week issue due to the disconnect”
Yes, I had heard that one of the issues with weekend working (currently) is there are fewer consultants and experienced doctors around, leaving less experienced doctors with less support.
So I suspect there is much confusion, because a ‘junior’ doctor is simply someone who isn’t a consultant or GP, not as is probably most people’s perception someone who is only recently qualified and can count their years of experience on the fingers of one hand. The BMA are exploiting this perception, by using recent graduates to put the ‘junior’ doctors case to the media, rather than those who may have 10+ (or even 20+ in some specialisations) years of postgrad experience.
Once you appreciate the breadth of experience encompassed by the junior doctor label, the rationale for the change proposed by the government begins to make sense.
The problem with the 7 day a week scenario is that Hunt is depending on the current administration and health professionals to take on 25% more hours without supplying the wherewithal (in either money or staffing) to safely and satisfactorily cover those hours. Even if Hunt started today, it would still take 7 years to start to get into position to do so.
@Roland, consultants are on call evenings and weekends so that’s not really the issue. It’s more a case of front line services being 24-7 (because they need to be), but some of the supporting and back office services that a hospital needs are 9-5/5 days. Consequently although emergency care is there, not everything (radiographers, tissue analysis, blood screening, etc etc) that doctors may need to do or get information from is there.
A Social Liberal – thank you – the issue in a nutshell. To fully staff at the weekend, an objective that no one disagrees with, you need to provide additional staff – you can get by the odd weekend by overtime or considerably reduced cover but to do it week by week needs an injection of additional hours into the work pool at at levels and in all disciplines.
I think before General Election the Tories asked themselves how can we deflect accusations about privatising the NHS? Why not promise to make it even better and have it fully staffed 7 instead of 5 days – presumably said Hunt or Cameron? Well that’s that sorted forgetting to small detail of where all the extra hours will come from. At this point perhaps they slapped each on the back and off they went to another company Board meeting or lavish dinner.