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September 19, 2016

Private Eye Medicine Balls 1424
Filed under: Private Eye — Dr. Phil @ 1:16 pm

Striking Alternatives

Do junior doctors have an alternative to more strike action, which the BMA is currently planning? Some feel that the reappointment of Jeremy Hunt as health secretary and the government’s intransigence in trying to force through a ‘cost neutral’ extended 7 day NHS service based on deliberate falsification of the evidence leaves them with no alternative. Others fear the BMA will flounder. As one ‘senior’ junior doctor put it: ‘I’m not striking again. The BMA agreed to this contract yet now calls us to strike again because we disagreed with its own recommendations.’ MD is not a member of the BMA, because of its tendency to shaft and silence NHS whistle-blowers, but unless it can blow the whistle relentlessly on why contract imposition is more harmful to patients than more strikes, it will lose public support and fail.

So what are the alternatives? Justice for Health – a social justice movement founded by five junior doctor activists – have secured a full, expedited Judicial Review hearing in the High Court on September 19 and 20 to challenge health secretary Jeremy Hunt’s power to impose a contract on junior doctors.  It has also successfully challenged Hunt’s exorbitant demands for security for costs (£150,000 to be raised in 7 days). Indeed Hunt has gone to extreme lengths to avoid being held to account in the High Court, and any judge worth his or her salt will have a field day with Hunt’s repeatedly fallacious claims that weekend admissions to UK hospitals are associated with increased deaths. The fact that he has repeated these assertions having been corrected by several expert authorities on the subject suggests he is either a liar or just very stupid. The fact that these falsehoods are being used to push through a ‘seven day’ NHS without proper planning or safe staffing may be prove to be dangerous for both staff and patients. If you take staff off weekdays to work the weekends, it will probably make weekdays less safe. One in ten junior doctor posts are currently unfilled, with large clusters going begging in emergency specialties. Hunt’s stance has alienated staff and even frightened patients, with some reports of harm from patients failing to seek help at the weekend [BMJ 2015;351:h4596].

Hunt knows he can get away with cherry picking statistics in the House of Commons or on the BBC, and he is merrily torturing them until they confess to his ideological fancies. He gleefully told Andrew Marr that “eight studies in the last five years show evidence of the weekend effect.” Yet only four of these studies were independently peer-reviewed, of which three derive data from the same study population (thus not independent to each other) and only two utilise sample data collected from the last decade. The remainder of the supposed eight ‘studies’ are reports or opinion pieces, and do not represent independent new data, and are not peer-reviewed medical research. Hunt then made claims about 6,000 deaths from a paper that hadn’t been published, and 11,000 deaths based on a paper commissioned by, er, NHS England and so hardly independent. He even made a statement about babies dying at the weekend based on a paper which found the greatest risk of death was actually a Thursday. Indeed the overwhelming body of high quality, peer reviewed evidence contradicts Hunt’s misleading and divisive political showmanship.

To have such a person as Hunt running the health service and free from any accountability when he makes such harmful errors must stop. There needs to be an evidence based policy unit in the government that fact checks Hunt before he opens his mouth. As Glasgow GP, writer and broadcaster Margaret McCartney observes; ‘If the NHS is to survive, we have to stop wasting money on things that don’t work, or cause far more harm than good.’ Her list is an impressively long one, from the top down imposition of a hugely wasteful market system in the NHS, to the obscene management consultant and PFI bills, to the unproven screening and over-medicalisation of people with ‘risk factors’, rather than spending precious resources on treating those who are genuinely ill and need urgent help.

To cut the crap out of the NHS requires evidence based policy making at the top, and humane working conditions at the bottom where patients, carers and staff feel unafraid to raise concerns. Dr Chris Day is another junior doctor activist and whistle-blower who discovered when he raised concerns at Lewisham and Greenwich Trust that junior doctors have no legal whistleblowing protection at all. As with Justice for Health, he has put in a huge amount of time and effort, at considerable personal cost, to fight for whistle blower protection for all 54,000 junior doctors. Health Education England has now promised to ‘close this loophole.’ Dr Day remains unconvinced anything will change. His fight goes on. Seats for Justice for Health v Hunt can be obtained via the website.