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| Jeremy Hunt gives NHS consultants ultimatum on weekend working | Jeremy Hunt gives NHS consultants ultimatum on weekend working |
| (6 days later) | |
| The health secretary, Jeremy Hunt, has accused the main doctors’ union of walking out of NHS consultants’ contract talks aimed at preventing “catastrophic consequences” for patients at weekends. | The health secretary, Jeremy Hunt, has accused the main doctors’ union of walking out of NHS consultants’ contract talks aimed at preventing “catastrophic consequences” for patients at weekends. |
| Hunt said he recognised the efforts of consultants, many of whom already work on Saturdays and Sundays, but that he would impose weekend-working contracts by September if an agreement could be reached. | Hunt said he recognised the efforts of consultants, many of whom already work on Saturdays and Sundays, but that he would impose weekend-working contracts by September if an agreement could be reached. |
| The Department of Health (DoH) had been trying to negotiate with the British Medical Association since 2012, he said, but the union walked out of talks last October. | The Department of Health (DoH) had been trying to negotiate with the British Medical Association since 2012, he said, but the union walked out of talks last October. |
| He told BBC Radio 4’s Today programme that if working patterns did not change there would be “catastrophic consequences”, because there is a greater risk of hospital patients dying at weekends. | He told BBC Radio 4’s Today programme that if working patterns did not change there would be “catastrophic consequences”, because there is a greater risk of hospital patients dying at weekends. |
| “We have got nearly 10,000 more doctors in the NHS compared to five years ago, so we are recruiting more doctors to the NHS. But it is incredibly inefficient to have a service that cranks up on a Monday morning [and] starts to wind down after lunch on a Friday,” he said. | “We have got nearly 10,000 more doctors in the NHS compared to five years ago, so we are recruiting more doctors to the NHS. But it is incredibly inefficient to have a service that cranks up on a Monday morning [and] starts to wind down after lunch on a Friday,” he said. |
| “And if you are admitted to hospital on a Friday and you have an important test and then you are told you are going to have to stay in hospital for the Saturday and the Sunday, and then you won’t get a decision on whether you can leave hospital on a Monday or a Tuesday when a senior consultant can come and see you – no consultants want that for their patients.” | “And if you are admitted to hospital on a Friday and you have an important test and then you are told you are going to have to stay in hospital for the Saturday and the Sunday, and then you won’t get a decision on whether you can leave hospital on a Monday or a Tuesday when a senior consultant can come and see you – no consultants want that for their patients.” |
| The head of the BMA, Dr Mark Porter, told the BBC that doctors supported an improved, seven-day NHS service, but other factors were to blame, including a lack of resources. | The head of the BMA, Dr Mark Porter, told the BBC that doctors supported an improved, seven-day NHS service, but other factors were to blame, including a lack of resources. |
| He said the proposed contract changes could mean fewer consultants were available mid-week. | He said the proposed contract changes could mean fewer consultants were available mid-week. |
| Earlier, the BMA said the contract change was a “wholesale attack on doctors” and a blatant attempt by the government to distract from its “refusal to invest properly in emergency care”. | Earlier, the BMA said the contract change was a “wholesale attack on doctors” and a blatant attempt by the government to distract from its “refusal to invest properly in emergency care”. |
| The proposed contract would have at its core the controversial weekend working provision, but would include the abolition of overtime payments that Hunt has described as extortionate. | The proposed contract would have at its core the controversial weekend working provision, but would include the abolition of overtime payments that Hunt has described as extortionate. |
| I have yet to meet a consultant who would be happy for their own family to be admitted at weekends | I have yet to meet a consultant who would be happy for their own family to be admitted at weekends |
| Under the current contract, last negotiated by Labour in 2003, consultants can opt out of non-emergency work outside the hours of 7am to 7pm Monday to Friday. | |
| Hunt was due to outline his contract proposals as part of a speech to the King’s Fund on Thursday setting out his 25-year vision for the NHS. | Hunt was due to outline his contract proposals as part of a speech to the King’s Fund on Thursday setting out his 25-year vision for the NHS. |
| He will say a patient has a 15% higher chance of dying if they are admitted to a hospital on a Sunday than on a Wednesday, implying that the inflexibility of consultants leads to unnecessary deaths. | He will say a patient has a 15% higher chance of dying if they are admitted to a hospital on a Sunday than on a Wednesday, implying that the inflexibility of consultants leads to unnecessary deaths. |
| He will point to research showing that the pay of 40,000 consultants in England and Wales rose by 50% between 2001 and 2005. | He will point to research showing that the pay of 40,000 consultants in England and Wales rose by 50% between 2001 and 2005. |
| Related: NHS funding: what does the £8bn spending increase actually mean? | Related: NHS funding: what does the £8bn spending increase actually mean? |
| Hunt will say: “Around 6,000 people lose their lives every year because we do not have a proper seven-day service in hospitals. No one could possibly say that this was a system built around the needs of patients 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’.” | Hunt will say: “Around 6,000 people lose their lives every year because we do not have a proper seven-day service in hospitals. No one could possibly say that this was a system built around the needs of patients 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’.” |
| He will condemn the BMA by saying: “They are not remotely in touch with what their members actually believe. I have yet to meet a consultant who would be happy for their own family to be admitted at weekends or would not prefer to get test results back more quickly for their own patients. Timely consultant review when a patient is first admitted, access to key diagnostics, consultant-directed interventions, ongoing consultant review in high-dependency areas and proper assessment of mental health needs: I will not allow the BMA to be a roadblock to reforms that will save lives. | He will condemn the BMA by saying: “They are not remotely in touch with what their members actually believe. I have yet to meet a consultant who would be happy for their own family to be admitted at weekends or would not prefer to get test results back more quickly for their own patients. Timely consultant review when a patient is first admitted, access to key diagnostics, consultant-directed interventions, ongoing consultant review in high-dependency areas and proper assessment of mental health needs: I will not allow the BMA to be a roadblock to reforms that will save lives. |
| “There will now be six weeks to work with BMA union negotiators before a September decision point. But be in no doubt: if we can’t negotiate, we are ready to impose a new contract.” | “There will now be six weeks to work with BMA union negotiators before a September decision point. But be in no doubt: if we can’t negotiate, we are ready to impose a new contract.” |
| Hunt will demand that the majority of hospital doctors must be on seven-day contracts by the end of the parliamentary term. They will not be required to work longer hours, but be more flexible in their shifts. | Hunt will demand that the majority of hospital doctors must be on seven-day contracts by the end of the parliamentary term. They will not be required to work longer hours, but be more flexible in their shifts. |
| Hunt is proposing a crackdown on overtime pay to consultants who work at weekends. | Hunt is proposing a crackdown on overtime pay to consultants who work at weekends. |
| Porter said: “Despite whatever the health secretary may claim, his simplistic approach ignores the fact that this is a much broader issue than just doctors’ contracts. | Porter said: “Despite whatever the health secretary may claim, his simplistic approach ignores the fact that this is a much broader issue than just doctors’ contracts. |
| “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. | “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. | “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. |
| “This is a blatant attempt by the government to distract from its refusal to invest properly in emergency care. So, I say again to the health secretary, get real and show us what you mean.” | “This is a blatant attempt by the government to distract from its refusal to invest properly in emergency care. So, I say again to the health secretary, get real and show us what you mean.” |
| Related: NHS lacks money and staff for seven-day operation, David Cameron told | Related: NHS lacks money and staff for seven-day operation, David Cameron told |
| The DoH said consultants earned an average full-time equivalent wage of £118,000, about four times the average for a nurse, and a report by the National Audit Office showed that 71% of extra work carried out by consultants who had opted out of weekend work was paid at locally negotiated rates, sometimes costing four times more, up to £200 an hour. | The DoH said consultants earned an average full-time equivalent wage of £118,000, about four times the average for a nurse, and a report by the National Audit Office showed that 71% of extra work carried out by consultants who had opted out of weekend work was paid at locally negotiated rates, sometimes costing four times more, up to £200 an hour. |
| Government sources said hospital efficiency at weekends was severely reduced by the absence of consultants capable of making critical decisions about patient treatment, including discharge or further emergency work. | Government sources said hospital efficiency at weekends was severely reduced by the absence of consultants capable of making critical decisions about patient treatment, including discharge or further emergency work. |
| Hunt’s speech is aimed at reassuring the electorate that a majority Conservative government is committed to NHS founding principles: free at the point of use regardless of ability to pay. | Hunt’s speech is aimed at reassuring the electorate that a majority Conservative government is committed to NHS founding principles: free at the point of use regardless of ability to pay. |
| As part of the coordinated Tory attempt to colonise previously secure Labour territory, Hunt will reassert the party’s surprise election pledge to find an extra £8bn for the NHS by the end of the parliament. | As part of the coordinated Tory attempt to colonise previously secure Labour territory, Hunt will reassert the party’s surprise election pledge to find an extra £8bn for the NHS by the end of the parliament. |
| “We are passionate about what the NHS stands for: the belief that the highest ideal for any civilised society is to offer its citizens access to high-quality healthcare irrespective of means.” | “We are passionate about what the NHS stands for: the belief that the highest ideal for any civilised society is to offer its citizens access to high-quality healthcare irrespective of means.” |
| He will point out that hospitals that have already instituted seven-day working, such as Salford Royal and Northumbria, have seen improvements in patient care and staff morale. | He will point out that hospitals that have already instituted seven-day working, such as Salford Royal and Northumbria, have seen improvements in patient care and staff morale. |
| He will also propose that pay progression be linked to levels of responsibility and achievement, not time served. The replacement of outdated local clinical excellence awards with more transparent payments for achieving excellence will also be up for discussion with the BMA along with proposals for improved terms for those consultants with the most demanding unsocial work patterns. | He will also propose that pay progression be linked to levels of responsibility and achievement, not time served. The replacement of outdated local clinical excellence awards with more transparent payments for achieving excellence will also be up for discussion with the BMA along with proposals for improved terms for those consultants with the most demanding unsocial work patterns. |
| According to Hunt, the plans will mean that doctors working in some of the toughest areas in the NHS, such as A&E and obstetrics, will be properly rewarded and there will be faster pay progression for consultants early in their career. | According to Hunt, the plans will mean that doctors working in some of the toughest areas in the NHS, such as A&E and obstetrics, will be properly rewarded and there will be faster pay progression for consultants early in their career. |
| • This article was amended on 21 July 2015. An earlier version said incorrectly that under the current contract, “only consultants in A&E are expected to work weekends or evenings, and the remainder can opt out if they are asked to work outside the hours of 7am to 7pm Monday to Friday”. |