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Doctors: Hunt willing to impose seven-day working Jeremy Hunt: Doctors 'must back seven-day working'
(about 2 hours later)
Health Secretary Jeremy Hunt is prepared to impose seven-day working on hospital doctors, he will say later. Health Secretary Jeremy Hunt has said he is prepared to impose seven-day working on hospital doctors.
Mr Hunt will accuse the British Medical Association of being out of touch in his bid to force weekend working. Mr Hunt told the BBC that a "Monday to Friday culture" in parts of the NHS had "tragic consequences" and said 6,000 people die each year because of this.
Talks with the BMA broke down last autumn and with no sign of a breakthrough Mr Hunt is expected to set a September deadline to agree a deal. British Medical Association leader Dr Mark Porter said the union supported more seven-day working but accused Mr Hunt of being "too simplistic".
If there is no agreement, he will say, he is willing to force different arrangements on new consultants. A September deadline is expected to be set by Mr Hunt for a deal with the BMA.
The current consultant contract means senior doctors can opt out of weekend work as long as it is non-emergency in nature - although they are still expected to be on call.The current consultant contract means senior doctors can opt out of weekend work as long as it is non-emergency in nature - although they are still expected to be on call.
Mr Hunt is due to talk about the issue in a speech in London later.
Drive up standardsDrive up standards
By ensuring all new consultants do not have this right, Mr Hunt believes over the course of the parliament he will gradually get enough senior doctors in place to drive up standards at weekends. By ensuring all new consultants do not have this right, Mr Hunt believes over the course of the parliament he will gradually get enough senior doctors in place to drive up standards at weekends.
While he is within his powers to impose such a deal, the move threatens to sour relations with the medical profession - especially as a number of hospitals have already started altering rota patterns to create a more even spread of cover.While he is within his powers to impose such a deal, the move threatens to sour relations with the medical profession - especially as a number of hospitals have already started altering rota patterns to create a more even spread of cover.
The BMA pulled out of talks last year amid concerns over workload.The BMA pulled out of talks last year amid concerns over workload.
But in a speech in London on Thursday, Mr Hunt will claim 6,000 people die each year because care at weekends does not match that given during the week. Analysis: Nick Triggle, BBC News Health Correspondent
Analysis
There is robust evidence showing that a weekend admission is linked to a higher chance of death, but what is still not obvious is what exactly causes this.There is robust evidence showing that a weekend admission is linked to a higher chance of death, but what is still not obvious is what exactly causes this.
Research from three years ago published in the Journal of the Royal Society of Medicine showed 1.3% of people who are admitted to hospital die within 30 days.Research from three years ago published in the Journal of the Royal Society of Medicine showed 1.3% of people who are admitted to hospital die within 30 days.
Death rates were higher for weekend admissions - compared with admission on a Wednesday they were 16% higher for Sunday and 11% for Saturday.Death rates were higher for weekend admissions - compared with admission on a Wednesday they were 16% higher for Sunday and 11% for Saturday.
But, crucially, it was not clear to what extent this was down to a lack of experienced staff.But, crucially, it was not clear to what extent this was down to a lack of experienced staff.
Another factor could have been the fact that people with a greater severity of illness may be admitted at weekends because of a lack of services in the community for those at the end of life.Another factor could have been the fact that people with a greater severity of illness may be admitted at weekends because of a lack of services in the community for those at the end of life.
That in itself is an argument for more seven-day services across the whole health service. But whether that can be afforded is another matter. Speaking to the BBC, Mr Hunt said: "The problem dates back to 2003 when the then government gave consultants the right to opt out of working at weekends - that's a right that nurses don't have, midwives don't have, paramedics, ambulance drivers and so on don't have and that has created a Monday to Friday culture in many parts of the NHS with tragic consequences for patients.
"They [the BMA] 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," he will say. "And if you want the evidence it's very straightforward.
"I will not allow the BMA to be a road block to reforms that will save lives. "We have around 6,000 avoidable deaths every year because if you are admitted to hospital on a Sunday you have a 15% higher chance of dying than if you are admitted on a Wednesday."
"Be in no doubt, if we can't negotiate, we are ready to impose a new contract." He said it was "not a war against consultants" and that "many medical directors" and professionals bodies "want that sense of vocation and professionalism brought back into the contract".
He will also make pledges about greater transparency and improving the way technology is used in what is being billed as his "25-year vision" for the health service. "If you are admitted on a Friday afternoon or a Saturday and there isn't a consultant there that is one of the critical things that can lead to an avoidable death," he said.
The comments come just a month after he tried to entice GPs to move towards more seven-day working by promising to recruit extra staff to relieve the pressure on services. "We are not asking any doctor to work longer hours or unsafe hours... but there will be times where we do need that senior consultant cover at weekends."
BMA leader Dr Mark Porter said the union supported more seven-day working but accused Mr Hunt of being "too simplistic". His comments come just a month after he tried to entice GPs to move towards more seven-day working by promising to recruit extra staff to relieve the pressure on services.
The BMA has argued that to improve care at weekends you also need more support services such as diagnostics and pathology as well as care in the community to allow patients to be discharged.The BMA has argued that to improve care at weekends you also need more support services such as diagnostics and pathology as well as care in the community to allow patients to be discharged.
"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. "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," said Dr Porter.
"How will he ensure there isn't a reduction in mid-week services or fewer doctors on wards Monday to Friday?" added Dr Porter. "How will he ensure there isn't a reduction in mid-week services or fewer doctors on wards Monday to Friday?"
The BMA has also released a survey of 2,000 adults which found two thirds did not believe the NHS could afford seven-day services.The BMA has also released a survey of 2,000 adults which found two thirds did not believe the NHS could afford seven-day services.
Are you affected by the issues raised in this story? Are you an NHS hospital doctor? Please email haveyoursay@bbc.co.uk with your experiences. Are you an NHS hospital doctor? Are you a patient who has had to go to hospital at the weekend? Are you affected by the issues raised in this story? Please email haveyoursay@bbc.co.uk with your experiences.
Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways:Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways: