Reforms to NHS practice continue to divide opinion as Health Secretary, Jeremy Hunt, accuses the British Medical Association (“BMA”) of walking out on talks over Consultant’s working Saturdays and Sundays.
Mr Hunt has said the current policy of only A&E Consultants having to work weekends has “catastrophic consequences”, with patients dying due to lack of input from senior clinicians. Data suggests that patients have a 15% higher risk of dying in hospital on a Sunday as opposed to a Wednesday.
Mr Hunt wishes to reach an agreement with the BMA for this change in working practice to be implemented by September 2015, but has said he will implement the reforms in any event. He said “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”.
Dr Mark Porter, Head of the British Medical Association, has said that doctors support a seven-day NHS service, but that lack of resources are one of the barriers. The BMA has previously accused the government of “[refusing] to invest properly in emergency care”. He said “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?”
Mr Hunt has pointed out that 10,000 extra doctors have been recruited in the last 5 years, suggesting that the resources are already in place. He said “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 … I will not allow the BMA to be a roadblock to reforms that will save lives”. He stresses that doctors will not be expected to work more hours than they currently do, but will be required to be more flexible with their shifts.
The issue of the quality of care delivered on different days has long been in the spotlight. The issue is not just contained to weekends but also entire months. On the first Wednesday in August, newly qualified doctors take up their jobs. That day is now known as “Black Wednesday”, with patients being put at a 6% increase in risk of death due to the fact that they are under the care of inexperienced doctors; a fear that continues throughout the summer as they settle into their new roles.
Whilst this might be an extreme example, it highlights the risks posed to patients by doctors not being adequately supervised by more senior colleagues, and adds weight to Mr Hunt’s drive for a new way of working. Whether or not funding and other resources are going to be available to make these changes work however, remains to be seen.
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