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Trust me I'm a doctor

Posted on February 27, 2016 at 10:55 AM

It is often said that there are three types of lies: lies, damned lies and statistics. But statistics never lie, unless they are abused or misinterpreted and this usually requires the input of a politician. Recent statements by the secretary of state for health illustrate this perfectly.

Firstly, he wants consultants to work a seven-day week and highlights the importance of this by quoting an excess of 11,000 deaths amongst patients admitted to hospital at the weekend. He said that doctors have a “nine to five weekday culture” and have “lost a sense of vocation”. He overlooks the fact that over two thirds of consultants, like me, already work weekends and assumes that forcing the remaining one third to follow suit will cut the weekend death rate. He ignores the fact that consultants do not and cannot work in isolation, we work in teams. So without the investment to fund a full complement of supporting staff, our sole input would be almost valueless. Of course, we all want to be sure that when we fall ill, the care we receive will be top quality irrespective of the day of the week or time of the day, but this is no way to go about achieving that goal.

Secondly, he has rather messed up the figures for his proposed contract for the junior doctors. He said that overall these doctors would be better off by 11%, but the total pay budget would be unchanged. How can this be? Unless he is planning to reduce the workforce, I can only think of one explanation…politicians use magic money rather than the normal money you and I use. Probably the same magic money the banks used in 2005 before the financial crisis. Despite the title of ‘junior’, the striking doctors are highly educated professionals in their 20’s and 30’s; not children, so they had no trouble spotting the flaws in Mr Hunt’s sums. Without access to the book of spells, junior doctors were forced to base their calculations of income on normal rather than magic money and it appears that many of them will be worse off. In particular those who work unsocial hours in the emergency services that the secretary of state wants to run seven days a week. Junior they may be, but they certainly have a better grasp of maths and statistics than Mr Hunt.

Thirdly, it is often claimed that the main problem with the NHS is inefficiency. This allows the government to justify imposing £20 billion ‘efficiency savings’. One spokeswoman on BBC ‘Question Time’ recently claimed that Germany enjoys a much better health service than we do in the UK, but only spends 2% more. This is misleading because they spend 2% more of their GDP. If the UK spent the same proportion of GDP on health as Germany does, the NHS budget would increase from £150 billion per year to £185 billion. Now that really would make a big difference.

Although maths may be a weakness for members of the government, when it comes to spin, they certainly excel. They are already trying to demonise the ‘greedy’ junior doctors by saying this is simply a dispute about money and one national newspaper has joined in, labelling their leaders as ‘Moet medics’ enjoying a lavish lifestyle on their current salaries. The junior doctors, in turn, have responded on Twitter with their usual good humour.

But this is much more than a simple spat about wages. Most of the medical Royal Colleges (which do not engage in disputes about doctors’ terms and conditions of employment) have made statements supporting a negotiated settlement. They have highlighted the potential long-term harm to the health service that may well occur if this is not achieved.

Polls suggest that about two thirds of the population and the overwhelming majority of consultants and GP’s support the junior doctors cause. I am sure that not one of them wishes to see patients come to harm, but they realise that if a solution is not found and the government goes ahead with it’s threat to impose an un-negotiated contract, this will seriously threaten the future of healthcare in this country. Over 70% of junior doctors balloted said they would leave the UK to work abroad if this goes ahead. This cannot be allowed to happen – they are our future consultants and GP’s. I for one will need them as I get older.

When it comes to the public perception of trustworthiness, politicians rank even lower than estate agents and bankers (I know, hard to imagine isn’t it?). While doctors and nurses have the highest scores. But I do have concerns about the aftermath of strike action. I fear that sympathy for the junior doctors will wane if the conflict escalates. But take it from me; the NHS is in serious trouble already and we cannot cope with any more. Almost all of the independent health-watch organisations such as the King’s Fund argue that substantial investment is needed to maintain an acceptable level of health service. The current conflict between the government and the junior doctors is just the tip of a massive iceberg. And if you are a patient, you are sailing on the Titanic. Whatever the politicians say, there are no quick, easy fixes. Trust me, I am a doctor

Western Morning News 27th February 2016

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