#ImInWorkJeremy

[wonkylegs]

Doctors across the UK hit back at Jeremy Hunts attack on the professions weekend working with #ImInWorkJeremy Twitter campaign.

Hunt is trying to blame Doctors for a failing in providing a joined up and properly funded service rather than looking at the problem and coming up with
proper solutions he's looked
at consultants to be a scapegoat
Various news sources to appeal to all political bents
www.independent.co.uk/life-style/health-and-families/health-news/iminworkjeremy-doctors-send-jeremy-hunt-photos-of-themselves-working-over-the-weekend-10398504.html

www.dailymail.co.uk/news/article-3166330/ImInWorkJeremy-Doctors-Twitter-post-pictures-work-Jeremy-Hunt-claimed-medics-weren-t-doing-weekend-shifts.html

metro.co.uk/2015/07/18/iminworkjeremy-nhs-workers-inundate-jeremy-hunt-with-247-selfies-5301742/

You are completely right it's about the team - the NHS system relies on a strong team but our current political outlook seems to be about destroying that team bit by bit and pointing the finger of blame at anyone who isn't a politician.

Puremuscle …. ”Jeremy Hunt is totally mis-using statistics to form the conclusions to suit his agenda (which is probably privatisation in the longer term) and to encourage further headlines about lazy, highly paid doctors.”

Dismissing the rather lame Conservative (versus Labour PFI) use of the private sector ‘privatisation’ scare stories aside, maybe Consultants are taking the ‘threat’ of a 7-day NHS personally rather than looking at the big picture – like WHY for years doctors are getting more overworked e.g. from 1999 to 2010 we had around net 3 million more citizens and probably due to the NHS Act of 2000, we had 13,000 FEWER general and acute beds.

So governments can often add to the ‘front line’ problems, we know that, but we are where we are, a lot of money whether 30-year Private Finance Initiative deals committing the tax payer to pay £70 billion for £11 bil worth of hospitals and services, training up doctors and forcing them overseas, or IT systems that didn’t work – the demand is STILL growing, new NHS money can only ever be a new sticking plaster on the now when we can already see where new demand will come from - so we HAVE to think of different ways to address that GROWING demand on the NHS.

www.telegraph.co.uk/health/healthnews/9356942/Blair-defends-PFI-as-NHS-trusts-face-bankruptcy.html

www.telegraph.co.uk/health/healthnews/8779598/Private-Finance-Initiative-where-did-all-go-wrong.html

March 2007: “Doctors' training system 'a shambles'”
www.telegraph.co.uk/news/uknews/1544307/Doctors-training-system-a-shambles.html

“As much as £2 billion has been spent on the training of up to 8,000 doctors who find themselves without a new job under a Government initiative.”

'Disastrous' £11.4bn NHS IT programme to be abandoned
www.telegraph.co.uk/news/health/news/8780566/Disastrous-11.4bn-NHS-IT-programme-to-be-abandoned.html

”A multi-billion pound IT project started by Labour to link all parts of the NHS is to be abandoned.”

The current government is backing the Chief Executive Head of the NHS Simon Stevens to reorganise the NHS, they have not just gone all ‘Maverick’ and coming up with initiatives out of thin air – so surely a reorganised, funded NHS, planned together with the head of the NHS, adding to the capacity extending out to 7-days what is currently done in 5-days, is a real plan for a UK that saw demand massively increase, when NHS capacity didn’t , despite hundreds of ££billions spent and influencing NHS Trust budgets for many years to come.

Clearly this will mean more government money, doctors and god knows what else to staff the NHS 7-days a week, but was anyone ever told medicine and the total needs of their ‘clients’ were a Mon to Fri week job – or that the population using their services will dramatically fall, rather than rise?

It is in no ones interest to over work anyone within the NHS beyond their abilities or functional hours in a day/week, but it seems with the capacity problems that we face we have to try for a full 7-day hospital service – and look for the government to do their part better planning, spending, and providing the extra staff/support that those within the NHS need – which could actually REDUCE some of the current stresses on the NHS and their professionals.

honeysucklejasmine .... specifically I am not saying anything, I am looking at the capacity, past mistakes and huge stresses within the current mainly 5-day week we all keep hearing about from those within, and suggesting the 7-day week in whatever services may be needed could be a good idea.

The population isn't going to reduce by a few million, hundreds of ££billions can be spent and still reduce capacity, surely we need to do things SMARTER and not resist change that could be the only near term option to ease CURRENT stresses in the system, rather than say have the NHS look to CUT some services before it crashes.

Reading about the NHS shitty pay scales, MAYBE the NHS has had its day, as when the NHS Act of 2000 encouraged private sector provisions, that was when many NHS professionals had the choice/started going over to what the socialist would tell us is the private 'dark side'.

I guess Hunt recently trying to stop the extra money the NHS Trusts pay for private sector/agency temps etc might take away some of the attraction of moving from the NHS within the UK.

But if every doctor is going to moan whatever governments do and threaten to go abroad, maybe an insurance based system like they have abroad is what we need, to keep good under worked doctors etc, here - trained up by the private sector?

Just saying.

Lets ask Mr Farage to expand on old policies and come up with insurance based solutions as if governments can't think or run a decent health service and can only spend £billions of taxpayers money badly, why not have a U.S. style service?

Ipity- my post was simply in response to isits post suggesting that nurses work harder than doctors and were poorly paid, non elite, etc.
Of course most nurses work for a moderate salary but I was pointing out the starting and top salaries aren't worlds apart.
I absolutely agree with you that we are a team and that nurses have so many useful roles and skills that doctors do not have. You are quite right re Mid Staffs but in comparison to the flack that GPs have had for many years nurses (and actually hospital Consultants too) have escaped quite lightly.

isit-I'm not sure that I grasp the point of your later post as I don't see any HCP disagreeing about the need for change. Most of the problems that you seem to be quoting are relating to political and managerial decisions. I don't think anyone is resisting change more reacting to the constant media backlash and JH's erroneous suggestions. It is human nature after being constantly berated for years when one is actually trying very hard to do a good job under difficult circumstances to feel pretty pissed off.

puremuscle ... our public services often gets let down by politicians, but while I'm bias, I suggest that based on what was inherited and money to spend, the one JH over the past 6-years has so far done a better job than the 6 previous cash flushed but clueless Health Minister over 13-years - so why not give him and the current NHS head a chance, as demand is only going up and we need new ideas not ideological soundbites and/or perpetual warnings 'the NHS is going to crash under the Tories 10 minutes after the election'.

Puremuscle from a nursing point of view I don't know many nurses that think they work harder than the doctors, far from it. Nursing and medicine are very different jobs requiring very different skill sets, definitely not comparable in responsibility or hard work. Also, I imagine there are some nurses on 100k but probably not many! The majority of senior nursing roles are band 7 which pays £40,558 at the very top. Just thought I'd point that out so no one was under any illusion that we were all sitting on wads of cash!

As for the consultant issue. They do work weekends. Its utter tosh from Mr Hunt to suggest otherwise.

. Called it right I reckon.

mrsbap- I apologise if my post re nurses salaries gave the wrong impression!

isit-I'm starting to wonder if you have some kind of connection to the current government. I wouldn't trust JH as far as I could throw him and he comes across as a thoroughly unpleasant man. The previous labour government also made some terrible decisions and created huge wastage in the system.

Puremuscle thats ok, I just didn't want people trying to hit me up for loans and what not

Dh is a hospital consultant, has been on call from Saturday morning until Monday morning and has been too blood busy to tweet.

JH is indeed a cunt clueless.

I work in an allied health profession which currently in the Trust I work for, does not work weekends. We're sure prepared to do so (if not exactly jumping for joy at the idea) but there are a few barriers to it, like there are so few of us that we would probably work one weekend in four to cover 4 hospitals and a rehab centre at a time. As there's no extra money, that would mean fewer of us working during the week. I am not sure what would happen to the juniors in our profession that we support in their training and who couldn't do that cover at weekends - they would take longer to do their postgrad training I suppose, which would be a huge waste. Maybe we could do more of the training with virtual scenarios [ponders]

Can someone explain to me why doctors can't do a max of 48 hours (as per the working time directive) per week including weekends as standard? If there aren't enough doctors (as I'd imagine) then why can't we train more? As far as I'm aware there are more capable candidates seeking med school places than places available so supply shouldn't be a problem.

It seems that when doctors talk of weekend work it is often on call and or in addition to their normal working hours, is this correct? If so it wouldn't be surprising if someone working excessively like that would be more liable to making the mistakes that JH (who I'm no fan of) implies are causing the higher weekend death rate.

If doctors and allied health professionals do shift to a 7 day week then surely it would be a good thing to have elective surgery and outpatient clinics at the weekends?

It seems such a waste of resources to have theatres etc lying empty 2/7ths of the time. Surely this would speed up treatment times, shorten waiting lists and have a long term postive effect on public health?

Athens, training new doctors is not an immediate solution. It took my DH about 18 years of training (including the initial medical degree) before he became a consultant. You would also need more supporting staff. There's no point performing operations if there's no one to look after patients. A weekend on call takes up an entire 48 hours. Whilst covering emergency work, a Dr is unable to do elective work. The NHS would have to become emergency work only or become very unsafe.
There probably aren't enough beds for extra patients either. DH frequently has to cancel patients off his elective list because they have rum out of beds. Last winter, the hospital were using day-case beds for overnight stays which meant that simple operations could not be performed.

Athena - to put it simply its money.
A fully functioning 7 day service would require investment rather than the slashing of budgets we are currently seeing. One of the main costs is staffing, so yes it is a waste of resources not to use expensive facilities but without the expenditure on staff they are useless. Most drs do not oppose 7 day working if fully resourced and staffed, they oppose being told they do not work weekends when most of them actually do and then told they are lazy and overpaid and it's their fault that people die because they don't want to provide a 7 day service with a 5 day set of resources. Hunts drawn a direct causation from an ability for consultants to opt out of weekend work with death rates, when most drs don't actually do this and the studies authors actually say this cannot be concluded from the study. Hunt has very bluntly plucked a statement to pick a fight with senior drs rather than looked rationally and fairly at the data.

Puremuscle …. Re your ”isit-I'm starting to wonder if you have some kind of connection to the current government. I wouldn't trust JH as far as I could throw him and he comes across as a thoroughly unpleasant man. The previous labour government also made some terrible decisions and created huge wastage in the system.”

I wish I had a Pound for every time I offered FACTS showing a government Ministry and services ‘wasn’t fit for purpose in 2010’, I was accused of being PART of the current government – but I am not, never have been, and never have and never will be, even be a Member of a political party, even the one I’ve voted for around 40-years.

Why would you or anyone within the NHS NOT trust Jeremy Hunt, he and his party were not in charge for the 1997 -2007 to use that BEST decade in probably 100-years to increase the NHS annual budget and max out the UK’s credit card, to REFORM the NHS to meet the new challenges of an EU cross borders policy and the ‘baby boomers’ reaching retirement – and they BLEW IT, and not only that, they were covering up the 'bad practice' cracks in the system.

”Mid Staffs: Labour Government ignored MP requests for public inquiry into deaths”
www.telegraph.co.uk/news/uknews/9875660/Mid-Staffs-Labour-Government-ignored-MP-requests-for-public-inquiry-into-deaths.html

”Former Health Secretaries Andy Burnham and Alan Johnson ignored 81 requests for a public inquiry into Mid Staffordshire NHS Trust in the two years after it was first warned of poor NHS care, it has emerged.”

In my opinion not only should the NHS workers and USERS understand that much on the old NHS Budgets were wasted, future budgets have been impacted by those Labour 30-years PFI deals and their TRUST is better placed with a minister that has an extra £10 bil a year to spend but had commercial experience of how to run a business (so looks for efficiency savings, or “slashing of budgets” to some) – while trying to protect junior workers and patients from senior workers.

“NHS 'to get whistleblower guardians'”
www.bbc.co.uk/news/health-31362196

”NHS trusts will have to appoint a guardian to help whistleblowers in England, ministers have confirmed.”

”The measure was called for by Sir Robert Francis after he warned staff too often faced "bullying and being isolated" when they tried to speak out.”

”Sir Robert, who led the public inquiry into the Stafford Hospital scandal, also said a new national officer should be appointed to help the guardians.”

”The government immediately accepted all his recommendations.”

”Health Secretary Jeremy Hunt said: "If we don't get the culture right we will never deliver the ambitions we have for the NHS."

Money is NOT the ‘front line’ answer if government minister bow and scrape to all the influences of stronger willed professional public sector associations and trade unions, never look for efficiency savings, borrow recklessly and cover up NHS mistakes as they did within the 13-years before the current administration – none of which has been or Jeremy Hunt;’s watch, he’s just doing his best to handle the fallout from that legacy.

“Blair's legacy:Health”
news.bbc.co.uk/1/hi/health/4555344.stm

“No government has ever invested more in the health service than Labour under Blair and yet the NHS is mired in deficits with patients taking to the streets to prevent the closure of their local hospitals.”

“Joyce Robins, of Patient Concern, said: "I feel sorry for Blair, but the money has been wasted."

“This seems to be the crux of the issue. The public was promised record amounts of money would flow into the NHS. And so it has.”

“But the problem is it has not necessarily gone where many would expect.”

“Once pay hikes - consultants and GPs have both received lucrative increases - covering for deficits and rising drug costs are taken into account, the 7% budget increases actually equate to about 2% for services, according to the King's Fund.”

”Surveys have repeatedly shown that when asked what they think of the NHS people reply it is in crisis.”

Maybe Consultants complaining about Hunt, is like stars owing their career and lifestyle to the BBC, telling this government to leave the BBC alone, everything is fine.

The nhs needs a lot more money if it's to function fully 7 days a week inc elective surgery and routine clinics. But the govt is slashing funding. They can't say one thing and do another.

There aren't enough staff, either Drs or nurses or ODPs, phlebs, radiographers, etc.

It's very simple to say well train more but it's not that easy. We have a big nursing recruitment crisis where I work but we can't increase student numbers as we don't have the capacity to give more students placements. There aren't enough wards for them. It will be similar with med students Id have thought. Plus the fact as pointed out it takes many years for Dr to be trained in a speciality. Some specialities are struggling to recruit, a&e for example have a problem nationally, major shortage of Drs and heavily rely on agency Drs. Is the fact that it's a 24/7 speciality something which makes it less appealing? Dunno.

I think many specialities are struggling to recruit at the moment not just the 24/7 ones. I think we are going to have to accept that we need to offer more incentive for these specialities not less.
In dh's speciality they tried to recruit a consultant last year but there weren't any suitable candidates with sufficient training - they are expected to have topped up their professional exams with a research degree plus at least one overseas fellowship in an international centre of excellence. This costs the candidate money plus the speciality involves working conditions that many just don't cope with. I imagine working conditions in A&E aren't fun either. We have to accept that if we want the best surgeons then we have to do something more than crossing our fingers and hoping enough trainees enjoy that speciality.

Whether listening to Ambulance Drivers up to Consultants it is clear that the whole NHS system is creaking at the seams, but even if the public demand is better channelled e.g more GP's stop A&E walk ins etc, the DEMANDS will only increase.

The public needs to know that is has a government health man with a plan, working with an NHS man with a similar plan, who will do whatever is needed to set the NHS up on a sustainable footing not just for now, but also by planning for the future - and few can say that this government has not been afraid to tackle difficult decisions, or have not annually put a lot more money into the NHS as other budgets are cut.

A 7-day plan is huge, but so is the demands, and reading the comments here money alone can not solve shortages in skills etc at the moment, but clearly the SOONER all these problems have started to be be addressed, the better.

A coherent NHS 7-day plan across all specialities will have to be carefully costed, for the government health man, to pitch to the government money man, to fund it - and that is what grown up governments do, especially one that has planned to balance the UK's books by 2019/20, so new money going into government projects aren't BORROWED and the national debt increased further.

So unless anyone within the NHS can think of a way to slash NHS demand e.g. compulsory euthanasia at 70-years old and turn us wrinklies into Soylent Green (thus reducing Food Bank demand at a stroke(?) - can everyone within the NHS currently (and rightfully) complaining please think positive re any plans to EASE the capacity problems now, for in the near future, that ultimately should ease that pressure?

As there is nothing worse for simple citizens seeing public sector problems/ results, and hearing those public sector workers won't change as they know best vs a government and its taxpayers, whether in teaching, the police force or NHS.

When everything is running smoothly and bars can be raised in the future, fine, tell government to feck off, but not please when results show change is needed and the government has a reasonable whiff of policy/financial competence about them. IMBO

Isitme, one of the problems is the interference from managers and probably government. One example, DH set up an outreach clinic at another hospital about 100 miles away from home so people could be seen in their community. This worked extremely well and brought income into his service, his patients were happy and more turned up to appointments because they didn't have to travel so far. However, the managers saw it as him slacking off because he wasn't on-site so this clinic was cancelled. The managers are constantly undermining DH and his colleagues. He had a moment about 3 years ago where one of the senior managers shadowed him for a day, he pointed out areas of inefficiency and she was astonished by how much he actually did and how things could be improved. Unfortunately she left for another job so nothing was acted on.

The long term problem seems to be training/recruitment/retention then doesn't it?

A basic problem is that governments only govern for 5 years but it will take 20 years of a coherent consistent strategy for the NHS to overcome its problems.

Could the number of medical schools be increased?

There must be ways to increase the capacity of the NHS to be used for student placements.

It seems daft to have high youth unemployment but also a major recruitment shortage across health care professions.

Then basic labour market economics will also address the cost problem because an increase in supply of labour will reduce the cost per person.

Increasing medical schools wouldn't help. You need to increase number of hospitals in order to provide more placements. Oh, but there's not enough staff or money to do that is there.....

And yes attrition both from uni and from actual qualified staff needs addressing. Talking to a student midwife who's just about to qualify, they started with 18 in their group and only 3 have finished. The rest have thought bollocks to this and walked.

The Tories are simply intent on forcing everyone into the private sector by making the national health service so unbearable, there's no other option.
The rhetoric re deficit and cuts, austerity, etc. Look at who benefits.

isit-I have no idea whether you have not been reading the posts of the many doctors and other HCPs that are currently all over the media or whether you are wilfully choosing to misunderstand.

Of course HCP know better than the general public and the government do what is going on in the health service because they spend a good part of their lives working for it. The health secretary has no experience of health care whatsoever. I believe that he has had some business failures as well as successes.
I would never be arrogant enough to presume to tell a teacher his/ her job because I am not a teacher and have never worked as a teacher.

The fact that the previous Labour government made some appalling decisions (I don't think anyone is ignorant of these) does not excuse JH insulting and lying about doctors in order to fulfil his personal agenda.

Teaching new medics becomes a 'time' problem again. Managers allow 10 minutes per consult during which a Dr has to examine, discuss and consent with a patient. Teaching time is limited. Those 48 hours don't go very far. An operation can be performed more quickly and confidently by an experienced consultant than a new junior. Operations and appointments bring money into a service so managers are trying to maximise income not teaching opportunities.