#ImInWorkJeremy

Last weekend (19^th & 20^th July 2015) tweeter was alive with #ImInWorkJeremy as NHS staff tweeted that they were working that weekend. They told of busy shifts, early starts, and listed the other staff they were working with, even Consultants.  This was a direct challenge to Jeremy Hunt and his latest plan for a seven-day NHS, because if you’d listened to him lately you’d have thought that the NHS was running only a skeleton staff at weekends and wilfully putting patients’ lives at risk. The #ImInWorkJeremy tweets painted a very different picture.

Jeremy Hunt’s argument has been that if you’re admitted to hospital at a weekend you’re 16% more likely to die then if you’re admitted during the week, and 6,000 people a year die needlessly because of the “poor” healthcare at weekends (1). And who fault is this? Hunt says it’s hospital consultants because they “refuse” to work weekends.

Margaret McCartney, in the BMJ, neatly took apart the 16% statistic (2). This figure comes from a 2009-10 study of English hospital admissions, during a thirty day period. There were 14 217 640 admissions and 187 337 deaths during this time, which is a death rate of 1.32%. Of that 1.32%, there was a 16% increase of deaths if the patient was admitted on a Sunday, but this means that there’s a 0.2112% increased risk of death for all patients admitted on a Sunday, and not a 16% (2). Also, there is no evidence for why there is this increase, it’s not just because the senior Consultant was at home that day.

The 6,000 deaths a year caused by “poor” care at the weekend, this figure comes from an unpublished study (1). Therefore no one can analyse the data, the study, its findings or even see what the study was about. We can’t check this figure because no one knows where it came from. This is one of the most dishonest uses of statistics, quoting ones that no one else can check.

But these criticisms don’t seem to have stopped Hunt, he is now threatening to push through this reform with or without the support of NHS staff, and as he does so he’s painting a prejudiced and out-of-date picture. According to Hunt, Consultants are fat-cats, more interested in playing golf than seeing their patients on a Sunday afternoon. This image isn’t true but it gleefully appeals to tabloid newspaper prejudices and makes good headlines. It also plays into the old image the bullying Consultant who nobody dares question.

The truth is that many Consultants are already working weekends. The 2003 Consultants contract, the one Hunt wants to rip up, says that senior doctors can opt out of weekend work only if their work is non-emergency/urgent, but they are still expected to be on call. So why does Hunt want to change this?

Am I being paranoid in fearing that there is an agenda behind Hunt’s plan? Consultants have been very vocal opponents of current changes being imposed on the NHS, especially the Health and Social Care Act 2012. Is this an attempt to silence them, to break their perceived power? If so what for, more contracts in the NHS? More privatisation of the NHS? Hunt’s actions are certainly confrontational, his talk of lazy doctors and consultants putting patients at risk. This is not the behaviour of someone wants to negotiate and improve patient care.

And what was Hunt’s reaction to #ImInWorkJeremy? On Friday (19^th July) he posted a picture of himself, on a hospital ward, on twitter, and in the background could be clearly read patients’ names and details. He breached patient confidentiality (3).

I was working last weekend, I tweeted #ImInWorkJeremy both days, and both days I was late leaving because of the volume of work we had to do. Jeremy Hunt, he was on holiday, the start of his seven weeks summer holiday.

Drew Payne

@drew_london

July 2015.

P.S. This blog was originally written for and published on the RCNi website

My Blogs Featuring Jeremy Hunt

These are the links to blogs where I discuss Jeremy Hunt’s handling of the NHS, either blogs that are discussing his handling of a certain situation or that they are discussing a certain situation and make reference to Hunt’s behaviour.

                                    

The 6.5% Problem

Readthe Small Print Before Signing

 

When You Just Don’t Understand the Situation

 

The 1% Problem

 

Their Lips are Moving but I Don’t Believe a Word That They Say...

 

Data Protection: Another Jeremy Hunt Failure

 

Tomorrow is the Day

 

The Computer Says No

 

Jeremy Hunt: The Man Who Doesn’t Understand Nursing?

 

Where Have All the EU Nurses Gone?

 

Is Failure Ever an Option?

 

And the Truth About Stress

 

Mrs May and the Act of Scapegoating

 

Stop Lying Jeremy

 

Just When I Thought the NMC Had Hit Rock Bottom…

 

Not in My Name

 

Four Corners of the Same Room

 

Sorry is the Easiest Word to Say

 

An Honest Day's Pay for an Honest Day's Work?

 

Why I am Supporting the Doctor's Strike, And It wasn't a Hard Decision

 

A Worrying Change

 

 

Drew Payne

What Has the NHS Ever Done for Us?

The NHS was founded 70 years ago today (1). I’m a child of the NHS. I was born into the NHS (It is a lot older than me) and I have lived all my life under the NHS. It is the only healthcare system I have known and but it is the only healthcare system I would want to live under.

The NHS is a very different organisation to the one I was born into. Back then, in the mid-sixties, it was a very patriarchal organisation, doctor knew best and doctor made all the decisions for you. But society as a whole was very like that, men in authority and in power (and the vast majority were men) made the decisions for us. It was only in the seventies that attitudes began to change.

When I started my nurse training nurses had just stopped wearing hats and aprons and I was repeatedly referred to as a “Male Nurse”, which I objected to even back then. There was still so much attention paid to how well you made a patient’s bed, perfect hospital corners, and there was just talk about the “extended role”, there were nurses who refused to give IV drugs because they said it wasn’t part of “basic nursing care.”

The job I do now is vastly different to the one I was trained to do, apart from the fact that I work in the community and I was trained to be a hospital nurse, and that’s the way it should be. My job has evolved into that of a healthcare professional, specialising in patient care, it has evolved into a role that patients require, not just what we think they need.  In the same way, the NHS had changed, unfortunately not always for the good.

I have experienced many of the changes in the NHS, so many of them driven by political ideology and not always by clinical need, and many of those changes haven’t benefited the NHS, but the NHS has survived them. The NHS has also weathered many scandals, I have lived through more than my fair share of them, and it has still kept the public confidence, this year 57% of the public said they were satisfied with the NHS (2). How the NHS has survived all these things, I feel, is due to the dedication of its staff, we are still the greatest resource the NHS has.

The NHS was the first national healthcare system were access to treatment was based on citizenship rather than what you had paid into a scheme or your ability to pay for your treatment (3). This means treatment is determined on need, and not ability to pay or have you paid enough into an assurance scheme. It is free at the point of need. For me, this is still the best system, a system based around patient care and not ability to pay/fund your treatment.

In the last year of my nurse training, I considered moving to the United States to work, once I’d qualified. On a holiday there, that year, I had an informal visit to a Phoenix hospital, in Arizona. I was shocked at how much of a nurse’s work was taken up with billing patients for their care. Everything a nurse did for a patient had to be recorded so that the patient would later be charged for it. Patient care could also be determined by their ability to pay, such as some patients receiving cheaper dressings because the nurses knew the patient couldn’t afford the more expense ones, even if that expense dressing was the one for their wound.

Our press likes to talk about the “failings” of the NHS, and my blog has been very critical of the way the NHS is treated, but the NHS is still one of the best healthcare systems in the world. This is not just me talking big, last year the Commonwealth Fund found that the NHS is the best, safest and most affordable out of eleven different developed countries (4), including Canada, the United States, Germany, France and the Netherlands (5). I am proud of this, we all should be proud of this and singing this from the rooftops.

What is the alternative to the NHS? A private healthcare system, like the United States has and has been muted by different right-wing politicians down the years? If that was the case my parents probably wouldn’t have been able to afford to have me, I was their third child. Two and a half years ago I broke my ankle at work (Read more it about here), I could never have afforded the surgery and treatment it cost to repair it, which is anything from $13,000 to $22,000 plus (6).

I work as a Community Nurse, as part of a District Nurse team in Islington, North London. The majority of my patients could not afford to pay for the treatment they receive, yet for many of those patients our care is a lifeline.

I am proud that my country has the NHS and has had it for seventy years. I am also proud to work for the NHS because I have seen first hand how the NHS has changed people’s lives and how the NHS has maintained the quality of people’s lives. And I will continue to shout as loud as I can to protect the NHS because I’ve looked at the alternatives and I don’t like them.

Drew Payne