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| Jeremy Hunt heralds NHS 'Reformation' as he heads for showdown with doctors | Jeremy Hunt heralds NHS 'Reformation' as he heads for showdown with doctors |
| (6 days later) | |
| Jeremy Hunt has set out his ambition to make sweeping NHS changes to create a “more human” seven-day service that has fewer targets but more transparency. | Jeremy Hunt has set out his ambition to make sweeping NHS changes to create a “more human” seven-day service that has fewer targets but more transparency. |
| In a speech he declared his most important yet, the health secretary said the NHS was facing a “Reformation moment”, as the health service once described by former chancellor Nigel Lawson as a national religion was being questioned and challenged to become more open. | In a speech he declared his most important yet, the health secretary said the NHS was facing a “Reformation moment”, as the health service once described by former chancellor Nigel Lawson as a national religion was being questioned and challenged to become more open. |
| Related: Seven-day NHS: five questions that need to be answered | Related: Seven-day NHS: five questions that need to be answered |
| But his ultimatum to consultants that a new weekend working contract would be imposed on them put him on collision course with the British Medical Association, which said the plan was a “wholesale attack on doctors”. | But his ultimatum to consultants that a new weekend working contract would be imposed on them put him on collision course with the British Medical Association, which said the plan was a “wholesale attack on doctors”. |
| Announcing a series of changes in a speech at the King’s Fund in London, Hunt said he wanted to see a profound change in culture in the NHS to focus on patients, and no longer tolerate avoidable deaths. | Announcing a series of changes in a speech at the King’s Fund in London, Hunt said he wanted to see a profound change in culture in the NHS to focus on patients, and no longer tolerate avoidable deaths. |
| “This is my offer to the NHS today: more transparency in return for fewer targets,” he said. “Learning and continuous improvement at the heart of a more human system where we eliminate any conflict between organisational priorities and what is right for the patient sitting in front of you.” | “This is my offer to the NHS today: more transparency in return for fewer targets,” he said. “Learning and continuous improvement at the heart of a more human system where we eliminate any conflict between organisational priorities and what is right for the patient sitting in front of you.” |
| Central to Hunt’s plans are proposals to change working patterns for consultants, including an end to the opt-out for weekend working. The health secretary has issued an ultimatum, saying he is prepared to impose new contracts by September if an agreement cannot be reached. | Central to Hunt’s plans are proposals to change working patterns for consultants, including an end to the opt-out for weekend working. The health secretary has issued an ultimatum, saying he is prepared to impose new contracts by September if an agreement cannot be reached. |
| In the wide-ranging speech, he also announced: | In the wide-ranging speech, he also announced: |
| Hunt appears to be prepared to antagonise the doctors’ union in the same way that Theresa May, the home secretary, squared up to the Police Federation and Michael Gove riled the teaching profession when education secretary. | Hunt appears to be prepared to antagonise the doctors’ union in the same way that Theresa May, the home secretary, squared up to the Police Federation and Michael Gove riled the teaching profession when education secretary. |
| His predecessor Andrew Lansley clashed repeatedly with the medical community at the beginning of the last parliament. | His predecessor Andrew Lansley clashed repeatedly with the medical community at the beginning of the last parliament. |
| Hunt’s ambitions for sweeping changes were met with support from the NHS Employers body, but the BMA decried the “wholesale attack”. It said the ultimatum was a blatant attempt by the government to distract from its refusal to invest properly in emergency care. | Hunt’s ambitions for sweeping changes were met with support from the NHS Employers body, but the BMA decried the “wholesale attack”. It said the ultimatum was a blatant attempt by the government to distract from its refusal to invest properly in emergency care. |
| However, speaking on the BBC Radio 4’s Today programme, Hunt said the Department of Health had been trying to negotiate with the BMA since 2012, but the union walked out of talks last October | However, speaking on the BBC Radio 4’s Today programme, Hunt said the Department of Health had been trying to negotiate with the BMA since 2012, but the union walked out of talks last October |
| He said there were “catastrophic consequences” of not having a seven-day health service, as there was a greater risk of patients dying in hospitals at weekends. | He said there were “catastrophic consequences” of not having a seven-day health service, as there was a greater risk of patients dying in hospitals at weekends. |
| “We have got nearly 10,000 more doctors in the NHS compared to five years ago, so we are recruiting more doctors to the NHS. But it is incredibly inefficient to have a service that cranks up on a Monday morning, starts to wind down after lunch on a Friday,” he said. | “We have got nearly 10,000 more doctors in the NHS compared to five years ago, so we are recruiting more doctors to the NHS. But it is incredibly inefficient to have a service that cranks up on a Monday morning, starts to wind down after lunch on a Friday,” he said. |
| “And if you are admitted to hospital on a Friday and you have an important test and then you are told you are going to have to stay in hospital for the Saturday and the Sunday, and then you won’t get a decision on whether you can leave hospital on a Monday or a Tuesday when a senior consultant can come and see you – no consultants want that for their patients.” | “And if you are admitted to hospital on a Friday and you have an important test and then you are told you are going to have to stay in hospital for the Saturday and the Sunday, and then you won’t get a decision on whether you can leave hospital on a Monday or a Tuesday when a senior consultant can come and see you – no consultants want that for their patients.” |
| The health secretary said he had yet to meet a consultant who would be happy for their own family to be admitted at weekends. | The health secretary said he had yet to meet a consultant who would be happy for their own family to be admitted at weekends. |
| Speaking on the same programme, Dr Mark Porter, who leads the BMA, said doctors wanted to improve the service of the NHS over a seven-day week but other factors were to blame, including a lack of resources. | Speaking on the same programme, Dr Mark Porter, who leads the BMA, said doctors wanted to improve the service of the NHS over a seven-day week but other factors were to blame, including a lack of resources. |
| The new contract will have at its core the controversial weekend working provision, but will also contain the abolition of lucrative overtime payments that Hunt describes as extortionate. | The new contract will have at its core the controversial weekend working provision, but will also contain the abolition of lucrative overtime payments that Hunt describes as extortionate. |
| At present, under a contract last negotiated by Labour in 2003, consultants can opt out of non-emergency work outside the hours of 7am to 7pm Monday to Friday. | |
| A patient has a 15% higher chance of dying if they are admitted in a hospital on a Sunday than on a Wednesday, Hunt points out, clearly implying the inflexibility of consultants leads to unnecessary deaths. | A patient has a 15% higher chance of dying if they are admitted in a hospital on a Sunday than on a Wednesday, Hunt points out, clearly implying the inflexibility of consultants leads to unnecessary deaths. |
| Hunt also pointed to research showing that the pay of 40,000 consultants in England and Wales rose by 50% between 2001 and 2005. | Hunt also pointed to research showing that the pay of 40,000 consultants in England and Wales rose by 50% between 2001 and 2005. |
| • This article was amended on 21 July 2015. An earlier version said incorrectly that under the current contract, “only consultants in A&E are expected to work weekends or evenings, and the remainder can opt out if they are asked to work outside the hours of 7am to 7pm Monday to Friday”. |
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