Weekend hospital work needs weekend backup, Mr Hunt

http://www.theguardian.com/society/2015/jul/20/weekend-hospital-work-needs-weekend-backup-mr-hunt

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Jeremy Hunt paints a dishonest picture in his talk to the King’s Fund by relating high death rates among patients admitted to hospital at weekends to the lack of seven-day elective work by consultants (Hospital consultants face ultimatum, 16 July). One reason for excess deaths among weekend admissions (which happen all over the world) is that patients are not admitted for elective surgery at weekends, so all weekend admissions are emergency cases, which have a higher risk of death.

Related: Jeremy Hunt gives NHS consultants ultimatum on weekend working

The response on Twitter with the #ImInWorkJeremy hashtag last weekend confirms that all contracts require consultants and those in training to cover emergency work out of normal hours, which are defined as 7am to 7pm, Monday to Friday. Since 2003, contracts might include a requirement to work at weekends at enhanced rates of pay to do elective (planned) work.

Mr Hunt wants all future contracts to require hospital doctors to do planned work at weekends, but this will do nothing to improve emergency cover. He does not explain where the money to pay for the extra support staff in the labs and imaging departments is to come from, and what will happen to weekday clinics and operating sessions if doctors are working at weekends.

Without an increase in the number of doctors, who take years to train, and increased funding, seven-day routine working is not possible. The £8bn promised to the NHS by 2020 by the Conservatives before the election is insufficient to cover inflation, let alone this idea. Wendy SavageCautley, Cumbria

• As a junior doctor working in a UK hospital, I am trained to practise evidence-based medicine. I expect my elected representatives to practise evidence-based politics, spending our money wisely, and for the greatest good.

What we know about mortality after acute hospital admissions is only that it increases at weekends. There is no hard data explaining the reasons why. Yet Jeremy Hunt proposes the solution of seven-day weekday working in hospitals.

What we know about this “solution” is that stretching weekday services across seven days entails the seven-day presence of the small army of junior and senior ward-based doctors, pathologists, radiologists, nurses, clinical support workers, technicians, porters, administrators and so on who currently ensure the full functioning of the hospital Monday-Friday.

If Jeremy Hunt is really committed to seven-day weekday services in hospital, he must provide the funding for said small army over seven days, not five. Without that additional funding, he will merely be overextending an exhausted, broken and demoralised workforce to paper over the cracks of an NHS already stretched to breaking point. As an NHS doctor who loves her patients, I dread the consequences of imposing this rhetoric on our health service without the funds to make it a reality. Dr Rachel Clarke Wheatley, Oxfordshire

• It must surely be the height of arrogance for Jeremy Hunt to say the BMA is “not remotely in touch with the views of its members” when he, as culture secretary, did not have the first idea what his right-hand man was up to. Carol GreenOxford

• An early day motion in support of homeopathic hospitals signed by Jeremy Hunt in 2007 says “complementary medicine has the potential to offer clinical and cost-effective solutions to common health problems faced by NHS patients”. Does he not worry about exceeding the homeopathic concentration of consultants at the weekends in hospitals?Ann KinslerWinchester