In this junior doctors row, even real doctors can become spin doctors.

Sarah-Wollaston_2985657b

Dr Sarah Wollaston is Conservative MP for Totnes and Chair of the Commons Health Committee. She is a former GP and teacher. Her daughter, a junior doctor, left the NHS last year with 8 of her friends to go to Australia. She has consistently voted in favour of easing restrictions on private companies to deliver healthcare in the United Kingdom:

 

http://www.theyworkforyou.com/mp/24761/sarah_wollaston/totnes/divisions?policy=6677

Dr Wollaston has penned a “balanced” piece for The Guardian, looking to apportion blame for the junior doctors strikes on both the government and junior doctors:

http://www.theguardian.com/commentisfree/2016/apr/03/in-this-junior-doctors-row-both-sides-have-lost-sight-of-the-patient

This attempt is about as impartial as Bill O’Reilly’s “No-Spin Zone” programme on Fox News, with a combination of subtle spin and phony ignorance.

Here is a dissection of some key points in her article:

“Sick people seem an afterthought as the government and the BMA pursue an unnecessarily toxic debate”

No they don’t, the BMA and junior doctors’ entire motivation is to safeguard the future of care in this country.  The BMA are well-supported, but if anything much less powerful than other doctors’ unions around the world.  This has come about following years of erosion and in-fighting. If anything, junior doctors are upset that the BMA have not been going far enough:

http://doctoryak.com/blog/what-if-the-government-were-negotiating-with-the/

“Many of my daughter’s colleagues are not planning to join her on the journey home next year and there has been a marked increase in the numbers applying for certificates to work overseas.”

I wonder why?

“The dispute looks set to erupt into a dangerous full walkout by junior doctors. The British Medical Association claims that the contract will harm patients by stretching doctors too thinly across seven days while reducing their take-home pay. The government insists that patients are being put at risk by understaffing at the weekends and that the contract reduces doctors’ maximum hours and consecutive shifts while increasing basic pay by 13.5%.”

She knows better than anyone that net pay will go down for many, yet uses the same smoke and mirrors technique used by her colleague Jeremy Hunt meant to fool the public – “increasing basic pay by 13.5%”. She is being disingenuous here because anyone who has looked at the contract knows that out-of-hours pay is cut significantly so net pay is down for many fields, especially emergency ones.

And how could the government set up the world’s first and only routine national health service when it has been reducing funding for the NHS since it took power? https://youtu.be/r60Hf2CmxE0

 

“It seems to me that the contract is more about the manifesto commitment to a seven-day NHS and the perceived barrier of premium Saturday pay rates”

Well no argument here.

“Mine was the last generation of doctors to endure crushingly unsafe 120-hour working weeks and I have no romantic nostalgia for the 72-hour shifts commonplace in the late 1980s”.

But we have her on record insinuating that “doctors today shouldn’t complain, we had it worse in our day” and this is the crux of her emotion when it comes to this issue – she doesn’t think these unsafe hours are “all that bad” compared to what she went through. A former doctor who has this kind of attitude should not have this role, because they are using their own personal experiences to influence their judgment. There are many doctors much more experienced than her who had it a lot worse and know that this logic is at best irrelevant (the world is different now), at worst dangerous.

“Pressing ahead with a full walkout however, will serve only to harden attitudes and solves nothing. Most importantly, it will be disastrous for patients”.

New Zealand had a full walkout for 4 days a decade ago – patient waits were shorter, and emergency outcomes were better when staffing was only done by consultants and staff grades. It achieved the desired effect perfectly as New Zealand vastly improved its junior doctor contract, halting an exodus to Australia and attracting hordes of British doctors (when the net flow was previously the other way round).

 

“How can it be argued that patients will be safer only if all Saturdays are paid at the premium rate, however infrequently worked? Given the scale of concessions and protections on maximum hours and consecutive shifts, the BMA could have declared victory and moved on to focus on the deeper and longstanding causes of discontent.”

More spin – No one is saying this. And also this isn’t about some childish notion of “victory”. Furthermore, do you not think protections against tired doctors aren’t a worthwhile concession? Or do you want your daughter returning from her jaunt in Australia working unsafe shifts?

“Many more of their duties could be shared with others such as pharmacists, physician associates and admin staff”

Well in many hospitals we are seeing physician associate posts advertised (with salaries twice those of junior doctors) but the erosion of junior doctors’ work to become what it is today has happened over two decades now so this is going to take a long time to fix, and people like you who have taken roles in politics should have been coming out a long time ago.

“In some hospitals, such as Salford Royal in Manchester, electronic patient records are finally reducing the scandalous waste of time and resources that come with duplication and paper trails.”

In other hospitals such as Addenbrooke’s in Cambridge, electronic patient records have cost hundreds of millions and effectively bankrupted the hospital, introduced too quickly and with many, many glitches, effectively slowing down and losing continuity for patients.

 

“A constructive relationship between doctors and government will take time to rebuild; it cannot be imposed and it will not happen unless both sides put patients first and start listening. Saving lives must take priority over saving face.”

And as someone who is a former doctor and part of this government, you should practice what you preach and not keep coming out with this spin (feigned under the guise of a balanced inbetweener of two warring factions), when you know how much of a disgrace these proposals have been, you know how much the NHS has been wilfully under-funded and you personally have sanctioned the many Private Finance initiatives popping out like fungus on a damp corpse.

Share

Jeremy Hunt’s 7-Day NHS lie

 

Jeremy Hunt wants the world’s first 7-day routine health care service.
This is a hollow manifesto promise. It is as fantastical as baby unicorns for all 9 year-olds.

He is using this as his fuel to put pressure on frontline healthcare staff, which is already causing many to leave, and will render the NHS unsustainable.

This will open the sluicegate for wide-scale privatisation of the NHS. The evidence of his intentions is clear for all to see.

Please don’t let this happen.

Please tweet in support:
#juniordoctors
#saveournhs
#keepournhspublic
#nomorehuntlies
#7dayunicorns

This video will never be monetized.

Share

What if the government were negotiating with the NZRDA rather than the BMA?

image

by Nima Ghadiri

The government is currently locked in a dispute with junior doctors over a proposed new contract.  The organisation representing junior doctors is the British Medical Association (BMA), a trade union which was founded in 1832 and represents all United Kingdom doctors, not just Junior Doctors.  The chair of the BMA’s junior doctor’s committee  is  Johann Malawana.

Chief areas of contention in the contract are: removals of national safeguards (fixed financial penalties) for organisations when Junior Doctors work long hours, cutting out minimum break requirements,  re-designation of the normal working week leading to an added day when hospital resources are lacking, and disadvantages to doctors who work less-than-full-time and have families.

Jeremy Hunt, the Secretary of State for Health, has stated that the British Medical Association (BMA) have misrepresented Junior Doctors and has targeted the union aggressively in a bid to win public opinion.  This has been echoed in much of the tabloid press, who have used social media photos of the BMA Junior Doctors’ committee in order to portray them as wealthy manipulators of the Junior Doctors that they represent.

Indeed, The BMA has had a tumultuous relationship with Junior Doctors lately. Many felt that the union did not fight hard enough following various events which have taken place over the last decade: Loss of House Officer Accommodation, shortages of training posts, the ill-received Medical Training Application System (MTAS), pay increases below inflation and consistently increasing GMC and examination fees.

Nevertheless, in this battle, Junior Doctor consensus (based on a Facebook group which is 63,000 strong) is that the BMA is working hard and representing the position appropriately, but is simply underpowered. Junior Doctors who have worked abroad, in particular New Zealand, will know just how underpowered the BMA is.

image

The  New Zealand’s Resident Doctor’s Association “NZRDA” was founded in 1985. It represents only Junior Doctors, rather than all doctors.  British doctors who move to New Zealand tend to be surprised about the power of this organization, which is very proactive and consistently anticipates future problems.

Over time, the NZRDA have (chiefly through their firebrand negotiator Deborah Powell) negotiated a number of improvements on an annual basis by means of their Multi Employer Collective Agreement “MECA”. These have included: consistent increments in pay, final year medical students being given a salary, free canteen food during working hours, training and membership costs being covered, presence of cross-cover and relief doctors to cover short-term absences, ease in going out-of-programme for family or travel.  There is even a motivation for hospitals and clinics to ensure that their junior doctors claim all of their annual and study leave, as the amount not used becomes “cashed out” as a payment.

image

The NZRDA have been aggressive in the few instances when conditions have deteriorated.  In April 2008, the NZRDA gave notice of a nationwide 48-hour strike over pay, conditions and ongoing issues of retention, as 40% of Kiwi doctors were moving to Australia.  At the time, a first year house-surgeon in NZ earned 88,000 NZD (£40,000) on average.  Junior doctors sought a 10% pay rise over three consecutive years ( twice that of other health service workers) rather than two rises of 4% over two years.

image

The strikes were widely seen as a success which brought the desired outcome for the doctors, caused no harm to patients (indeed, emergency department waiting times were markedly reduced), has improved retention of doctors and made New Zealand a very attractive destination for British and other doctors.  They have also empowered the NZRDA to fight annually for better conditions.

image

In a hypothetical situation, what would happen If the NZRDA were transplanted to the negotiating table in the United Kingdom?  Based on their track record, they would be keeping the government on their back feet.  In particular, they would not hesitate to legally challenge the government, for example Jeremy Hunt’s assertion that we do not already have a seven-day emergency NHS has led to well-documented patient harm.

image

Unfortunately, the BMA may simply not have the strength to attack on all fronts in order to secure a fair and safe contract this time round. However, a Union is only as strong as the will of its members, and for the Junior Doctors this is currently very strong indeed. One outcome of the current dispute will be a galvanised and stronger British Medical Association. Which is precisely what the government don’t want.

Share