Wednesday, 18 May 2016

Deal on junior doctors pay dispute is v welcome but remember we in Northumbria NHS have junior doctor/consultants on a 7 day system already

I am well known for my support for the NHS, not least as I owe my life several times over to the NHS, and my grandmother was a hospital matron. And I delighted to hear from the BBC
that the junior doctors dispute over weekend pay will soon be resolved. All other concerns over 3 + years of negotiations have been met. The fair point to make is that the issue of Saturday pay sees doctors being offered a better deal than all other comparable services like Police, Ambulance, paramedics etc. Their increased pay also comes out of the overall NHS pot of money, which has gone up under this government, but is still stretched. Given a limited financial pot of taxpayer’s money many of my other constituents are asking why should junior doctors be paid more than other public professionals?
Most importantly, we already have a pilot project of 7 day NHS – here in Northumberland. The Cramlington Emergency Care Hospital operates a 365 days per year consultant and junior doctor cover: this is a true 7 day NHS. This is the model for the future that does not presently exist in the rest of the NHS. So anyone calling for a pilot project can see examples here in Northumberland ,or at the Salford Hospital in Manchester. I have been to Cramlington several times and met the teams of doctors, consultants and nurses. Although there have been teething problems the system work very well. Health outcomes are better.
I would make four other key points:

Firstly, the health service is now treating more people, has more doctors, more nurses and even more midwives. The funding is going up and it remains free at the point of delivery. This will never change. There is no privatisation or forced payment agenda, and anyone who says so is simply scaremongering. However, the NHS rightly gets value for your and my taxpayers funding and long may that continue. The Government’s financial commitment to the NHS has already seen a like-for-like increase of 10,700 more hospital nurses and 10,100 more doctors. Despite the pressure on national finances, last year’s spending review committed the Government to a £10 billion real-terms increase in the annual NHS budget by 2020. By the end of the Parliament, the supply of doctors trained to work in the NHS will have increased by a further 11,000+. While it is true that pressures on the NHS will continue to increase on the back of an ageing population, we are not saying that the current workforce will have to bear all the strain of delivering a seven-day service, even though, of course, they must play their part.

Secondly, there is a concern that the Government may want to see all NHS services operating seven days a week. Let me be clear: our plans are not about elective care, but about improving the consistency of urgent and emergency care at evenings and weekends. To do this, the Academy of Medical Royal Colleges has prioritised four key clinical standards that need to be met. These include: making sure patients are seen by a senior decision maker no more than 14 hours after arrival at hospital; seven-day availability of diagnostic tests with a one-hour turnaround for the most critically ill patients; 24-hour access to consultant-directed interventions, such as interventional radiology or endoscopy; and twice daily reviews of patients in high dependency areas, such as intensive care units. About one quarter of the country will be covered by trusts meeting these standards from next April, rising to the whole country by 2020.

Thirdly, there is the concern that proper seven-day services need support services for doctors over the weekends and evenings, as much as doctors themselves. Less than half of hospitals are currently meeting the standard on weekend diagnostic services, meaning patients needing urgent or emergency tests on a Saturday or Sunday, such as urgent ultrasounds for gallstones or diagnostics for acute heart failure, face extra hours in hospital at weekends or even days of anxiety waiting for weekday tests. Our new standards will change this, with senior clinician-directed diagnostic tests available seven days a week for all hospitals by 2020.

Finally, there is a legitimate concern that a seven-day NHS needs to apply to services offered outside hospitals if we are properly to reduce the pressure on struggling A and E departments. So, as announced last month, the Government’s seven-day NHS will also see transformed services through our GPs. We are committing an extra £2.4 billion a year for GP services by 2020-21, meaning that spending will rise from £9.6 billion last year to over £12 billion by 2021—a 14% real-terms increase. Thanks to this significant investment, patients will see a genuine transformation in how general practice services operate in England. By 2020, everyone should have easier and more convenient access to GP services, including at evenings and weekends. We will not be asking all GP practices to open at weekends to deliver this commitment, but instead using networks of practices to make sure that people can get an evening or weekend appointment, even if not at their regular practice. We have committed to recruiting an additional 5,000 doctors to work in general practice to help meet this commitment, and we will support GPs in this transformation by harnessing technology toreduce bureaucratic burdens.

I am delighted that there appears to be a resolution to this dispute.