Sunday 17th January

Well, we all support the Doctors, don’t we?  Even though by the standards of many they might appear fairly well paid, they have spent years learning to heal us and they notoriously have to work nights and weekends.  And there is the rub.  Their pay at weekends is considerably higher than during the week and the Government is trying to force a new contract on them to reduce the number of hours which are considered as “unsociable”.  Jeremy Hunt argues that it is unacceptable that death rates at Hospitals are higher at weekends than during the week.  He is also somehow trying to blame Junior Doctors for this situation, he claims that the country voted for a 24 hour, seven day a week NHS at the last election and the Junior Doctors are standing in the way of this.

Well, I doubt very much if a single voter voted Tory because of this nebulous promise; all polling suggests that the public do not trust the Government with the NHS at all.  And of course there already is a 24 hour, 7 day a week NHS; there always has been.  Casualty departments have worked on this basis for years, and wards do not shut up and clear their patients out at 6 on a Friday night.  It may be true that there is lower staffing rota-ed on at weekends and nights but who is responsible for that?  Hospital Administrators of course.  And you can hardly blame them, they are being pressured by the Government to keep to ever-tighter budgets and the only tool at their disposal, as every business realises, is to reduce the wage bill.  And in all likelihood even if Mr. Hunt succeeds and Junior Doctor’s pay is reduced somewhat at weekends I suspect that these same Hospital Administrators will simply leave rotas unchanged and save a bit of money from the wage bill.  If the Government is truly concerned at the levels of health care available at weekends the solution is simple.  They could and should order Hospital Administrators to fully staff our wards and hospitals at the weekends and any additional cost should be met by Central Government.  The real scandal in the NHS, and one of the reasons costs are rising so fast is the ridiculous situation where an Agency nurse is paid far more (or actually the Agency which employs them is) than regular NHS nurses, who have had their pay restrained for six years already.  Simple solution here too; raise nurses pay and insist that no Agency nurses will be tolerated after say one year.

You see, all of these decisions are political choices, there is no inevitability, there is no single answer; there is always a choice.  And despite this Government’s declaring that they have continually increased spending on Health, we spend 8% of GDP whereas in Europe it is almost 11%.  And there is no reason why we cannot spend more and tax a bit more to pay for it.  The public has never been explicitly asked if in order to have a world class NHS would they agree to a fair increase in taxation.  I suspect that they might agree, but at the last few elections parties have been forced to deny any plans for tax increase, as if this were the worst thing that could ever be contemplated.  So, support the Doctors but don’t be surprised if whatever the outcome there is little change in weekend coverage after all.