Junior Doctors Contracts — House of Commons, 2016-04-25
Topic: Health
Jeremy Richard Streynsham Hunt (Conservative, Centre-right): We have many choices in life, but one thing over which we have no control is the day of the week that we get ill. That is why the first line on the first page of this Government’s manifesto said that if elected we would deliver a seven-day NHS, so we can promise NHS patients the same high-quality care every day of the week. We know from countless studies that there is a weekend effect showing higher mortality rates for people admitted to hospital at weekends. The British public know that, too. Today, we reaffirm that no trade union has the right to veto a manifesto promise voted for by the British people. We are proud of the NHS as one of our greatest institutions, but we must turn that pride into actions. A seven-day service will help us to turn the NHS into one of the safest, highest-quality healthcare systems in the world This week, the British Medical Association has called on junior doctors to withdraw emergency care for the first time ever. I will update the House on the extensive measures being taken up and down the country to try to keep patients safe. But before I do so I wish to appeal directly to all junior doctors not to withdraw emergency cover, which creates particular risks for A&Es, maternity units and intensive care units I understand the frustration that many junior doctors feel that, because of pressures on the NHS frontline, they are not always able to give patients the highest quality of care that they would like to. I understand that some doctors may disagree with the Government about our seven-day NHS plans and, in particular, the introduction of a new contract. I also understand that doctors work incredibly hard, including at weekends, and that strong feelings exist on the single remaining disagreement of substance: Saturday premium pay. However, the new contract offers junior doctors who work frequently at weekends more Saturday premium pay than nurses, paramedics and the assistants who work in their own operating theatres, and more than police officers, firefighters and nearly every other worker in the public and private sectors Regrettably, over the course of this pay dispute 150,000 sick and vulnerable people have seen their care disrupted. The public will rightly question whether this is appropriate or proportionate action by professionals whose patients depend on them. Taking strike action is a choice. If they will not listen to the Health Secretary, I urge them to listen to some of the country’s most experienced doctors—Professor Sir Bruce Keogh, Professor Dame Sally Davies and former Labour Health Minister Lord Darzi—who have all urged doctors to consider the damage it will cause to both patients and the reputation of the medical profession Let me today address some of the concerns raised by junior doctors: first, that a seven-day NHS might spread resources too thinly. 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. I can today tell the House that by the end of the Parliament the supply of doctors trained to work in the NHS will have increased by a further 11,420. 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 are: 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 in 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&E departments. So, as announced last week, 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 to reduce bureaucratic burdens Returning to the strikes, the impact of the next two days will be unprecedented, with more than 110,000 out- patient appointments and more than 12,500 operations cancelled. However, the NHS has made exhaustive preparations to try to make sure that patients remain safe, and I want to thank those many people in NHS England, NHS Improvement and every trust in the country who have been working incredibly hard over this weekend to that effect I have chaired a series of contingency planning meetings, bringing together the operational response across the entirety of the NHS and social care systems. From this, NHS England has worked with every trust to ensure that they have plans in place to provide safe care, with particular focus on their emergency departments, maternity units, cardiac arrest teams and mental health crisis teams. As part of their duties for civil contingency preparedness, trusts also have major incident plans in place which are ready to be enacted if required. NHS England has also asked GP practices and other primary care providers in some areas to extend their opening hours so that patients can continue to get the important but non-emergency care that they need, such as follow-ups and assessments Finally, we have set up a dedicated strike page on the NHS website to provide as much information as possible to the public on local alternatives to hospital care, where these alternatives are, and when they are open. This website is now live and can be reached at www.nhs.uk/strike. The NHS 111 system will also work as normal during the strike, and has been provided with additional staff to cope with expected increased demand. We would encourage people who are concerned that they may need urgent care to visit this website, and call 111 in advance of showing up at an A&E department The NHS is busting a gut to keep the public safe. However, we should not lose sight of the underlying reason for this dispute, namely this Government’s determination to be the first country in the world to offer a proper patient-focused seven-day health service. To help deliver this, the NHS will this year receive the sixth biggest funding increase in its history. But it is not just about money, as we know from the mistakes of previous Governments. It is also about taking the tough and difficult decisions necessary to make sure that we really do turn our NHS into the safest, highest-quality healthcare system in the world. This Government will not duck that challenge. I commend this statement to the House.