The BMA's challenge to David 'call me Dave' Cameron: Seven-day NHS: BMA challenges David Cameron to answer seven questions over seven days – asking, what's your plan for seven-day NHS services?
Demand answers about seven-day services
(issued Sunday 30 Aug 2015)
Seven-day NHS: BMA challenges David Cameron to answer seven questions over seven days – asking, what’s your plan for seven-day NHS services?
The BMA has today published the first in a series of questions in national newspapers, calling on David Cameron to set out the detail of his plans for more seven-day NHS services.
Since announcing his plans in the Spring1 to introduce what he described as the world’s first ‘truly seven-day NHS’, the prime minister has so far failed to give any detail or outline how he plans to fund or deliver on his ambition.
Instead, doctors have had their professionalism and dedication to patients repeatedly called into question at a time when NHS staff, as highlighted by the recent social media campaign, are already providing a first-class service, every day of the week.
The BMA has clear that it supports more seven-day hospital services and that patients should receive the same high standard of care across the week. However, we have rightly and repeatedly raised legitimate concerns over how the government expects the NHS to fund and staff it, and what impact it could have on mid-week services.
In his speech on seven-day services in May, David Cameron used the word “plan” 18 times2 but has so far signally failed to produce one. So the BMA, starting today3, is publicly asking David Cameron seven key questions over seven days, starting with: ‘When will the prime minister define what he means by a ‘truly seven-day NHS’?
Commenting, Dr Mark Porter, BMA council chair, said:
“The BMA has been quite clear that it supports more seven-day hospital services and that patients should receive the same high standard of care across the week4, but we have also raised repeated concerns about the lack of detail and the apparent absence of any plan as to how the government intends to deliver this.
“David Cameron promised a ‘truly seven-day NHS’ before and after the general election, even going as far as to use the word ‘plan’ 18 times in one speech, but has so far signally failed produce one. There has been no detail to define what he means, how the NHS can fund and staff it, and its impact on weekday services.
“Instead, showing more regard for headline-grabbing soundbites than plans, the government has gone out of its way to deliberately misrepresent the excellent care NHS staff already provide every day of the week.
“We already know that nine in 10 consultants work evenings and weekends for the NHS5, that over 60 per cent of GPs regularly work outside of their normal hours6 and that junior doctors continue to work around the clock providing care for their patients, including in some cases examples of doctors’ working days on end or 90-hour weeks.
“It is not just doctors wanting answers. A recent public survey showed that two thirds of respondents do not believe the NHS can currently afford seven-day services in hospitals, while three quarters do not want to see a reduction in mid-week services7.
“Given the current funding squeeze on NHS Trusts, the only way for many hospitals to increase the number of doctors over the weekend would be to reduce the number of doctors providing elective care during the week. If that is what David Cameron means by a ‘truly seven-day NHS’, than he should say so.
“And with the latest figures showing a rise in the number of graduates turning their back on general practice8 the prime minister needs to be honest with the public. The government’s pre-election pledge to recruit 5,000 GPs to open all surgeries over seven days – rowed back on after the election9 – has been shown to be mere rhetoric and completely undeliverable on the ground.
“So far the government has refused to say what it defines as seven-day services – despite publically admitting there is a ‘general public interest in making this information available for the sake of greater transparency and openness’10. This is why we have taken the extraordinary step of publishing our questions.
“The lack of detail or any outline plan for a seven-day health service shows a complete disregard for people already concerned at the mounting pressures on the NHS. At the very least, we all deserve answers to the legitimate questions which the BMA is asking this week.”
Notes to Editors
3Today’s advertisement has been published in the Independent on Sunday
4For more on the BMA’s position on seven-day services please click here
5For more information on the BMA’s research into consultants’ on-call work please click here.
6The latest figures from the BMA’s quarterly tracker survey found that 61.1 per cent of GPs reported that they ‘always’ work outside of their regular hours, with 30.2 per cent reporting that they ‘sometimes’ do this. More information can be found here
7A survey of 2,041 adults in England was conducted by Britain Thinks between 22nd and 25th June 2015. Respondents were asked to say how far they agreed or disagreed with the below statements.
At present, the NHS cannot afford to deliver seven-day services in its hospitals
Agree (net) – 68 per cent (1,388)
Disagree (net) – 9 per cent (182)
Neither agree nor disagree – 16 per cent (329)
Don’t know – 7 per cent (142)
Providing more hospital services at the weekend should not mean that fewer services are available during the week
Agree (net) – 84 per cent (1,718)
Disagree (net) – 4 per cent (89)
Neither agree nor disagree – 9 per cent (184)
Don’t know – 2 per cent (50)
For more information on the survey please click here
8The latest figures are available from the GP National Recruitment Office here
9Dr Philippa Whitford (Central Ayrshire) (SNP): The Secretary of State mentions recruiting 5,000 extra GPs, but I note in a recent speech that that was downgraded from a guarantee to a maximum. With 10% of trainee posts unfilled and the BMA’s recent survey suggesting that a third of GPs will leave in the next five years, is that not going to be difficult? Has the Secretary of State had any consultation with the BMA and the royal college to ask why they are leaving?
Mr Hunt: It will be difficult. The commitment has never been downgraded: we always said that we needed about 10,000 more primary care staff, about half of whom we expected to be GPs. We have had extensive discussions about the issues surrounding general practice, such as burn-out, the contractual conditions and bureaucracy. We are looking at all of those things. The commitment is to increase the number of GPs by about 5,000 during the course of the Parliament, and that is a very important part of our plan to renew NHS care arrangements.
(Hansard, July 7 2015)
10In June 2015 the BMJ (British Medical Journal) issued a Freedom of Information request to the Department of Health asking for its definition of a ‘truly seven-day NHS’. The Department of Health responded by saying that it held the information but would not release it. Click here for more information
The British Medical Association (BMA) is the voice of doctors and medical students in the UK. It is an apolitical professional organisation and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of care.
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British Medical Association
Dear prime minister,
In May, you announced your intention to extend health services for the world’s first ‘truly seven-day NHS’, stating that there is a plan to deliver this. Doctors who care for patients day in and day out and understand their needs have been clear in their support for more seven-day hospital services.
Having repeatedly called for the detail of how a ‘truly seven-day NHS’ would be delivered, we are now asking you to define what you mean by this and to show us your plan to deliver it.
Patients become ill and need high-quality urgent healthcare over a seven-day week – this has never been in dispute. Doctors and other healthcare staff agree and are already working all across the country to deliver this, and of course they want to do more for the patients for whom they care.
The government’s pledge to address the funding crisis in the NHS is based on delivering services at current levels: broadly, routine and non-urgent care across five days and urgent and emergency care over seven. How does your plan propose to find the money to pay for the additional services that you have set out in your vision?
The NHS is already understaffed, and some medical specialties, especially emergency medicine have significant difficulties in recruitment. Doctors have already been trying to deliver improvements in weekend and nighttime care so know that a ‘truly seven-day NHS’ will need a full team of healthcare staff to deliver it, not just doctors but nurses, managers, healthcare support workers and scientific, therapeutic and technical staff, for example. What’s your plan to find, train and fund these in order to deliver a truly seven-day NHS?
Those working in the NHS have highlighted the increasing strain that health services are under, due to more patients presenting with more complex needs than ever before. How does your plan ensure that a ‘truly seven-day NHS’ will involve no reductions in existing weekday services and that no existing services will have to close?
The NHS is something for all of us to be proud of, led by a workforce dedicated to delivering free healthcare for all, wherever and whenever patients need it. Without knowing how you intend to deliver a seven-day NHS, we are increasingly concerned that it is simply an empty political promise which risks damaging the existing NHS services on which we all rely.
So, on behalf of doctors and patients across the country, we’re asking: Will you show us your plan?
Dr Mark Porter