Firstly, if we can believe the statistics, and in this case we have no reason to doubt them, then it is factually correct to say that there is a higher rate of patient death within 30 days of admittance on weekends than of patients admitted on other days of the week. The unanswered question concerns the reason for this factual observation. Most experts, including some of the government’s own advisors, say that Jeremy Hunt is ‘rash’ and ‘misleading’ the public when he says it is attributable to the number of junior doctors working on weekends, or, indeed, that it has anything at all to do with the contracts of junior doctors. It could be that less ill patients are scheduled for weekday admission, while more acutely ill patients are admitted on weekends. Whatever happens to the NHS, it has to be said that Jeremy Hunt has wilfully deceived the public on this matter in order to strengthen his case for breaking the strike.
Secondly, the rapid rise in mental health disorder has been well documented recently and is of serious concern to the nation. Suicide is the leading cause of death of males of working age. Dr Lucy Johnstone, consultant clinical psychologist in Bristol, says that according to a recent report of the mental health task force the biggest factor driving the massive increase in mental distress is inequality. The Joseph Roundtree Foundation, an anti-poverty charity, argues that for many living standards have fallen since 2007. Many families falling below the Minimum Income Standard (MIS) have at least one adult who is working. It is not laziness that is forcing families into deprivation, it is poor working pay and conditions, the steep rise in housing costs and withdrawal of government assistance. These are the facts. One would hope the Minister of Health might be honest with the public about them.
Thirdly, at the moment there are ongoing secretive negotiations to do with the UK signing up to a Trans-Atlantic Trade Treaty, TTIP. Such a treaty would give investors legal rights which go beyond both UK and EU law, according to Michael Bowsher QC, the former chair of Bar Council’s Law Committee. He says the treaty poses a real and serious threat to future UK government decision-making. It is said that TTIP procurement rules could force privatisation upon the NHS by forcing the NHS to contract out services that it wants to keep in-house. If the EU referendum debate centres on the question of UK sovereignty one wonders why this issue with TTIP is not also being openly and publicly debated at this time. Instead the government seems determined to keep these negotiations firmly behind closed doors.
Fourthly, we learn this week of a government initiative to change the provisions for maternity care under the NHS. Uncomplicated births have been deemed to cost the NHS around £3000. The proposal is to allow mothers-to-be to make choices over birthing arrangements and that this will determine how the NHS money is to be spent on them. Rather than providing good advice, regardless of cost, as well as good care for all mothers, the intention of this new directive is to impose self-rationing on pregnant women, who will be asked to make choices on the basis of the cost of the services they choose. It seems clear that those who wish, and can afford, to go above and beyond the budget allowance might well at some point in the future find themselves able to obtain better, more costly services at their own expense. This goes completely against the ethos of the NHS to provide the best care possible to all regardless of the ability to pay. Better off patients who elect to have extra, more costly services within the NHS infrastructure would be to some extent subsidised by the service as a whole, as is already the case when private services are provided on NHS premises. It is one more privatisation initiative through the back door.
Jeremy Hunt has been lying low since his attempt to impose new contracts on junior doctors, hoping to undo their resolve and sweeten the medicine by upping his offer to them. The junior doctors are incensed at how they have been treated by the minister and have refused to back down. Three more 48-hour strikes are tabled: 9th March , 6th April and 26th April. The junior doctors are calling for a judicial review of the government’s plan in impose a new contract on them.
For democracy to work well there should be openness and accountability in government. It is becoming increasingly apparent that what this government prides itself on is its lack of transparency. The NHS is not broken, it is an institution of which the British are rightly very proud. We should be very careful not to allow this government to kill it off.