Healthcare Reforms: Not Safe, Not Fair

For 68 years the National Health Service in the United Kingdom has demonstrated the fundamental human right for everyone of the enjoyment of the highest attainable standard of physical and mental care. This standard is now threatened by the new contract proposed in recent years by Jeremy Hunt. The issues arising from the Conservative goals for the Health service have resulted in the strikes on 26 and 27 April by Junior Doctors and the first ever walkout from the Accident and Emergency Services in NHS history. This issue sparks many human rights concerns in England; the health services in both Wales and Scotland are holding to their current contracts.

Striking Junior Doctors protest at the Department of Health 6th April 2016, by The Weekly Bull

In their 2015 manifesto, the Conservative Party vowed to continue to increase spending on the NHS, so that by 2020 an additional £8 billion will have been spent, while working towards an NHS that functions fully seven days a week. The seven-day workweek is especially significant in reaction to a report by the British Medical Journal that claims there is a higher death rate if a patient is admitted on a weekend compared to any other weekday. However, since assuming office there have been systematic cuts to NHS funding. Some critics, such as Jeremy Corbyn, are claiming that the current government is attempting to parcel up the NHS for privatisation. Whether true or not, the end goal of the current health policy is the effectiveness of treatment akin to the basic right of everyone to the best possible care.

Nevertheless, this could be seen as being at odds with other opinions on what constitutes the most effective health service. The new contract has offered Junior doctors a 13.5% pay rise in return for their working week extending from 7am to 7pm Monday to Friday to 7am to 9pm Monday to Friday, then 7am to 5pm on Saturday with hours on weekends until 7pm both Saturday and Sunday. They would receive a lower pay for unsociable hours than they did previously, and have later shifts. This means that Junior Doctors, who make up a great proportion of the medic community, will be stretched to longer hours and receive less pay for unsociable hours. The pay they receive for sociable hours of work will be increased, but these also extend well beyond the parameters of what many of us consider a normal working day. Not to mention that many of these doctors are responsible for peoples’ lives. This is not the full extent of the what the new contract will do to the NHS, although is the sum of the ‘human’ cost, in very basic terms.

Moreover, Junior Doctors already work unsociable hours; it is unlikely that you will find a junior doctor who does not work weekends. Essentially, the seven-day workweek already exists for the National Health Service, but it lacks the staff to make this effective without selling out elective shifts to private companies, which is another matter entirely. The new contract limits the number of hours that may be worked and how many shifts consecutively worked, but the option is still open for a junior doctor to work up to 10 hours a day for over seven days, or to work five 13 hour shifts consecutively- and this would be considered ‘normal’. This not only exploits the doctors involved, but also surely threatens the health of patients. The commendable end goal of a seven-day National Health Service is being contorted by the measures the Health Secretary seems prepared to take, which challenge the rights and safety of both the doctors and their patients.

Part of a Junior Doctors Strike Picket outside Norfolk and Norwich University Hospital, by Roger Blackwell

Junior Doctors’ rights are being threatened by the current Government’s ‘new contract’ for the NHS. Does it then follow that the strikes on 26 and 27 April threaten the patients’ rights to the best possible health care? Different sources vary, though clearly thousands of appointments and operations will have been cancelled during the strike. However, the Accident and Emergency Service is being manned by Senior Consultants in the absence of Junior Doctors, demonstrating the unity of the NHS in their general reaction to this new deal. It is also important to remember that one of the issues at the heart of the strike is that doctors believe that the new contract is “not safe” for patients either; they are also on strike for the right of patients to the best possible healthcare. Obviously there is an issue with a depleted healthcare service in England, however this will only last for two days. The implications of the new contract, if they are as damaging as some people claim, could be much more detrimental to our right to the best possible care.

The strikes are also the outcome of failed negotiations between the British Medical Association and Jeremy Hunt; the recent outburst in the House of Commons by Dennis Skinner not so subtly implies that the severity of these strikes in relation to previous strikes is due to Jeremy Hunt’s lack of an attempt to re-negotiate or even re-initiate talks with the BMA. It is extremely unlikely that Junior Doctors want to be on strike; they would most likely rather feel secure in their jobs and safe in their roles rather than stretched to the point of breaking in an already overextended system. Ministers have been attempting to implement a new contract since 2012, which is sorely needed considering the current contract is 15 years old and therefore does not accurately reflect the economic situation nor the increased numbers of those using the NHS.

The fact still remains that most in the medical profession, particularly those in the BMA, feel that their interests are not reflected by the Health Secretary who has no prior experience in the health service before his appointment to his current position in 2012. For the general public, who expect to be protected by both their Government and their National Health Service, there has been overwhelming support on social media for the strikes; the vast numbers who took to the streets is a testament to the severity of the risk many feel this new contract will pose towards public safety. Far from attaining the aims of their manifesto, the Conservatives seem to be acting against the very advice of those qualified to understand what measures should be taken to protect both the doctors and patients within the NHS. Criticising those doctors who have had to resort to strike action and still are not being heard seems contradictory to providing the best possible care that they are campaigning for.

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