Health secretary unswayed by “weekend effect” research as doctors talks resume

Health secretary Jeremy Hunt has said that new research challenging claims that more patients die in hospital at weekends will not change his attempts to impose new 7-day working  junior doctors’ contracts.

The new contracts cut premium pay rates for weekend work in a bid to honour the Conservative Party’s election commitment to create a “seven day” health service.

But they have led to a dispute with the British Medical Association doctors’ union that has run since autumn and culminated in a two-day junior doctors’ strike late last month. Hunt is in talks with the BMA in an attempt to end the dispute this week.

Hunt was being grilled by MPs from House of Commons Health Committee in a session about funding for the National Health Service – as it emerged that Oxford University research questioned a central part of his argument to impose the new contracts.

Data from more than 90,000 stroke patients, by Dr Linxin Li and Professor Peter Rothwell from the Oxford Vascular Study, has not yet been published, but has been the subject of media reporting.

But in a statement, Rothwell said that the effect may be down to miscoding of low-risk admissions as acute emergency admissions by non-clinical clerical staff.

Stroke data were used as a test case – but Rothwell and a colleagues said accuracy of administrative data does differ substantially between weekend and weekday admissions in other acute conditions.

Under questioning from Dr Philippa Whitford, of the Scottish National Party, Hunt referred to an older study published in the British Medical Journal that backed up his argument.

He also argued that the Oxford University data backed the case for a “weekend effect” after all.

Hunt added that standards of care laid down by the Academy of Medical Royal Colleges also back his argument for the changes to the junior doctors.

Hunt said: “Our judgement is that it would not be possible to offer that commitment [to a 7 day NHS] without some changes in contracts. I think that there has been too much focus on the junior doctors’ contract.”

Hunt added that other areas that needed to be changed, included diagnostic tests and consultant cover.

MPs also heard details about how England’s NHS must save around £14 billion if it is to meet a government-imposed target to save £22 billion in the five years to 2020.

The committee heard that around £6.7 billion of savings will come from national budgets held by the Department of Health, plus a further £1 billion that has been diverted from capital budgets.

Around £8.6 billion will come from funding cuts, with the remainder coming from service changes from NHS organisations that are due to be announced in summer.

Hunt added that the NHS was on track to make savings on use of agency staff. He said spending on agency staff had increased from £2.5 billion to £3.76 billion in the last three years, but had begun to fall since October because of spending controls.

Related stories:

England’s doctors agree to five-day pay dispute truce

What doctors say about the junior doctors’ strike

 

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