Views And Reviews No Holds Barred

Margaret McCartney: What Hunt did next

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5980 (Published 09 November 2016) Cite this as: BMJ 2016;355:i5980
  1. Margaret McCartney, general practitioner
  1. Glasgow
  1. margaret{at}margaretmccartney.com

Jeremy Hunt has pinned his NHS badge back on. “Let’s not argue about statistics,” he said recently.1

In his Conservative Party conference speech, however, the health secretary was talking about four key standards that the Academy of Medical Royal Colleges recommends. One was that, “whatever day of the week it is, highly vulnerable patients should be checked by a consultant twice a day.” Hunt said that this happens “in just one in 20 hospitals.” He added that “patients should be checked by a senior doctor within 14 hours of being admitted,” which was happening “in just one in 10 hospitals.”2

Let us, indeed, argue about statistics. It sounds as though only a small minority of patients are seen by consultants frequently enough or in good time. The first target Hunt mentioned is that patients in high dependency care should be seen twice a day by a consultant and once daily in other areas, in all specialties. The second is that 90% of patients are seen by a consultant within 14 hours of admission in all specialties. One in 20 hospitals is meeting the first 90% target; one in 10 is meeting the second.

Although not meeting the targets, the hospitals aren’t doing as badly as he suggested. In fact, 85% of patients in intensive care units are seen twice a day by a consultant. And Hunt referred to “senior doctors,” but the data audit included only consultants. Similarly, most patients are seen by a consultant within 14 hours of arrival at hospital—an average of 79%.3 4

No wonder the UK Statistics Authority has written to the Department of Health urging it to pay “greater attention” to “a description of methods, including the approach to sampling; quality assurance; a balanced description of findings; [and] frankness, in terms of setting out any limitations of the approach.”5

Hunt, we’re told, intends to improve morale by using the lure of honours. The NHS is in meltdown, but the Empire strikes back

Hunt has also pledged to nurture more home grown doctors by increasing places at UK medical schools. But then he announced that he would order newly graduated doctors to work for the NHS for four years, resulting in “more home grown doctors.”

Where’s the evidence? We have no idea whether this will result in more doctors bailing out to the city sooner, though I suspect that it will damage morale. But don’t fear: Hunt, we’re told, intends to improve morale by using the lure of honours.6 Seriously? The NHS is in meltdown, but the Empire strikes back.

And he claimed, “When you look at our safest hospitals . . . it’s not about the level of funding but the quality of leadership.” Please don’t tell us that catastrophic cuts to social care, small GP surgeries being declared “unviable,”7 and the resulting crush in emergency departments have nothing to do with inadequate funding.

In a way, however, all of these problems are about poor leadership—originating from the office of the secretary of state.

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