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Cameron’s pledge on seven day working is branded “empty headline grabbing”

BMJ 2015; 350 doi: (Published 19 May 2015) Cite this as: BMJ 2015;350:h2713
  1. Gareth Iacobucci
  1. 1The BMJ

Prime Minister David Cameron has reiterated his pledge to implement full seven day working in the NHS in his first major speech since the general election.

In a speech at a health centre in the West Midlands the re-elected prime minister said that his government would expand access to routine GP and hospital care to allow patients to receive the same service at weekends as they did from Monday to Friday.1 He said that the transformation would be funded from the £8bn (€11bn; $13bn) a year his party had pledged to invest by the end of the parliament to support NHS England’s Five Year Forward View.

But doctors’ leaders said that this funding would be enough only to keep current NHS services running and would not be enough for an expansion to full seven day working. The BMA said that the plans as they stood were uncosted and “empty headline grabbing.”

In his speech Cameron said, “Our commitment is to free healthcare for everyone—wherever you are and whenever you need it. That means getting the best care and making that care available for everyone—free—wherever they are and whenever they need it.

“I don’t underestimate the scale of the challenge in making all this happen. But just as we came together as nation to create the National Health Service nearly 70 years ago, so I believe that together, by sticking to the plan, we can become the first country in the world to deliver a truly seven day NHS.”

Cameron said it was a “shocking fact” that mortality rates among patients admitted to hospital on a Sunday were up to 16% higher than among those admitted on a Wednesday. He said that the shift to seven day working would deliver a safer NHS and save more lives.

The prime minister said that the changes would not mean staff working longer hours but would require a more flexible approach to work patterns, with “key decision makers being around at the weekend, junior doctors being properly supported, and resources like scanners up and running wherever they are needed.”

But Mark Porter, chairman of BMA council, said that although patients should have access to high quality healthcare whenever they needed it, the government had not set out how it could translate its announcement into reality. He said, “Crucially, the £8bn promised by the prime minister is the bare minimum needed for the NHS to simply stand still and will not pay for extra services.​

“The real question for the government is how they plan to deliver additional care when the NHS is facing a funding gap of £30bn and there is a chronic shortage of GPs and hospital doctors, especially in acute and emergency medicine, where access to 24 hour care is vital.

“Without the answer to these questions this announcement is empty headline grabbing and shows that, even after polling day, politicians are still avoiding the difficult questions and continuing to play games with the NHS.”

Maureen Baker, chair of the Royal College of General Practitioners, said, “Access to GP services is extremely important, but prioritising weekend and evening access must not come at the expense of access and services during normal hours so that patients end up worse off. Practices must be able to tailor their services to the needs of their local populations.”

Clare Marx, president of the Royal College of Surgeons, said, “Mortality is higher for patients admitted to hospital at the weekend, so the government’s commitment to making seven day care one of its early priorities is very welcome.” But she added, “This move will require significant change in the NHS. To aid NHS planning, the government or NHS England should commission and publish in-depth financial modelling of the anticipated cost of seven day services and skill shortages.”

Nigel Edwards, chief executive of the healthcare think tank the Nuffield Trust, said that moving to a seven day service would also help improve the flow of patients through hospital and avoid large backlogs on Monday mornings. However, he said, “Whether the government will provide the funding available to achieve this aspiration is a key question. The extra £8bn it has pledged by the end of 2020-21 will be enough to keep existing services running but little else.”


Cite this as: BMJ 2015;350:h2713


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