Her comment was a factual and considered response, certainly in comparison to the majority on Twitter. Generally, the Health Secretary’s appearance drew a torrent of criticism and vitriol, including plenty of simple abuse reminding us all – in case we could forget – what his surname rhymes with.
NHS staff have been outraged – I don’t think that’s an overstatement – by the Health Secretary’s behaviour in recent months. In arguing for a fully seven-day NHS, he has managed to give the impression that many hospital doctors avoid working weekends. Worse, he has refused to apologise for saying that ‘there are 11,000 excess deaths because we do not staff our hospitals properly at weekends’. Refused to apologise even though the report from which that statistic is drawn says it would be ‘rash and misleading’ to assume that those deaths are avoidable, still less that they are caused by having too few doctors on duty. It should also be noted that these additional deaths occur for patients admitted to hospital on a Friday, Saturday, Sunday or Monday – so more ‘half the week’ then ‘the weekend’.
A tragedy in all this is that there are issues about seven-day working that do need considering and which run the risk of getting lost amid all the bile. Returning to hip operations, Margaret McCartney is right to pull-up the Secretary of State for his mistake (he surely meant to say ‘hip replacementoperations’, though even this is not correct since some hospitals do schedule them on weekends). Yet if you arrive in hospital on a Saturday having brokenyour hip, you will on average wait more than 10% longer to have it reset than if you arrive on a Monday. That’s a delay that needs understanding and tackling.
Where does this data come from? Not a health charity’s analysis or a Freedom of Information Request but rather the National Hip Fracture Database report. It is researched and written not by a pressure group but by managers and doctors who want to improve the performance of their hospitals and the lives of their patients. The report is incredibly detailed, outlining the performance against a range of standards for each of the NHS trusts taking part.
It raise however raise a lot of questions. For example, it shows an alarming variability in the percentage of patients who receive surgery within 48 hours, from 95.3% in the best performing trust to just 14.7% in the worst. And it does not really address the questions of what contributes to this, whether a lack of weekend working or any other factor. Yet the drive for improvement is clear.
How best can we support that improvement drive? Surely it is by highlighting and supporting their work (and others like them), by encouraging further rational analysis and debate. We can also give a voice to the patients who wait too long so that we don’t forgot the human side of those statistics. And we may even need to draw attention to the poorer-performing hospitals and campaign for their improvement.
All of those actions stand a chance of improving the situation, more so if we combine them with a thorough review of on the future of health (and social care) in England so that we have the resources in place to make the improvements we need. At Independent Age we are running a campaign, calling for exactly that.
Does it help to make unsupported statements that infuriate the very people who will need to initiate, design and implement these improvements? Of course not. Which is why Jeremy Hunt has to change his tone and his tune on seven-day working, if it is not already too late for that.