4 Eylül 2016 Pazar

The junior doctors’ dispute is about the future of the NHS | Letters

Deborah Orr asks for a clear message from the junior doctors (Junior doctors, what exactly is it you are striking for?, 3 September). I am not a junior doctor but perhaps I can help. The NHS can barely staff a five-day routine service (emergency care is already 24/7). So stretching the same staff over seven days will make the service unsafe and a junior doctor’s job intolerably stressful. A seven-day NHS cannot be delivered on a five-day budget. The NHS is under direct attack by the most pernicious health secretary in a generation and the junior doctors’ contract is part of this attack. The junior doctors have the courage to call it how it is and are attacked by columnists who claim to care about social justice. Aneurin Bevan said: “The NHS will survive as long as there are folk who are willing to fight for it.”
Dr Jon Dickson
Sheffield


Deborah Orr states that “more senior medical professionals” – presumably consultants – “would like to be generously compensated if they started being asked to turn out for weekend shifts themselves”. How many times do we need to explain to journalists that all doctors, including consultants, already work at weekends? There are fewer of them than during the week, because there are no routine outpatient clinics or operating lists, but they all take their turn on the rota to cover emergency work and deal with inpatients. The idea that hospitals are somehow devoid of senior doctors at the weekend is a myth, as is Jeremy Hunt’s assertion that simply increasing the numbers of junior doctors at the weekend will allow him to introduce the “seven-day NHS” – whatever that means.
Dr Bob Bury
Leeds


Studies in Oxford, Manchester and York have shown that there is no “weekend effect”. The number of patients dying on Sundays is the same as any other day, possibly slightly fewer. The electoral slogan was devised by political spin-doctors to divert attention from the underlying problems of the health service. Why then are politicians and exorbitantly overpaid administrators attempting to arrange the working practices of junior doctors? Doctors are already working weekends. Let them arrange their weekend rotas within the constraints of an overstretched NHS, and end this controversy. Jeremy Hunt`s arrogant stance following the cabinet reshuffle – rumours of my demise have been much exaggerated – is an unacceptable slur on all those working at the bedside. Time for a change.
Emeritus professor Sidney Lowry
Bangor, Co Down


Like many medics, I have been saddened by the trend throughout the present century for the NHS and local authorities to contract out an increasing part of their treatment and care services to the private sector, given the risk that private sector providers will care more about their profits than their patients. For the BMA to have reneged on the terms to settle the junior doctors’ dispute which they accepted earlier this year, and to threaten strike action on the scale now announced, suggests that the medical profession too cares more about the profits its members make from the NHS than about their patients. I am about to resign as a BMA member.
Professor Ian Leck
Woodstock, Oxfordshire


The outcome of this dispute will affect more than the junior doctors: the future of the NHS is at stake. On 9 May, before the health select committee, Jeeremy Hunt advocated “moving forwards … towards the kind of budgetary arrangements you would find in … Kaiser Permanente’’. Kaiser Permanente is the largest private health maintenance organisation in the US, and one of the subjects of Michael Moore’s film Sicko about the dire state of healthcare in the US. Hunt and the government aim to run the NHS into the ground so it can be taken over by this private company and its ilk.
Professor Fay Dowker
London


What your headline (NHS ‘needs EU employees to avoid collapse’, 25 August) fails to acknowledge is that the government doesn’t mind if the NHS collapses. In fact, it has been the neoliberal plan for several decades. The NHS has been brought to the point of collapse by deliberate underfunding (not “overspending”), a hospital and bed closure plan (we now have less than one third the beds per head of population than Germany), shortsighted manpower planning and cynical scare stories about safety.


This is all presided over by the NHS chief executive Simon Stevens, former vice-president of the US private healthcare company UnitedHealth, and a secretary of state, Jeremy Hunt, who was co-author of a book calling for the end of the NHS (another co-author was Greg Clark, secretary of state for business, energy and industrial strategy). Meanwhile their friends like Richard Branson are circling like vultures.


The result will be no recognisable NHS in a few years time (Oliver Letwin gave it five years) – not by accident but by design.
Dr Paul Hobday
Leader, National Health Action party


We’re disturbed by David Babbs’s article (Politicians have failed the NHS. We need people power to save it, 26 August). The 38 Degrees report on NHS “sustainability and transformation plans” to which he refers doesn’t point to what’s behind NHS England’s carrot-and-stick strategy.


By offering additional funding for NHS commissioners who satisfactorily reduce their deficits and by threatening punitive “special measures” for those who don’t, the STPs will serve private sector interests. NHS cuts to reduce deficits will mean the NHS, and the public, having to seek more services from the private sector. More public money will benefit private companies whose services cost far more than a publicly funded, publicly run NHS. Less accessible services and longer waiting times will push the public to pay for private health insurance.


Babbs omits to mention US influence in NHS restructuring, which Jeremy Hunt has acknowledged. Major US consultancies and healthcare corporations like McKinsey and UnitedHealth are heavily involved. But he confirms that 38 Degrees commissioned Incisive Health, lobbyists for Virgin Healthcare and the privatisers’ NHS Partners Network, to produce its crowdfunded report. It’s not surprising it glosses over what the STPs prefigure – the replacement of an NHS once recognised as world leading in cost-effective public healthcare by a privatised system whose providers’ financial interests will have undue sway. As members of 38 Degrees, we think it’s vital that it isn’t seen as an NHS privatisers’ tool.
Barbara Beese, Julia Campbell, Verite Reily Collins, John Furse, Jim Grealy, Merril Hammer, Karl Hevera, Ian Irvine, Tina Mackenzie, Craig Nicol, John Ralph, Linda Robinson, Teresa Schaefer, Heinz Schumi, Margaret Spector, Alexandra Veres, Martin Woodford
38 Degrees Chelsea and Fulham Group


Sustainability and transformation plans are being drawn up in conditions of secrecy imposed by NHS England – as its North Midlands director of commissioning operations, Wendy Saviour, told a recent meeting of Shropshire clinical commissioning group: “STPs are not meant to be published at all. They should not go to board meetings. Some of them contain very radical things… These are highly political and highly contentious. Once they’re washed off and the national messages are gathered together, they will be published.”


We think this is an appalling abuse of our democratic rights and call for protests at local authorities’ health and wellbeing board meetings, clinical commissioning group meetings and at NHS England offices. Health and wellbeing boards are notionally responsible for seeing that STP governance and decision-making processes “maintain democratic legitimacy”. Councillors need to explain how this is possible given there is no statutory basis, and how they can square their duty to represent and fully inform us, whilst colluding in NHS England’s imposition of secrecy and dubious legality.


STPs are highly political and highly contentious because they involve huge cuts and NHS privatisation by a process of parcelling up the NHS into a new form of public/private partnership called accountable care organisations – think PFI, but for services as well as buildings. The unacceptable outcome will be an NHS that offers reduced services, ends national terms and conditions for staff and is modelled on private American health insurance schemes.
Jenny Shepherd Chair, Calderdale and Kirklees 999 Call for the NHS
Steven Carne 999 Call for the NHS
Madeleine Dickens Sussex Defend the NHS
Dr Alex Scott-Samuel
Jackie Grunsell GP
Ted Schrecker Durham University
Colin Hutchinson FRCOphth
Deborah Harrington National Health Action party campaign team
Christine Hyde North Kirklees Support the NHS
Jackie Brook and Chrissie Parker Friends of Huddersfield Royal Infirmary
Ian Wonnacott Psychotherapist
Rosemary Hedges Secretary, Calderdale 38 Degrees NHS Campaign
Coral Jones GP
Andrea English Advanced nurse practitioner
Dr Mike Galvin
Mel Walker Children’s learning disability nurse
Victoria Kennedy Huddersfield KONP
Sandra Shearn Calderdale 38 Degrees NHS Campaign
Dave Ash National Health Action party executive
Paul Cooney Huddersfield KONP
Carol Ackroyd Secretary, Hackney KONP
Jean Hardiman Smith Defend Our NHS Cheshire
Julie Ingram Barnsley Save Our NHS
Stephanie Clarke Calderdale 38 Degrees NHS Campaign
Jody Clark Fighting 4 Grantham Hospital
Stephen Maclean Chair, Sussex Partnership Unison branch


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The junior doctors’ dispute is about the future of the NHS | Letters

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