Junior Doctors: Industrial Action

Debate between Lord Birt and Lord Prior of Brampton

Monday 25th April 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, first, the need for a seven-day service has been recognised by the medical profession for a number of years. I remember reading the Future Hospital report four or five years ago in which the Royal College of Physicians talked about a seven-day service. Of course, it was the academy of the royal colleges that produced the 10 clinical standards that underpin a seven-day service. The issue is not whether or not there should be a seven-day service; the more serious issue that has been raised is whether we have the resources to deliver a seven-day service. We argue that we are putting enough resources into the NHS to do that. So I think that the principle of a seven-day service, certainly for urgent and emergency care, if not for elective care, is well accepted by the medical profession.

Interestingly, on the point about the number of people leaving—the resignations that the noble Lord referred to—I was pretty horrified to hear about the son of someone on the noble Lord’s Benches who had left the NHS to go to work in America two years ago, I think. He described a pretty torrid time working in the NHS as a junior doctor. To cap it all, when he went, there was no exit interview. No one was really concerned or knew that he had gone. That is just another illustration of the fact that we have not sufficiently respected or valued junior doctors in the NHS.

[Lord Birt (CB)]

My Lords, I wholly support the Government’s objective of seven-day working in every part, eventually, of the health service. However, I observe that the Government are trying to achieve these objectives, as the noble Lord, Lord Hunt, has just said, in a very economically adverse climate where health spend per head is in decline, in a country where the population is expanding very rapidly, and where we see significant bottlenecks right across the system. All of us can see how important junior doctors are to the system. I do not know how many of your Lordships saw the excellent BBC series on junior doctors a year or so ago set at the Royal Liverpool Hospital, in which their importance to the system and dedication was simply remarkable. We would all, I am sure, stand behind that. They should not be threatening to withdraw their labour, but it is amazing that a group of such dedicated workers can even consider doing such an inappropriate thing—they are not natural strikers. The question I put to the Minister is this: as I said, the Government’s objective is correct, but should they not move towards it with greater stealth in the context of moving towards a health service that is again appropriately funded?

[Lord Prior of Brampton]

My Lords, I echo the sentiments of the noble Lord. I recognise the vocational commitment of junior doctors and that they are not natural strikers. It is a tragedy that we have got into this situation. There are no winners in this dispute and only one absolutely clear loser: the thousands of patients who are now suffering. The noble Lord asked whether we could have got here with greater stealth. These discussions have been going on for three years. We have had one independent review done by the DDRB and a number of independent assessments of the impact on mortality of not working at weekends. The Government are putting £10 billion of new money into the health service over the next five years, which was asked for by the NHS. In the NHS there will always be a lack of resources: demand will always exceed supply in a system where there is no price mechanism. That is an issue that all Ministers have lived with in the NHS since 1948. However, I echo his views: it is tragic that we find ourselves in this position with junior doctors. They are not natural strikers.