BMA (Contract Negotiations)

Debate between Andy Slaughter and Helen Jones

Monday 21st March 2016 Westminster Hall

[Helen Jones (Warrington North) (Lab)]

Thank you, Mr Amess. It is a great pleasure to serve under your chairmanship. I beg to move,

That this House has considered e-petition 121262 relating to contract negotiations with the BMA.

This is one of a number of petitions on the website about the junior doctors’ dispute, including the perennial favourite “Consider a vote of No Confidence in Jeremy Hunt”. We have chosen this one for debate because it was begun after the Government’s decision to impose the contract, and therefore relates to the position that we are in now.

It takes a lot to make doctors go on strike; their nature and their years of training mean they are inclined to stay with their patients. So, when facing the first doctors’ strike in 40 years, it is fair to ask how we reached this position and what can be done to resolve it. I am sorry to say that I think most of the blame lies with the Secretary of State and the atmosphere that he has created. In saying that, I want to make it clear that I do not think the current contract is perfect by any means. It is too complicated, and it throws up some anomalies in pay. However, it has proved impossible to negotiate changes to that contract properly, due to the atmosphere of mistrust and suspicion that has been created by some of the comments made by the Secretary of State.

That atmosphere goes back some years, but it reached its lowest point in July last year, when the Secretary of State said that the NHS had a “Monday to Friday culture”. I have read since that he has never actually visited a hospital at the weekend. If that is true, perhaps he should, because he would find that many staff are working. So incensed were they at the idea that they did not work weekends that they took to posting pictures on Twitter with the hashtag “#ImInWorkJeremy”.

The Secretary of State then went further by telling doctors to “get real”. I think that people who make life-and-death decisions every day, care for terribly sick patients, work with emergencies in accident and emergency while putting up with drunks and insults, work in special care baby units, and care for frail, elderly, often confused people know what reality is. They do so in a national health service under huge pressure. Much of the equipment is now out of date and there is a repairs backlog worth £4.3 billion, but the capital moneys available were cut by £1.1 billion in the Budget. Doctors are working with out-of-date scanners and computers that crash, and because the Government see all support staff as inessential bureaucrats, doctors are mopping their own operating theatres or doing data input that any competent clerk could do. I think that they know the reality of what they face. To be told that by someone whose gilded path to ministerial office went through Charterhouse, Oxford and management consultancy is beyond parody.

The Secretary of State, again, had to say more than that. He looked at weekend death rates, and jumped to the conclusion that they were caused by staffing levels. He said clearly:

“Around 6,000 people lose their lives every year because we do not have a proper seven-day service”.

He later used the figure of 11,000. Again, he said that was

“because we do not staff our hospitals properly at weekends.”—[Official Report, 13 October 2015; Vol. 600, c. 151.]

I will spend a few minutes on the research quoted by the Secretary of State, because it does not actually prove that at all. The research paper that reached the conclusion that there were 11,000 extra deaths considered admissions from Friday to Monday, not just at the weekend, and considered death rates within 30 days of admission. Anyone who designs research will say that it is almost impossible to allow for all the things that could happen in 30 days. The researchers themselves did not draw the conclusion drawn by the Secretary of State. What they said was:

“It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.”

In fact, being rash and misleading is exactly what the Secretary of State was doing.

[Andy Slaughter (Hammersmith) (Lab)]

I thank my hon. Friend for her exposition of the petition. She is exposing behaviour by the Secretary of State that is not only insulting but misleading. This has been said to him time and time again, including by hon. Members in the Chamber. Does she draw the same conclusion as me? The Secretary of State knows what he is doing. He knows when he quotes those figures that he is quoting them wrongly, and that they do not prove what he says they prove.

[Helen Jones]

My hon. Friend makes a fair point. First, the research has its critics, and various bits of research done on deaths following weekend admissions have reached different numbers: 3,000; 4,400; 6,000. The problem is that it is difficult to ascertain cause and effect. If the research is adjusted for the fact that we admit different kinds of patient at the weekend—people are sicker and there are more emergencies, and not many elective patients in most trusts—there remains a slight increase in the death rate. The problem is that ascertaining the cause is difficult. As the hon. Member for Totnes (Dr Wollaston) pointed out in a previous debate on this issue, when hospitals look back at such deaths, it is difficult for them to find out what could have been done differently in those 30 days.

When a complaint was made to the UK Statistics Authority about the use of those data, it said:

“We are speaking with Department of Health officials to ask that future references to this article are clear about the difference between implying a causality that the article does not demonstrate, and describing the conclusions reached by the authors.”

The reason is that although the research shows us that something is going on that we need to investigate, it does not show exactly what is causing it. I do not know whether the Secretary of State understands that. If he does not, I must say that Oxford is probably not what it was. However, I suspect that he understands it very well.

House of Lords Reform Bill

Debate between Andy Slaughter and Helen Jones

Monday 9th July 2012 Commons Chamber

[Helen Jones (Warrington North) (Lab)]

rose—

[Mr Andy Slaughter (Hammersmith) (Lab)]

rose—