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A faulty production line

Hunt: 'I've yet to meet a doctor who doesn't want seven-day working'

The health secretary has claimed that he has ‘yet to meet’ a doctor who is not in favour of weekend working, adding that the BMA is out of touch with its members for opposing the Government’s plans.

Speaking at an event at the King’s Fund today, Jeremy Hunt claimed that all the royal colleges supported seven-day working and he ‘can’t hide his frustration’ at the BMA’s stance.

He said today that he was planning to impose seven-day working on newly qualified hospital consultants, but acknowledged that seven-day GP services would be harder.

The Government was ‘starting to have a good dialogue with the GP profession about the best way to do that [seven-day working]’, he added.

However, the health secretary said: ‘My frustration isn’t with doctors. I’ve yet to meet a doctor who doesn’t want to move to seven-day working. They are all very enthusiastic, and the royal colleges support this, but I can’t hide my frustration with the BMA.’

Speaking at the King’s Fund event, Mr Hunt acknowledged that ‘a very big capacity problem’ meant his seven-day general practice plans faced ‘different problems’ but underlined that, despite this, it was ‘essential’ to introduce ‘a seven-day NHS across primary and secondary care’.

Despite the claim that the royal colleges support his plans, RCGP chair Dr Maureen Baker took a stronger tone by saying GPs are already ‘being pushed to our limits in trying to provide a safe five-day service’ and that the health secretary’s speech sounded ‘alarm bells’ for GPs.

Meanwhile, NHS England has identified the GP contract as a ‘constraint’ to the rollout of the Government’s seven-day working plan, an independent report into seven-day working has revealed.

The NHS Pay Review body’s report on seven-day working said: ‘NHS England told us they had identified a number of constraints, including Agenda for Change staff pay, consultant and GP contracts, and working time, which constrain staffing and create uplifts for weekend work, thus increasing the cost.’

A spokesperson for Mr Hunt said he ‘would not speculate on [GP contract] negotiations’ at this point in time.

GPC deputy chair Dr Richard Vautrey told Pulse that although every doctor works to ensure there is ‘24/7’ access to GP services, ‘very few see the need for a routine care service on a Sunday afternoon’.

He said: ‘We do have a good dialogue and relationship with the secretary of state and NHS England and are trying to encourage them to see that the way to deliver their seven-day agenda is to build on and invest in the current urgent care service rather than creating a parallel service that ultimately undermine each other leading to poorer care for the patients in the area.’

He added: ‘The GP contract is not a block to change but, if invested in properly, provides a solid foundation on which to build.’

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  • Jeremy Hunt - online

Readers' comments (89)

  • few facts in case you missed it-
    Hon JH: Interesting read from WIKIPEDIA
    Sept 2012: BMA deputy chairman, Dr Kailash Chand, said "Jeremy Hunt is new Health Secretary—disaster in the NHS carries on. I fear a more toxic right winger to follow the privatisation agenda….
    Expenses: allowing his political agent to live in his taxpayer funded home in Farnham as a lodger whilst claiming the mortgage of his Hammersmith home:
    -----the error was caused by his misinterpretation of the rules ?
    ----- readily accepted that he was in error, and in breach of the rules of the House, in making a claim for utilities and other services on his Farnham home in the period during which it was still his main home
    -----his office arrangements were at best disorganised

    JH attracted controversy for suggesting football hooliganism played a part in the death of 96 football fans in the Hillsborough disaster; when it has been suggested that a lack of police control and the presence of terraces and perimeter fences were established as the causes of the tragedy.
    -----later apologised saying "I know that fan unrest played no part in the terrible events of April

    London Olympics: When it transpired that contractors G4S were not adequately prepared for the Games, Hunt announced that soldiers would be drafted in and that he had been forced to "think again" about the default use of private contractors.
    -----Eventually spend was double than the original budget but the event was a great success

    Hope is still there JH will see the error again and will come to the senses but I won't hold my breath this time....

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  • I would want neither to work nor to be a patient in Ivan Bennett's vision of general practice. Hopefully what happens in Manchester will stay in Manchester (to misquote somebody) and not be forced upon the rest of us.

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  • He's right
    We could do 2 jobs like many firemen and paramedics in the 4 days off

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  • Ivan Benett

    "Anonymous | Salaried GP | 18 July 2015 2:02pm, no no Ivan - i agree with the bit about 'go private' - do you have a model in mind ? " I'd love to know who you are. Actually we are already Private, in the sense that we are independent contractors and never really taken into the nHS completely. We can contract with anyone, for anything, and often do. Such as to the NHS, for training, with insurance companies etc
    "Anonymous | GP Partner | 18 July 2015 4:14pm" - It did make me chuckle, as I watch Andy Murray doing his best in the Davis Cup and at the moment loosing, I'd love to have a conversation with you to understand why you said this...you may be right and I need to hear it...I'm sure lots of patients would be interested too.
    What patients say they want is continuity, access and competence. Increasing capacity and expertise in General Practice does just that. So come on - lets hear it - you might be right so explain and let us know who you are!

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  • You cannot have continuity and 7 day access. They are mutually exclusive unless you plan to make the their GP work 7 days a week.

    I remember being exploited as a houseman, working 1 in 3 and 56 hour weekends. Thankfully I now am older and have savings to fall back on.

    Any move to 7 day working will see me withdraw my services years earlier than I would have done.

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  • Thanks Ivan - good points.

    I think the way forward is for those of us who want out of the NHS contract to develop alternative contracts to deliver care. The problem we have is we are not organised and it's easier to locum than go through the effort of starting a 'truly' private practice.

    One possibility is for the BMA to state that we will only deliver X amount of care on our current contract the rest will be private work. We would have to live with issues such as conflict of interest but surely that will be picked up via complaints and the rather expensive Quangos that monitor us. Perhaps we should move to part NHS and part private care - it would help deal with demand and reduce taxpayer costs?

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  • Una Coales. Retired NHS GP.

    Here is my pro bono article for the Indy Voices challenging Jeremy Hunt. Seems doctors are all at it now, up in arms and taking to social media against Darth Vader! http://www.independent.co.uk/voices/comment/the-odds-are-against-them-but-gps-can-defeat-jeremy-hunt-10400136.html

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  • I think the man is an odious conniving manipulative liar, but he has actually been quoted out of context here for a headline, and I am disappointed that Pulse seems to have lowered itself to the Daily Mail Journalistic standards.

    If you read his comments in full, he said he was yet to meet a doctor who didn't want the same service for their own family if they were ill, 7 days a week.

    Shame on you, Pulse.

    No need to stop to their level and spin so obviously against him. There is so much other ammunition, including all the other *hit he has spouted about 7 day working and forcing doctors to work weekends at same rates as other days without being able to refuse. This is a shabby headline.

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  • Hi Ivan
    I see manchester is about to slash hospital beds without having 'full 7 day GP availability in place' this should be fun, unless you are ill in Manchester

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  • I find it both shocking and puzzling why he( JH) was appointed to be health secretary.
    He apparently is disliked by the majority of health professionals, he has poor communication skills, appears untrustworthy and worse of all he is not qualified for the job he is trying to do.
    It's all very depressing.

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  • All this is simply a ploy to realise their ultimate goal ie privatise the NHS. It won't worry our honourable ministers though all of whom have millions in trust funds
    Mr Hunt is presumably well cushioned with dividends from his business 'Hot Courses'!!!!

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  • hang jeremy hunt upside down and tan his hide

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  • he can come and meet me i have loads of free appointments on a monday morning - not !
    mind you in a few weeks i will have loads of free appointments so delighted to tell him NO to me working 7 days- early retirement

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  • Thats funny - I remember seeing him in NW LMC meeting a couple of years ago where he was questioned on the 7 day opening and majority of GPs there expressed their concerns.

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  • Doctors probably would like a 7 day a week service but that does not mean they want to provide it.

    The problem with doctors is that they are only human beings not designed to work around the clock without a break ... the European directives states folk whould work 37.5 hours per week, come on Mr hunt, find me just one doctor that dopes that?
    My GP works a minimum of 60 hours per week plus.

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  • I would take the headline with a pinch of salt - I've been unable to find this quote anywhere except on Pulse. It may not necessarily change your views but it's sensasionalist and poor journalism if it was indeed not stated. I apologise if it was stated but I have found no record of these exact words.

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  • Ivan Benett

    Clare Morrison | Other GP | 19 July 2015 7:38pm

    Dear Ivan
    I have a number of questions. ...

    Dear Clare,

    Tanks for being brave enough to name yourself.
    No-one needs to work longer than they want to or more complex shift than they want to.
    Of course we need more GPs - lots - but that's not a reason not to do it. It's a reason to work hard to persuade young doctors to do GP (e.g. flexible working, pay their tuition fees, allow then to pursue special interests an spend more time with family etc). I have never said this is a cheap option.

    When I started we had 24 hour responsibility and worked long shifts weekends evenings etc, indemnity not a problem.
    There is insufficient demand for extending hours beyond 8pm during the week.
    The contractual concerns can easily be resolved and that's why we have a union.
    No split day unless you want it.

    I hope I've covered your questions but if not email me ivan.benett@nhs.net

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  • Ivan Benett

    Anonymous | GP Partner | 19 July 2015 4:41pm

    'You cannot have continuity and 7 day access. They are mutually exclusive unless you plan to make the their GP work 7 days a week.'

    I'm afraid the profession itself turned its back on continuity when it gave up 24 hour responsibility in 2004. GPs can't work 7 days a week, nor should they have to anymore. Continuity would be improved by spreading out urgent care response, where the evidence suggests that seeing the same doctor isn't so important to patients (provided they are competent). This will allow more planned care time for patients to see their own doctor in situations when continuity is most valued - where there is a mental health or long term condition, or an emotional element to the consultation, or at end of life.
    So more capacity allows for more continuity when needed and better access. Of course (as I keep saying) it will require more GPs, which we need to plan for and pay for - see previous response. I hope that adequately responds to your concern, if not email me - see previous comment

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  • Dear * unt
    I hope you never meet me!

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  • Dear Ivan

    With respect I think you are living in cloud-cuckoo land. Continuity of care is about seeing the SAME doctor. It is about developing a relationship (the doctor-patient relationship) and consequent to that an understanding of the personal needs of the patient in terms of both their "biomedical needs" and their psychosocial context. Your method does not promote continuity, it creates fragmentation. It leads to misunderstanding and disempowerment. Frankly it is the antithesis of "patient-centred care". The doctor-patient relationship has been shown to be therapeutic in itself.

    The entire issue about 7-day access is perceptual and about apparent convenience. Fundamental to this issue is that your service and the consequent doctor-patient relationship has no value. It has no value to the patient because it is free, and it has no value to you because it has become about meeting the perceived needs of the state and not the perceived needs of the patient.

    7-day access will not solve any issues but it certainly will create a lot. It will require a considerable increase in the number of GPs (and they aren't there), it will create a significant increase in costs (you still need to pay staff you know), it will increase the amount of litigation - principally because of the failure of continuity of care, and it will increase the unhappiness in the profession. The next point is that there isn't even a proven need just a particular political desire to pander to the perceptions of the electorate which lack any substance.

    The arguments that it will reduce the demand on secondary services and A&E have not been proven. This argument is continually repeated but the evidence that it makes a substantial and ongoing difference is lacking. You will just see the same sh*t on the weekend that you did during the week, and the people who were going to go to A&E will go there anyway. So now you have more GPs, more staff, longer hours and no improved productivity with a significant increase in cost. Your anecdotal report does not prove any point - in fact it proves the contrary to your argument: can you deliver a service for 3 quid a patient? Somehow I doubt it. From a business perspective you are cross-subsidizing on limited funds. Good luck with that.

    7 day access is not about real need, it is about perceived need. It has not been shown to be necessary, but it will prove to be very expensive. Clearly you have access - as does the rest of the UK/NHS - to unlimited funds.

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