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Four things Hunt should have put in the new deal

It appears that Jeremy Hunt has officially declared war on the medical profession with his so-called ‘new deal’. But doctors bit back: within days an online petition was launched calling for a parliamentary debate of no confidence in the Secretary of State. As I write, the signature count stands at 202,196 – twice the number required to trigger ‘the consideration’ of a parliamentary debate.

When he posed the ‘new deal’, Hunt called on statistics that show that patients admitted to hospital on a weekend have a 16% increase in mortality. However, thinking that this figure will reduce if consultants are seeing people in outpatients on a Sunday afternoon is naïve, if not dangerous. I remember my hospital jobs and why care worsens at weekends. I remember one house officer covering all the wards while more senior doctors got trapped on the admissions wards facing the never-ending queue. Nursing levels diminish. Labs shut up shop. I worked in a large teaching hospital where you could not get an ultrasound on weekends.

Richmond House is relying on medicine being popular with school-aged applicants, and that there will always be plenty of students to replace disenchanted doctors who emigrate. Unfortunately, the latest statistics from UCAS show that applications for medicine and dentistry are down this year from 97,800 applications to 87, 730. The vast majority of this decrease (7,500 applications) is from English applicants.

With existing doctors retiring, emigrating, and going part-time, and Health Education England consistently failing to produce GP trainees, the Government really can’t afford to alienate the existing workforce any further. Jeremy Hunt should take note: it was largely Andrew Lansley’s failure to bring health professionals with him through his infamous Health & Social Care Act that led to him being unceremoniously dumped immediately after the Act was passed.

So here are my suggestions for what the ‘new deal’ should have included (and what’s more, no contractual changes would be required to undertake them).

1 Increase the numbers of nurses on the wards and allow them to nurse rather than form fill.

2 Increase the number of medical staff to ensure all patients are reviewed daily for the first five days of their admission, regardless of the day of the week, by someone more senior than a foundation doctor.

3 Improve access to emergency diagnostics at weekends. Immediately and publicly commit to ensure that GP services are able to provide safe and effective five-day services with a complete workforce.

4 Publicly congratulate hardworking out-of-hours GPs for the high quality work which they already provide seven days a week.

We, as a profession, are exhausted, overworked, under-resourced and at breaking point.

But one thing is certain: the next 12 months will define Jeremy Hunt’s career.

Dr Phil Williams is a First5 GP in Lincoln, and former RCGP National Lead for the First5 initiative.