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More NHS workers come out against seven-day working

David Cameron’s plans for a seven-day NHS have come under further fire from healthcare professionals, some of whom describe them as a “fantasy”.

In a speech on Monday, the prime minister renewed his pledge to institute a seven-day NHS, including seven-day hospital care and seven-day GP access.

He argued that shift changes, not longer working hours, will enable the NHS to deliver a seven-day service.

In the Q&A session after the speech, Cameron even claimed the seven-day-a-week NHS will not necessarily cost more.

But since his comments a growing number of NHS professionals have described his vision as unrealistic.

Dr Mark Sanford-Wood, a GP in Braunton, North Devon, who sits on the GP committee of the British Medical Association, said under-funded practices were struggling to provide a "safe and quality service" even before "spreading the butter more thinly".

He told the Western Morning News: "All GPs are saying with cast-iron certainty we are struggling to provide a safe and quality service for the five days that we are already providing. A seven-day-week is spreading the butter more thinly on the bread.

"There is a finite number of GPs. If you expand the service 40% more you can't do that, it's impossible."

Dr Sanford-Wood went on to describe rural areas in Mid Devon where the population is so sparse it can only support a practice with one GP.

“Will they never get a day off? Or are they saying a collection of practices will offer a weekend clinic? It's a typical politician's rhetorical fantasy that doesn't address insurmountable problems,” he added.

Even in densely populated urban areas doctors are arguing that resources are spread too thin. Labour London Assembly health spokesman Dr Onkar Sahota said: “I'd like to see surgeries properly staffed and open seven days a week but it's concerning that the health secretary makes no mention of how he will deliver his pledge.

“In London we have a GP crisis on our hands, with our practices overstretched and too few doctors available to deliver care to our aging and expanding population. Adding more duties to an already overburdened workforce, without making it clear how this will be resourced, is not going to result in better care for patients.”

Professionals have taken to Twitter to vent their frustration at the plans and point out their failings. Dr Elizabeth Bates, a GP and clinical lecturer in primary care in Birmingham, pointed out that the 12-hour opening GP pilots failed and believes more “bang per buck” can be found elsewhere.

Writing in the Guardian, Professor Colin Leys, honorary professor at Goldsmiths University of London, describes David Cameron’s promise of a seven-day NHS as “curious” and says his reasoning is “rooted in ignorance, not evidence”.

He points out the NHS is already available seven-days a week, with out-of-hours GP services covering evenings and weekends, A&E departments always open, and inpatients treated around the clock at weekends with consultants on call.

He adds that GP practices can already earn extra funding for providing “enhanced services” on weekday evenings or at weekends, but that this has shown that demand for access at these times varies considerably according to demographics.

“This suggests that a blanket policy would waste resources: what would be helpful would be for NHS England to offer to assist every practice to work out the best way for it to meet the local demand,” he writes.

More worryingly for Cameron, Simon Stevens, the chief executive of NHS England, who was speaking alongside him on Monday, has warned that progress towards seven-day services may not be a priority because of cash shortages and the need to make other changes.

Stevens pointed out the £30bn funding gap and said expanding services would take time.

“We’ll need careful and disciplined phasing of our ambition to expand services – be it improved cancer care, mental health, primary care, seven-day services – all of which we want to do,” he said.

BMA council chair Mark Porter said it remained unclear as to how the services would be paid for when the £8bn was the “bare minimum” needed to keep the NHS going.

“The £8bn promised by the prime-minister is the bare minimum needed for the NHS to simply stand still and will not pay for extra services," he said.

“The real question for the government is how it plans to deliver additional care when the NHS is facing a funding gap of £30bn and there is a chronic shortage of GPs and hospital doctors, especially in acute and emergency medicine, where access to 24-hour care is vital.”

He added: ‘Without the answer to these questions this announcement is empty headline grabbing and shows that, even after polling day, politicians are still avoiding the difficult questions and continue to play games with the NHS.”

Unions are also cautious about the plans. Unison warned that it would ballot its members on strike action if a seven-day-a-week NHS operation was to be funded by cutting staff pay, while Dr Peter Carter, general secretary of the Royal College of Nursing, told the Independent that nurses will strike if the government tries to cut pay to deliver the seven-day NHS.

“I would particularly give a really strong warning to [health secretary Jeremy Hunt]: any attacks on unsocial hours, weekend working payments, would be strongly resisted,” he said. “While we don’t want industrial action, I do feel that for nurses that would be a red line.”

Tell us what you think – have your say below, or email us directly at [email protected]


Rod Price O/T Surgeon   20/05/2015 at 19:09

Working a three shift day will require an increase of salaries at only basic rate by 2/3. Running a "normal tescofied service at the weekend would increase the salaries at only basic rate by a further 2/7. Simple arithmetic, too much for an unmadated government elected by 24%, governing for 3%?

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