Weekend mortality: Hunt accused of ‘missing the point’
Jeremy Hunt has been castigated by the editor of the UK’s leading medical journal over alleged “misrepresentation” of the facts on weekend mortality at NHS hospitals – suggesting the Health Secretary does not properly understand the situation.
Mr Hunt has repeatedly asserted that understaffing at hospitals during weekends is causing 11,000 excess deaths every year. But in a letter to him, Dr Fiona Godlee, the editor of the BMJ, asks Mr Hunt to confirm he “fully understands the issues involved”.
The claim over the number of excess deaths, which is a key plank of the Government’s argument for what it calls a “seven-day NHS”, is based on a research paper published in the BMJ last month. It reported that 11,000 more deaths occur within 30 days of admissions to hospital on Fridays to Mondays than occur after admissions on Tuesdays to Thursdays.
While the paper did identify a lack of senior doctors and support services at the weekend as possible factors, it also points out that people coming to hospital at the weekend tend to be sicker.
The authors, who include NHS England’s medical director, Sir Bruce Keogh, were explicit that it was not possible to determine “the extent to which these excess deaths may be preventable” and said it would be “rash and misleading” to assume they were.
In her letter to Mr Hunt, Dr Godlee states: “Despite the authors’ very clear statements to this effect in the paper and elsewhere, you have repeatedly told MPs and the public via media interviews that these deaths are due to poor staffing at weekends, with a particular emphasis on
medical staffing. This clearly implies that you believe these excess deaths are avoidable.
“I ask you to publicly clarify the statements you have made in relation to this article to show that you fully understand the issues involved.”
Yet responding to Dr Godlee’s letter last night, the health minister Ben Gummer said that debating about “precisely how many of the thousands of deaths are avoidable misses the point”.
“Significant independent clinical evidence shows increased mortality in our hospitals at weekends linked to reduced clinical cover. The BMJ authors themselves acknowledge that,” he said.
“What all doctors want is to provide the best care for their patients, and the public rightly expect the highest standards whichever day of the week they are admitted to hospital – the Government is committed to supporting that.”
Mr Hunt has also been challenged on the excess deaths claim by a group representing more than 3,000 doctors, who last week complained to the Cabinet Office, claiming that Mr Hunt had breached the ministerial code by allegedly giving misleading information to Parliament.
The question of medical staffing at weekends lies at the root of the current dispute between the Government and junior doctors. Mr Hunt has told doctors he wants the new contract, which will increase basic salaries but will cut pay for working evenings and Saturdays, to help “eradicate” the weekend effect.
But fears that the proposals will lead to pay cuts for many and remove safeguards around working hours have led the doctors’ union the British Medical Association (BMA) to ballot members for strike action. It was announced yesterday that balloting would begin on 5 November and run until 18 November.
Announcing the ballot, Dr Johann Malawana, the chair of the BMA’s junior doctor committee, also raised the issue of Mr Hunt’s “rhetoric” on the need for more weekend staffing.
The Department of Health has said the plans for reforming junior doctors’ contracts will be cost-neutral, and while Mr Hunt has said he does not want to see any junior doctor face a pay cut, he has not been able to guarantee that none will.