The NHS, a lesson in politics

Jeremy Hunt is much cleverer than you think

The current government are trying to change doctors contracts. They are starting by forcibly removing opt-out clauses from consultant’s contracts, which supposedly prevents the government from running normal clinics at weekends. (well its an obstacle among many)

The government are demonstrating a wonderful command of the modern media landscape to ultimately force their will. Despite it being contrary to what is perceived as public opinion.

First find your narrative.

Saying that “we want a 24/7 NHS” on its own is next to useless. People will rightly question the expense of sourcing 30% more staff to cover the expanded working hours (an extra two days is around 28% more time) What you need is a diversion:

“It’s a shocking fact, but mortality rates for patients admitted to hospital on a Sunday can be 16% higher than on a Wednesday…” – David Cameron, 18 May 2015

That my friends is a master stroke. An “official” & “scientific” statistic that appeals to your base fears. From this the government has constructed a wonderful narrative; we must make a “seven day NHS”. Therefore we must re-negotiate contracts with all our staff. Anyone who objects is a murderer.

Can’t argue with science.

Well you can, thats the point of it. It is indeed true that a study suggests that you are more likely to die (eventually) if you are admitted over the weekend. The problem I would hope is fairly obvious. The NHS doesn’t do routine ops on a weekend, then the people arriving on Saturday & Sunday are up shit creek and need attention quickly. There are no simple procedures like wart removals & advances chiropody to dilute those selfish people that choose to have life threatening conditions.

That’s the science bit, lets get down to the Art

A Doctor created this Petition:

To debate a vote of no confidence in Health Secretary the Right Hon Jeremy Hunt

Jeremy Hunt has alienated the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff.

It has gained (at the time of writing) around 198k signatories. Its caused such a fuss that its had an official reply, which I shall annotate. First I need to point out a few things with the petition.

  1. Its short and to the point
  2. It has a single demand
  3. A single justification

The single justification is what the reply centers around. Without further ado, here is the reply with my annotations:

Many people do not realise that if you are admitted to hospital on a weekend, you have a 16% greater chance of dying. The Government wants to change this so that everyone can be confident that they will receive the same level of care whatever day of the week they are admitted to an NHS hospital.

Nice. Drop the clanger right at the start, try and make it sound conversational. “We know that we’ve redefined the argument using bullshit stats, there is nothing you can do now bitches”

NHS consultants already provide an outstanding service and show great dedication to ensuring patients get the best outcomes. But the Government has a duty to make sure the system is set up in a way which makes it as easy as possible for hospitals to organise their resources to maximise patient safety across every day of the week.

Oh hospitals can organise all they like, so long as you buy your services from my future employer. Oh and here is something about safety. you kill 16% of the entire population. Every month. (EDIT: delete that last bit.)

To understand more about the possible issues for staff contracts, last year the government asked the independent pay review bodies for NHS staff – The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) and the NHS Pay Review Body (NHSPRB) for their observations and recommendations about how the reform of employment contracts could help support the delivery of seven day services in England.

“We did some research which or may not backup our position. However we both know no-one in the media is going to read it, much less the public. But it doesn’t matter because if you stand up for yourselves, you must be for 16% higher mortality rate. HAHA GOT YOU AGAIN BITCHES.”

The reports were published this month. They identified that a major barrier to seven day services is a decade old contractual right in the consultants’ contract negotiated by their union representatives in 2003 that allows senior doctors to refuse to work non-emergency work in the evenings, at nights and at weekends. No junior doctor, nurse or other clinical group has any such right. Other senior public sector professionals who work in services required to keep the public safe, such as police officers, firemen and prison governors, do not have this opt out either.

Well no, the major barrier is we don’t have enough trained staff. We can’t wait 16 years for an increase in consultant numbers (Fucking UKIP, making importing foreigners a bit tricky.) Notice that they stop using “consultant” and use the term “senior”. That’ll come in handy later on.

Also they fail to mention that “non-emergency work” is still actually work. its just consultants aren’t running clinics.

The use of “nobody else gets this” is another masterful stroke. It fails to make clear that the Met only work 9 hour shifts and have lots of rest days. Not a hint of 80 hour weeks.

Whilst the vast majority of consultants work tirelessly for their patients, the opt out allows individuals to charge employers hugely expensive payments which are much higher than national contract rates (up to £200 an hour). The average earnings for a hospital consultant are already in the top 2% in the country at £118,000, and these inflated payments can make it difficult for hospitals to provide the weekend cover they know patients need.

so wait, we are paying locums at the weekend to do normal “non-emergency” duties? well I thought the NHS didn’t do “non-emergencies” at the weekend? Oh wait, thats right, its because you can’t hire enough consultants in the first place and need to buy in staff to cover sickness. A truly magnificent manipulation there.

To top it off they chase it up with “Consultants are rich cunts, and are TAKING YOUR HARD EARNED CASH SO THAT THEY CAN KILL BABIES” Good luck countering that biatch.

The report endorsed the removal of the opt out, as well as broadly supporting other changes to the consultant contract that would ensure the right level of cover is available every day of the week; not just Monday to Friday.

What we really want is the “other changes” This is just a side show. Also you doctors apparently don’t work nights. You are lazy fuckers that clock off early on a friday. Haha I still can’t believe you are buying the whole “non-emergency” shtick.

Under the new plans, doctors will still continue to receive a significantly higher rate for working unsocial hours and there will be a contractual limit (not an expectation) of working a maximum of 13 weekends a year.

We’re going to fuck all you doctors now. Oh come darling… don’t look like that. How else do you think we are going to afford the whole “7 day NHS”? Did you honestly think we’d hire extra staff? HAAA! you naive twats. All of you are going to get a pay cut, and you’ll be working 1/3 weekends. Its a target, not a limit. Wait no, scratch that last bit, lets wait till they sign it before we say that bit.

By the end of the Parliament, the Government hopes that the majority of consultants, in line with existing practice for nurses, midwives and junior doctors, will be on reformed contracts, working across seven days, to deliver a better service to patients. Hospitals like Salford Royal and Northumbria that have instituted seven day services have already seen improvements in patient care and staff morale.

There is no point grumbling, we know you won’t strike. Look these places did it. THE BEATING WILL CONTINUE UNTIL THE CLICHE IMPROVES

These new plans will mean that doctors working in some of the toughest areas in the NHS, such as A&E and obstetrics, will at last be properly rewarded and there will be faster pay progression for all consultants early on in their career. Under the new proposals, the highest performing consultants could be able to receive up to £30,000 a year in bonus payments, on top of their base salary.

We’ve never worked in a hospital, so we’re not aware that actually the shittest job is old age psych and Gerries in general. don’t worry you’ll still get to keep the ash cash.

However we do know its impossible to train enough consultants in time, so we going to drop the bar a couple of notches. That way we can make a case later on that we need to privatise the lot because standards have dropped so much. Did we tell you that Mr Hunt wrote a book about dismantling the NHS?

OH but here’s a carrot, once we’ve slashed your base pay, one of you will receive up to £30k. but only one. We can’t afford any more. It’ll be a post dated cheque though, I hope thats fine with you?

Of course, improving weekend care requires more than just ensuring greater consultant presence. That’s why the government is also addressing issues such as access to weekend diagnostic services, provision of out of hospital care to facilitate weekend discharges, and adequate staffing cover amongst other clinical groups,. But NHS leaders and the independent pay review bodies are clear that increasing the presence of senior clinical decision makers at weekends is vital, and that the consultant opt out remains a barrier to organising broader support services and staff rotas.

Oh fuck, what is it with you doctors and your fucking X-rays & blood tests. Don’t you know that radiographers can strike? Bollocks We’ve also privatised that already. BOLLOCKS. BOLLOCKS. can’t you just use a really bright light instead?

Oh shit you’re still here. Ermm, CONSULTANTS ARE BAD, THEY DON’T WORK WEEKENDS, YOU’RE ALL BABY KILLERS.

I don’t think they noticed.

The Government feels it is under an obligation to the public to do all it can to make NHS care at the weekend as safe as during the week through the delivery of seven day services this Parliament and that is what it will continue to do.

We own you bitches. Labour are too busy chasing parked cars. No one listens to social media, and the only people that vote are the same people that read all the news paper our mates own. GIVE UP. WE HAVE YOUR TESTICLES IN A CUP.

oh yeah, blah blah blah, democratic mandate. Hur, Man date.

Conclusions:

Whilst it may seem hopeless, you (the doctor) are actually in a surprisingly strong position. If you think about who the public trusts more; Doctors or Politicians, there is no contest. So what can you do. If you’re a doctor, you need to write to the BMA. Tell them that they need to get off their fat arses, hire a decent advertising firm and run a really dirty negative campaign against the government. (it worked for the Tories, they are in power, and everyone thinks that the SNP are worse than the IRA)

But that won’t work alone. You need hard cash to buy advertising space. Advertising space like the entire of westminister tube station. A massive picture of a crying baby, with the strapline: “your cuts costs lives Jeremy.”

Strategies in order of effectiveness:

  1. Imply the Minister for Health allowed Paedophiles to flourish (The Tories are doing it Here & Here note that he doesn’t actually need to have done it and I’m not suggesting he did.)
  2. Counter the 16% stat. Counter with “Tory cuts will kill a projected x thousand a year” don’t use science, use base fear.
  3. “Tory cuts stop NHS buying (Expensive) and (not very) powerful new cancer fighting drugs, killing x number of babies”
  4. “Funding changes have killed x number of people in the NHS n times more than mid staffs”
  5. Generally imply that some flagship political change is killing children.

This might sound abhorrent, it is. However its precisely what the government is doing now:
1,300 babies were killed or maimed through NHS negligence
Baby’s death could have been avoided but NHS That one is especially brazen as it’s precisely the reason why everyone was against the service in the first place
Jeremy Hunt Stands By His Claim That Babies Are ‘Killed’ By The NHS
Mr Hunt goes to war against NHS fat cats
NHS staff are killing 12,500 every year: And they operate on wrong body part once a week, reveals Hunt
NHS 111 helpline refuses to send out ambulances
NHS CT scans can damage patient DNA and kill cells Although that might be the wrong NHS.
Elderly face NHS discrimination under new UN death targets Bonus UN bashing too.

So my point is this. The NHS is worth protecting. To fight, you must know your enemy. You enemy is the government. It is a devious, clever and cynical foe. You must kick the BMA up its flabby useless arse. You must crowd fund some highly personal attack posters. Then, and only then do you start to negotiate.

5 thoughts on “The NHS, a lesson in politics

  1. “don’t worry you’ll still get to keep the ash cash”

    -Nope, the government are proposing the money gained from doing non-NHS professional work such as cremation forms or police reports should be given back to the government as such work is done ‘during NHS time’. Another of their 23 recommendations.

  2. Rang bma press team explained had contact thst could help with social media campaign.
    The BMA responded by telling they had their own in house communications team who knew what they were doing, and wanted things to be grassroots and not get involved.
    Told them fighting against millions of pounds Whitehall pr machine – didn’t seem to bother them st all!!

    What meant to do if have union is not listening, that is not moving with times, hoarding money that could be used on pr campaign that could annialate Mr hunt and spinning colleagues!

  3. Pingback: EMGAT statement on industrial action | EMGAT

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