With his usual disarming directness, in today’s Daily Telegraph, Boris Johnson tackles the issue of junior doctors and their strike. Boris begins:It is a feature of the ailments of the human race that they have absolutely no concept of anti-social hours. When I was a nipper I used to get the most fearful ear ache – otitis – and I remember one evening it came on; and I was jumping around on the bed and clutching my head and howling with a complete absence of decent self-control. They tried giving me camphorated vapours. They tried aspirin. I just got more and more plaintive and irritating. With great reluctance it was concluded that I needed to see a doctor – but where? This was when we were living in the wilds of Exmoor.
There was no doctor in the nearest village. Eventually my poor grandmother undertook to drive me in her old VW through the wind and rain and the dark, miles and miles over the moor to Dulverton and the abode of the great Dr Peck, the family physician. Long after suppertime we rousted him from his sitting room and got him to supply some antibiotics. Then there was another night when – I am ashamed to admit – my condition was thought to be so whimperingly bad that this saintly man came himself, on a journey that then (and now) requires driving up a long unmade track which in some places has fallen into the adjacent river. I remember my gulping relief when he appeared, with his brown leather briefcase and his stethoscope and the miracle penicillin.
Ever since that time I have had a Pavlovian reverence for doctors, and a belief that they are good people engaged in a superhuman struggle not just against the armies of disease but against the frequently unreasonable demands that are made by their patients. No one these days would expect their GP to flog across the moors to bring penicillin, let alone after hours or at the weekend. Those days are gone, and not just because nowadays they try to avoid prescribing penicillin for ear ache. They are gone partly because of the change in GP contracts in 2004, which took away the financial incentive for doctors to offer that kind of service; and partly because of the sheer weight of demand.
The trouble is that we have yet to come up with a sensible replacement – a system that delivers at all hours seven day a week. The result is that we have too many people arriving in Accident and Emergency departments, and waiting miserably, when they do not really need to be there, and we have far too many dying at weekends.
Study after study has shown that if you check into hospital on a Friday or a Saturday, you are much more likely to snuff it – with an increased weekend mortality rate of between 11 and 15 per cent. Now this may be because people are heroically containing themselves all the working week, and showing the fortitude that I lacked as a child, and then collapsing at weekends when their relatives have time to take them into hospital.
Or else – and this is what most experts think – the phenomenon is related to the comparative scarcity, during the weekend, of expert medical opinion. Anybody who has waited with a relative on those quieter days, desperate to see a consultant, will know what I mean. It is a problem that this Government is rightly trying to sort out.
To achieve a seven-day service in the NHS is something that is supported by the overwhelming majority of doctors, and Jeremy Hunt, the Health Secretary, is absolutely right to be pressing ahead with his reforms. So it seems incredible to me that we are faced with escalating industrial action from junior doctors, beginning with a strike tomorrow and then – for the first time in the history of the NHS – a complete “no-cover” strike on February 10, a total withdrawal of services by those 55,000 junior doctors, an action that must surely endanger the lives of patients.
How can they believe that this is the right thing to do? The crux of the dispute is about what constitutes “plain-time” (or the normal working day) and what are deemed to be “anti-social hours”. The doctors say that this is not about the money, but about their “work-life balance”. It is certainly true that being a doctor is about far more than the financial rewards. They are in it to heal and help their fellow human beings, and I have, as I say, a deep and primitive veneration for what they do.Distribution of hours for consideration.
But I am afraid it cannot be completely true to say that money is irrelevant to the problem. In the end, this boils down to how much the state will have to pay to get x number of doctors to work y number of hours, in order to provide a truly seven-day service and help the British population to live longer and in better health.
The Government estimates that 75 per cent of junior doctors will be better off as a result of the proposals and that only 1 per cent will be worse off – those that already work more than 91 hours per week. So what is the difficulty?
It is surely not irrelevant that the doctors’ leadership – the BMA council – would appear to be heavily infiltrated by people who are not just Labour voters but who regard Jeremy Corbyn as the messiah. One BMA council member, Jacky Davis, tweeted “Now we can all vote Labour again”, when the bearded one was elected.
Another council member, David Wrigley, said that with Corbyn in charge “we can beat the Tories and make this country great again”. One member of the BMA junior doctors’ committee, Yannis Gourtsoyannis, said “a victory for the junior doctors would signify the first real crack in the entire edifice of austerity in the UK”. It strikes me that at least some of these people are more interested in politics than their patients.
The BMA leadership is in the grip of advanced Corbynitis. They need to get back round the table. The arbitration service Acas says progress is being made and surely a deal can be reached. As for a strike: at the risk of traducing his memory, I can’t believe it is what Dr Peck would have done.