The Sins of the Hunt
The reappointment of Jeremy Hunt to Health Secretary seems odd given that so many of the staff distrust him and Jim Mackey – Head of NHS ‘Improvement’ – declared on the same day that the NHS was ‘in a mess’, would miss all its finance and performance targets and there had been “five years of decline on all of the things that people would worry about”. Theresa May kept Hunt waiting, testing if any sane woman wanted the job first, before ordering Hunt to fix his – and Andrew Lansley’s mess.
The odds aren’t good. Hunt struggles with critical thought, such as signing an early day motion to support homeopathy. After tweeting about meetings with pharmaceutical companies making new drugs for dementia, Hunt decided that GPs weren’t diagnosing dementia enough, so he offered them £55 per new diagnosis via screening them. The trouble is, ‘positive’ screening tests are wrong 80% of the time. Take 100 people over 65, and 6 will have dementia. If you screen them all, 23 will have a false positive. Only when the press found people were selling up and moving into care homes when they thought they had dementia, only to find they had mild cognitive impairment, did Hunt and NHS England ditch the bribe.
Hunt’s involvement in the Tory manifesto pledge to deliver ‘a truly 7 day NHS’ is unclear, but he decided to ambush the junior doctor negotiations to try to get staff working at weekends. When it was pointed out that staff were already working at weekends to provide emergency cover, and that taking more staff away from weekdays – when the wards are busiest – to work at weekends might not be a good idea, Hunt started firing off statistics. He repeatedly claimed that 11,000 more people die at the weekend because of lower staffing levels, even though the BMJ paper concerned said to assume the two were related would be ‘rash and misleading’, as did the National Statistics Authority, but he carried on telling the same untruth in the hope that it might one day become true.
On a roll now, Hunt said that you are 20% more likely to die at the weekend due to stroke. In fact, his data was 20 years old, and most recent data shows no day of admission difference. Tragically, patients swallowed the message that hospitals were less safe at weekends and delayed seeking help for life threatening illnesses. Hunt then decided to piss off consultants by claiming only 10% of hospitals had consultants seeing patients within 14 hours. David Speigelhalter, a professor of statistics, said this conclusion was flawed and Dr David Craven, a Fellow of the Royal Society said it was ‘simply impossible’ to know on the set of data used. But Hunt, like Gove, is long since sick of experts.
Unsurprisingly, the normally placid but numerate junior doctors don’t trust Hunt. His offer of a 13% and then 11% pay increase when the ‘overall cost envelop remains neutral’ sounded very fishy. His claim he could introduce a truly 7 day NHS without extra staffing or funding was just laughed at. His claim that he had the power to impose a new contract on them if they refused to accept it was when relations got really frosty. To be fair to Hunt, the BMA should spend its money on professional negotiators rather than using knackered junior doctors, but Hunt’s ‘go to war with the staff’ stance undoubtedly triggered unprecedented strikes. Junior doctors and medical students overwhelmingly rejected their final contract offer in an advisory ballot – despite the recommendation of the BMA and Hunt to accept it. Junior doctor leader Johann Malawana immediately resigned but Hunt has had the brass neck to remain when the vast majority of NHS staff would like him to leave. If he tries to impose the junior doctor contract again, he will doubtless be heading for a High Court challenge
May is not stupid. Hunt is a convenient smokescreen for the creeping privatization of the NHS. NHS England director of strategy Michael Macdonnell says the latest NHS reforms ‘offer private sector organisations an enormous amount of opportunity’. Virgin Care is busy hoovering up as many NHS services as it can. So many GPs are planning on reducing hours or retirement that practices are easily bought up. Private takeovers of hospital chains are on the cards, the bureaucracy of administering a market takes £4.5 billion away from the frontline and a Lords NHS Inquiry lead by the “Under Secretary of State for NHS Productivity” (sic), Lord David Prior is considering patient charges and insurance. Hunt is just the happy whipping boy, diverting attention from the real agenda.
MD’s NHS Revolution is at the Edinburgh Fringe August 5-27