Jeremy Hunt’s tenure at the Department of Health has so far been pretty inglorious.
Hunt tweeted on December 13 2013, “Shocking Labour not supporting measures in Care Bill that will prevent another Mid Staffs. Have they learned nothing?”
The Care Bill is however intensely complicated. The Government plans to widen the powers of trust special administrators face opposition both within and outside Parliament. There can, of course, be grounds for hospital reconfigurations where this improves the quality of patient care, however it is essential that this takes place with proper regard to due process.
And yet Jeremy Hunt has allowed himself to be completely at the mercy of health services journalists, some of whom are not particularly bright and who have little understanding of the English law. Specialist registrars in medicine, the rank below a Consultant, can only wonder whether they wish to become a NHS consultant working in such demanding conditions.
It is clear that the Secretary of State for Health, too, cannot have that clear an understanding of the current law, as he has now lost in the second and third highest courts in England and Wales.
However, by courting certain people, Jeremy Hunt has ensured that he cannot be attacked by key personnel in the clinical regulators.
The NHS would be nowhere without the opinions and views of patient campaigners, particularly in the discussion over reconfigurations. The quality of their work continues to be astounding. The news about the Mid Staffs Trusts reconfigurations is expected shortly.
A similar issue has arisen with NHS consultant cover.
If Jeremy Hunt wants a NHS Consultant to do 24 hours for example, he presumably will have to pay another NHS Consultant to act ‘as cover’ for the next 24 hour period. Otherwise, this will offend ‘patient safety’ so beloved of many who had themselves not prevented a Mid Staffs previously.
If Jeremy Hunt wants NHS Consultants to be there seven days a week, he will presumably also pay for the formidable army of dieticians, occupational therapists, physiotherapists, speech and language therapists, nurses, healthcare allied professionals, ward clerks, and so it goes on, too. The costing figures estimating what this might cost have been virtually non-existent so far.
If Jeremy Hunt wants a NHS Consultant to do the work instead of Specialist Registrars, he must ensure that they are adequately trained and revalidated on specialist procedures such as insertion of a central line, chest drain or pacing wires, and pay for this.
Otherwise, Jeremy Hunt is all talk and no action.
It’s been long known that Tony Blair wished the civil service to be more ‘innovative’ and not act like technicians. The deprofessionalisation which the NHS finds itself now is a genuine problem.
If private providers really want ‘an equal playing field’, is it not reasonable to request private providers such as Circle, Serco or Virgin to pay for Specialist Registrar training posts in their ‘NHS hospitals’? They are, after all, using the NHS logo.
Otherwise, despite the brand loyalty, the time possibly has to come where the ‘National Health Service’ gets rebranded as a ‘whole person care service’ (or similar). The NHS is unrecognisable to how it used to be recently, and the legitimised use of the NHS logo is simply causing confusion from members of the public. This is unless of course politicians can unit on re-framing the NHS away from a pseudomarket, but as a service which is comprehensive, universal, and free-at-the-point of need.
As it is, we’re left with Jeremy Hunt and some health services journalists, and the clinical regulators, trying to move policy incrementally by soundbite, often by completely ignoring the professionals who matter: the doctors, nurses and allied health professionals. They should spend less time managing the media, and more time managing the NHS.
It’s all gimmicks, gimmicks, gimmicks.
