So the junior doctors have had their strike with a threat of more to come. Not all doctors were on strike yesterday as emergency cover was maintained. In other words the junior doctors, under the direction of the BMA, decided that to press their argument home they were to impose on the patient weekend conditions on a weekday.
Throughout the day there were conflicting versions from striking doctors as to why they are on strike. One version complains that they will effectively get a pay cut with the new contract, another complains that they will no longer get higher pay for unsociable hours.
Most follow what is the quasi-official line of the BMA that this is all about patient safety. This is where the argument completely unravels. Study after study shows that discharge rates at weekends reduces massively (my personal favourite study is from the 2003 paper from the Emergency Medical Journal).
Reducing delayed discharges is not only crucial to the welfare of the individual patient but also to the patients waiting for admission and patients waiting to be seen in A&E only to be delayed by, you’ve guessed it, a delayed discharge elsewhere in the hospital. It is no coincidence that A&E sees its highest backlogs on Mondays when doctors resume non-emergency work and go about releasing patients who could otherwise have been set free to go home 24, 48 or sometimes 72 hours earlier. While the frantic bed unblocking goes on there are patients being denied the care and treatment they need.
In my own personal experience I have been told to come to hospital on a Sunday to collect a patient who was discharged only to wait for over 4 hours while nurses frantically searched for a doctor to sign a prescription. A consultant was found who was worked off his feet. If junior doctors were on shift his job would have been less exhausting, my friend would have been discharged a great deal earlier and the bed would have been free, for example, to an A&E patient.
Ironically it is in A&E where a junior doctor may well be working at the weekend and frustrated with weekend bed blocking due to lack of junior doctors on the wards. This account is repeated in the BMA’s own publication ‘Hospital Discharge: The Patient, Carer and Doctor perspective’, where patient “Julie” spoke of hours of delay due to not being able to find anyone to sign the paperwork. In this same publication a former chair of the BMA Junior Doctors Committee says of delayed discharges: “When done poorly patient care can suffer, with distressing consequences for the patient and their family.”
Jeremy Hunt has called on junior doctors to follow nurses, technicians, caterers, engineers and all the other people that make the NHS tick to work a regular weekend shift to nail the problem of delayed discharges. They have been persuaded by the BMA not to answer that call and go for the emotive argument of patient safety.
The actions of the highly qualified, dedicated but poorly led junior doctors have not only continued to leave patients at greater risk at weekends, but have exacerbated this by recreating these conditions on a weekday through industrial action.
Richard Short is the Northern Coordinator for Conservative Trade Unionists. This article contains his personal views and it does not necessarily reflect the views of Conservative Trade Unionists as an organisation.