Jeremy Hunt states that the contract he proposes to impose on junior doctors is to “protect patients.” In fact, it will not do so – unless he employs a lot more doctors (who are simply not available).
May I remind Mr Hunt – and all MPs, all civil servants, all members of the many Quangos, and all managers – of the basic principles of the practice of medicine, which are the foundations of the proper, safe care of patients in the NHS.
People who are sick (or those who fear their symptoms may be serious) consult a doctor – and become “patients.” The doctor listens to their symptoms, performs the appropriate examination, and then decides whether or not they need any investigations. The doctor then prescribes any necessary treatment, or may refer them to a hospital consultant.
Any investigations will be performed by professional staff in a pathology laboratory or in an X-ray (or “imaging”) department. The doctor (GP or hospital “specialist”) will then order treatment that may be carried out by that doctor or surgeon; or by nurses, physiotherapists, or other professional therapists.
The function of managers is to facilitate this process. The function of the Secretary of State (and any other “central administrators”) is to ensure that there are sufficient resources (particularly enough staff with the appropriate training and experience) for “the professionals” to perform their functions properly.
I would point out that the government has a longstanding “contract” with the public to provide a National Health Service. They cannot do this without doctors, so it is vital that they negotiate sensible terms and conditions of service for all doctors – and other professional staff – that encourages them to stay in this country and work for the NHS.
The contract which Mr Hunt has threatened to impose on doctors does not do this – nor does it allow doctors to protect their patients’ interests by ensuring safe care.