You know what the problem is with the NHS?
And I'm not thinking about too few nurses, although that is probably true, and I don't mean too little money, although that's a huge issue, and it's not that there's more of us and we are all living longer, although that's true too...no, the problem with the NHS is that consultants don't put in the hours.
The junior doctors have been negotiating with that nice Jeremy Hunt, and the last we heard, there was a major breakthrough in the issue of junior doctors' hours.
The breakthrough is that they are going to get the consultants to do some of them for them.
Consultants are set to lose their right to refuse to work at weekends. Union leaders are believed to have agreed to scrap the clause allowing senior hospital doctors to opt out of shifts on Saturdays and Sundays.
That is a great step forward to allowing the Government to plan for an NHS with supermarket-style opening hours that will give patients the same level of service every day of the week.
I'm sorry, that should read a "better" level of service every day of the week.
The last Labour government looked at consultants' contracts in 2003, and because of their genius and expertise at negotiation they gave them the right to refuse weekend shifts and at the same time increased their average pay by almost a third.
It was such a catastrophic screw up that consultants were being paid overtime rates of up to £200 an hour to fill in the gaps. Five per cent of all the money going on the NHS was being spent on their pay.
They got paid much much more to do less, and then the government wondered why there weren't enough doctors left to cover weekends and nights. It was because they were all playing golf, or asleep. Or both.
The contract stipulated that some senior staff would be on call, should a problem arise, but the problem with having consultants on call is that junior doctors don't want to call them.
Consultants are the ones that have the junior doctors' careers in their hands. They are their bosses. If you were at work at three in the morning on a weekend and something came up, would you want to call your boss at home, wake him up and tell him you can't cope?
No, neither do they.
There are lots of consultants who positively discourage their underling juniors calling them .
I've heard many stories about some junior doctor up to his elbows in a patient that is bleeding to death and the message goes out to the consultant on call and he or she just tells them to cope as best they can and they will be in to check on them in the morning
That is the problem with weekend and overnight cover in hospitals - it is being done by overtired juniors who do not have the experience to make some of the decisions, or administer some of the treatments required and they are petrified of calling up their consultant bosses to admit that fact, and if they do call them they are often treated like idiots and shouted at.
I know of consultants in different fields that happened to have been there and had to ring on-call consultants on behalf of struggling juniors who have been told to cope and only by being told by an equal will the on-call consultant bother to come in to save someone's life.
We are lead to believe that the new contract will take away the right of consultants to opt out of evening and weekend work, which isn't that bad for people that start on £75,000, a year.
That is what's wrong with the NHS - consultants act like lords and don't deign to come in after office hours and leave their inexperienced underlings to carry on without them while they put their feet up at home and congratulate themselves on what a great deal they managed to squeeze out of the last Labour government.
That, and the fact that there's too few nurses, too little money, there's more of us and we are all living longer.
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