Caroline Moore explores the potential impact of forced contract changes and possible Industrial Action on patient safety and NHS services…
The General Medical Council requires medical practitioners to address matters if , “patient safety, dignity or comfort is or may be seriously compromised” and to, “protect and promote the health of patients and the public”.
How medical professionals can satisfy these requirements has received widespread attention in recent weeks in relation to their concerns about patient safety. Such concerns stem from proposed reforms to junior doctors contracts, described as both, “unsafe and unfair”. In the light of this, the British Medical Association (BMA) has now stepped away from the negotiating table and voted to ballot the union’s members for industrial action. In short doctors could end up on strike!
There is the real possibility of a pay cut for junior doctors (which will not be addressed in this particular blog entry), but also legitimate questions raised by doctors as to how the new contract proposed by the Government will impact on the standard of patient care delivered across the NHS.
One of the biggest considerations is a threat to safeguards on the number of hours that junior doctors can work and still be said to deliver an acceptable standard of care. It’s really important to understand that doctors are not required to give patient’s excellent care, only reasonable care. It is the standard of reasonable care that is considered to be under threat.
The proposed changes pose a risk of ‘burn-out’ among junior staff who already provide care where human resources are stretched thin. In practice this means decisions are having to be made on a triage basis. It’s easy to see how this could result in a greater number of clinical negligence claims being brought against the NHS.
To add further context there has been a reduction in the government’s annual spend allocated to the NHS from 6.5% in 2012-13 to 6.2% in 2015-16. It is unclear what the solution is for the hospital trusts in these circumstances, hoping to retain levels of performance and delivery of service. Whilst having some sympathy with those making difficult decisions about how resources are allocated, I believe that when the victims of misallocation are patients then there needs to be a means of recourse for any loss that those patients suffer.
So will cuts actually save any money in real terms? As the level of funding falls, the number of potential negligence claims will increase. Of great concern to me is the prospect of cost benefits analyses being made about the cost of one potential claim vs another and treatment having to be apportioned accordingly.
The threat of industrial action by dissatisfied doctors is another reality to be faced. This is not the first time that junior doctors have considered industrial action. It’s understandable in the light of poor offers imposing contract terms that cut salaries and remove safe working pattern protections.
Hopefully matters will be resolved before so called ‘good-will activities’ are suspended and reduced services are implemented. However the reality is that further costs will have to be accounted for if the action goes ahead. It’s becoming increasingly clear that cutting funding and expenditure is hurting, not preserving the NHS.