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Jane Feinmann: Joshua’s story and its impact on patient safety

8 Dec, 15 | by BMJ

jane_feinmannLike most people who complain about unsafe healthcare, James Titcombe’s six year battle to hold Morecambe Bay Trust to account for the death of his nine day old son in 2008 was motivated “by the desire to prevent similar tragedies happening to others.” And like many, as he explains in his new book, Joshua’s Story, “the saddest memory is not his (Joshua’s) death but the events that took place afterwards”: a cover-up at local level that led to “missed opportunities to intervene at almost every level of the NHS” and almost certainly, according to Titcombe involved “an element of deliberate suppression.” more…

Will Marsh: Compassion and contracts—a leadership critique

7 Dec, 15 | by BMJ

will_marshAt this year’s London Psychiatric Trainee conference, I listened to Penelope Campling speak eloquently about the importance of compassion in the delivery of healthcare. In her book Intelligent Kindness, she argues that when we fail to promote connectedness between staff, and kinship with patients, we fail to address the “key dimension of what makes people do well for others.” Following last week’s decision by the BMA to suspend industrial action and re-enter Junior Doctor contract negotiations, the secretary of state for health, Jeremy Hunt, tweeted:

Victory for common sense. Strike shouldn’t have been called w/o talking to govt first but great for 7 day servicesmore…

Ted Willis: Seven days to save the NHS?

4 Dec, 15 | by BMJ

Ted WillisFor several months now we have been hearing the government argue that the NHS should provide a “seven day service.” Initially, it was maintained that this provision was required so that working people could see doctors without taking time off work. To many people it seems a no brainer. If Tesco can be open on Sundays, why should the NHS not provide a full service?

More recently, it’s been claimed that this government drive has been about poorer quality of care at the weekend. Fundamental to this line of argument are the ideas that it would prevent “excess deaths” among patients admitted at the weekend, and furthermore make better use of expensive capital resources. more…

Jessamy Bagenal: Junior doctors—What are we fighting for?

2 Dec, 15 | by BMJ

So what?

There has been a huge increase in the number of junior doctors who have joined the BMA since June when Jeremy Hunt began new tactics with NHS staff. Repeated inflammatory and insulting statements like “when you turn medicine into a Monday to Friday profession” have enraged doctors to an unprecedented state. The strike action has been suspended whilst talks continue. Some are angry and a previously united front has fractionated. But, even if, in some alternate universe the government agreed with all the BMA’s terms for a new contract would it matter? more…

Sarah Walpole: To strike or not to strike? What do the public think?

1 Dec, 15 | by BMJ

The government have accepted the offer to further negotiations on the junior doctors’ contract, and many doctors in training have breathed a sigh of relief that this dispute may be settled without the need for a strike. We are ready to take industrial action if that is what is required for the government to listen to the electorate and to protect health services, but we are aware of the short term disruption that a strike can cause and the potential to damage trust in the profession. We only want to strike if it will benefit our patients and the public overall, and if we have public support to do so. more…

Anna Warrington on opposing the junior doctors’ contract

1 Dec, 15 | by BMJ

anna_warringtonIn the past few months I have thrown myself into opposing the junior doctors’ contract that Jeremy Hunt has threatened to impose from August 2016. Along with a small team I arranged a 20 000 people strong protest in London, and I have contributed to a series of national news stories highlighting the truth behind the spin around Mr Hunt’s contract. more…

Chris Ham: Learning from others—devolved governance in the Australian state of Victoria

30 Nov, 15 | by BMJ

I spent a week working in Australia earlier this month and it made me reflect on similarities and differences with the NHS in England.

The funding context feels quite different, with healthcare spending in Australia having risen by 5% per year in real terms over the past decade. On the day I departed, a report in The Australian warned that this level of spending increase was unsustainable at a time of reduced economic growth and falling government revenues (the Chinese downturn being a key factor here). more…

Alice Gerth: Strike action is not the answer

27 Nov, 15 | by BMJ

The strength of feeling of anger within the healthcare profession is so strong that those not planning to take industrial action are reluctant to speak out. I want the public and my colleagues to know that I will be at work, not because I support the new contract, but because I do not support striking at this point in time.

My reasons lie in the principles of “Just War” ethics. Industrial action is a form of conflict. I do not have space to go into the theory in full, but will highlight the areas I feel we contravene. more…

Latest spending review: Hail to the chiefs . . . but major challenges remain

27 Nov, 15 | by BMJ

Chris Hopson_2015As the details of the spending review were announced this week, the scale of the achievement by Jeremy Hunt and Simon Stevens in securing a frontloaded NHS settlement became clearer.

The spending review is, in the words of the Institute for Fiscal Studies, “one of the tightest in post-war history.” Unprotected departments will see cuts of 19% over the five year period. And 2016/17 was always going to be the most difficult of the five years covered by the review. more…

Tony Rao: Politics, persuasion, and pickets

26 Nov, 15 | by BMJ

tony_rao2“What makes the current dispute all the more remarkable is that in 1975, only 56% of junior doctors voted in favour of industrial action.”

Junior doctors accept their lot with unparalleled stoicism. Since the inception of the NHS in 1948, they have tolerated their long hours of work for one main reason: a sense of vocation.

Since the 1956 Guilleband Committee reduced medical representation on government bodies from a near majority to fewer than 25%, the role of doctors in senior decision making is perhaps echoed in the current dispute between junior doctors and the government over the proposed junior doctor contract. This is accompanied by a similar parallel in the emigration of doctors from the UK as a result of comparatively poorer terms and conditions. In 1975, the newspaper of the Junior Hospital Doctor’s Association remarked that 450 doctors per year were leaving the UK, this being equivalent to 1 in 5 of the total annual output of medical school graduates. more…

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