“Everything should be made as simple as possible but not simpler.”
There’s a great book called Thing Explainer by Randall Munroe that explains lots of complex stuff in the simplest terms possible, using only the thousand commonest words in the English language. The dispute over the new junior doctor contract has become increasingly confusing, so let’s keep this really simple.
Jeremy Hunt said this new deal for doctors was meant to make ‘7 Day hospitals‘. He said ‘more people die on Sunday compared with Wednesday‘ and this is because of poor care and less doctors. He called this a ‘weekend effect’. The papers where we read about new events said this too, many times.
But new findings show there is no ‘weekend effect’. People sick at weekends go to hospital, but fewer people actually stay in hospital at weekends, and less people die, not more, on Saturday or Sunday. Only very sick people stay in hospital on weekends, while slightly less unwell people go home and come back during the week.
It is easier to explain if you use a story.
Here is a story.
Ten people go to hospital on Wednesday, two are very sick and will soon die, two are well but need urgent advice. All ten stay in hospital, and the two who need advice are seen by a special doctor who gives it to them. For that Wednesday ten people stayed in hospital, two people died, so the ‘risk’ of death is 2 in 10, which is 20%.
The same ten people go to hospital on Sunday. Two are very sick and will shortly die, two are very well but need urgent advice. The two who need advice see a general doctor, who arranges a special doctor to see them on Monday. They go home. The eight left stay in hospital. For that Sunday eight people stayed in hospital, two people still died, so the ‘risk’ of death is 2 in 8, which is 25%.
So because two well patients waited at home for advice, instead of staying in hospital, the ‘risk’ of dying on Sunday seemed to go up, by 5%, because of how they were counted, not because of how they were looked after.
So Jeremy Hunt said we need to make 7 day hospitals. We have ‘7 day emergency hospitals’ and we know now that those 7-days look after emergencies the same, every day.
Doctors don’t like the ‘new deal’ because it’s unfair to women, reduces pay, and spreads five days worth of doctors across seven days, for what we now know is no good reason. It also takes away the rules that stopped hospitals making doctors work unsafe hours.
Doctors told Jeremy Hunt this was a bad idea, but he forced the deal on them anyway. Jeremy Hunt told doctors they were killing patients by not agreeing to the new deal. This was a lie, and it made doctors sad. Many have now left.
Now Jeremy Hunt wants to talk again, but only about Saturday pay. Doctors know this was never about Saturdays, and now so do you. Jeremy Hunt told everyone that the new deal wouldn’t cost any more money than the old deal. So without a reason to change things, what does Jeremy want?
I’ll tell you what I want. I want to go back to looking after people again. I want to go to work and have enough doctors to look after everyone properly, every day. I want hospitals to have enough money to help us do that. I want the people in charge to only want that too. I simply want hospitals that continue to look after everyone based on need, not on how rich they are.
Now that you’re up to speed, what do you want?