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Say no to a post-truth health service

PORTER: Government must own its share of the challenges in healthcare

Doctors must resist a ‘post-truth’ health service, BMA council chair Mark Porter has warned in his New Year message to members.

Dr Porter writes that an approach that relegates the importance of facts and evidence is harmful to patient care and does nothing to address the long-term sustainability of the NHS.

He cites politicians’ ‘persistent, blinkered denial’ of the grave financial pressures facing hospitals and GPs. The BMA’s analysis of England’s 44 sustainability and transformation plans has uncovered a total of £26bn in cuts to health and social care over the next five years, and yet ministers speak only of efficiency savings or ‘bumps in the road’.

Dr Porter writes that, with social care under intense pressure, thousands of patients are suffering delayed transfers of care, which can threaten both their own health and the ability of hospitals to give them optimal treatment.

His New Year message finds similar pressures across the UK, such as in Northern Ireland, where GPs are considering submitting undated resignations.


An uncertain future for doctors

Dr Porter writes: ‘We need a Government that is willing to own its share of the challenges, not one that is obsessed with owning the headlines.’

He calls on the Government to take responsibility for the damage it has caused to doctors’ morale, and to the thousands of overseas-trained doctors facing an uncertain future after the EU referendum in June.

He points out the many consequences of an under-funded health service, such as the recent report of a five-fold increase in patients waiting for more than four hours after emergency admission.

‘The beds they are waiting for have been taken away in the name of cost cutting and efficiency. According to the OECD, the UK has fewer than half the beds of France and a third of Germany’s, per person – a difference in magnitude that cannot be explained away on definitions.’


Neglected responsibility

One key area where the Government is neglecting its responsibility is in ‘providing a working environment for junior doctors in which they have confidence’. He says the Government’s decision to impose a contract in England that is opposed by a clear majority of junior doctors is a ‘self-defeating squandering of goodwill on an unprecedented scale’.

Recent surveys from the GMC and Royal College of Physicians had found junior doctors were left demoralised, sleep-deprived and forced to miss essential training.

He said junior doctors working under the contract should use the new system of exception reporting to raise any instance where their actual work varies from what they are scheduled, and paid, to do.

‘This has the potential to be a safeguard and an early warning system, and shock employers or the Government out of any delusions about working hours to which they may succumb. The more that junior doctors use it when their hours are in variance, and report those inconvenient truths, the more effective it will be.’


Evidence saves lives

Dr Porter condemns the description of the thousands of doctors from other EU countries by one Government minister as one of the ‘main cards’ in Brexit negotiations.

‘So, to their patients they save lives, relieve pain and bring kindness and reassurance, but, to this politician at least, they are just negotiating chips.’

He writes that the plan to increase medical student places to supposedly make the UK self-sufficient in doctors raises many practical issues, and leaves overseas doctors feeling like little more than a ‘stopgap’.

Concluding by paying tribute to a new BMJ initiative which delivers high-quality clinical guidelines to healthcare workers in developing countries, Dr Porter writes: ‘It really is very simple. Evidence saves lives. The only place you can go without evidence – or ‘post-truth’ – is one where patients are harmed. We’ll stick with the facts – they serve our patients well.’

Read the New Year message in full

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