The government is pressing ahead with plans to introduce full seven-day-a-week care in the National Health Service despite a leaked report questioning the scheme’s viability.
Senior officials at the Department of Health expressed concerns about the plan due to staffing and budget constraints, according to a risk-assessment document seen by Channel 4 News and the Guardian. The report also suggested that patients may not notice any improvement even if full weekend services are available and that Brexit could limit the ability of the NHS to recruit staff from across Europe.
The seven-day NHS plan, which aims to provide the same level of care on weekends as on weekdays, has been at the heart of a bitter dispute between Jeremy Hunt and junior doctors that led to repeated strike action, including an unprecedented full withdrawal of services in April. The government wants to cut the amount junior doctors are paid for working on Saturdays.
Despite an agreement between the NHS and officials from the British Medical Association, junior doctors are set for a renewed wave of strike action after voting last month to reject the deal with the government. The leaked report also noted that the department saw doctors as the main impediment to the plans being rolled out.
Sources at the department on Tuesday moved to quash any speculation that the government may be rethinking the plan for a seven-day service, saying that it remains on track and noting that risk assessments typically list problems under a worse-case scenario.
The department said: “Over the past six years eight independent studies have set out the evidence for a “weekend effect” — unacceptable variation in care across the week. This government is the first to tackle this, with a commitment to a safer, seven-day NHS for patients and £10bn to fund the NHS’s own plan for the future, alongside thousands of extra doctors and nurses on our wards.”
The BMA said it backed attempts to improve the quality of care at weekends but warned that the government’s proposals lacked detail.
“To see in black and white that the government has not only ignored these concerns — and those of other leading healthcare organisations — but has also disregarded its own risk assessment warnings about the lack of staffing and funding needed to deliver further seven-day services, is both alarming and incredibly disappointing,” said Mark Porter, BMA council chair.
The lack of detail, Dr Porter added, “goes to show that this [the seven-day plan] was nothing more than a headline-grabbing sound bite set to win votes rather than improve care for patients”.
Junior doctors were balloted in July over whether to accept another version of the contract that the BMA had negotiated with health secretary Mr Hunt; 58 per cent of the 37,000 junior doctors and medical students who voted on the offer opposed it.
In the aftermath of the ballot last month, Mr Hunt said he would impose the new contract on England’s 50,000 junior doctors from October.
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