24/7 healthcare service calls ‘ridiculous’ - doctors

Calls for hospitals to provide all healthcare services on a 24-hour basis have been branded “ridiculous” by doctors.

Dr Mark Porter: NHS can barely afford current model. Picture: Ian Rutherford

Delegates at the British Medical Association (BMA) conference condemned suggestions that the NHS should operate a seven-day supermarket-style operation for all services, including planned appointments which have traditionally been restricted to weekdays.

It follows research which shows that more patients have poorer outcomes if they are admitted to hospital in the evening and weekends, leading some to call for changes to the way services are staffed at these times.

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Yesterday it also emerged that consultants working at the new South Glasgow Hospital will be expected to work evenings and weekends on site rather than being on-call when it opens in 2015.

At yesterday’s meeting in Edinburgh, Dr Mark Porter, chairman of BMA Council, said that the health service could “barely afford” its current model.

“Like many doctors here, I feel personally offended by the terms in which this debate has been couched,” he said.

“Like many of you I work nights and weekends as well, at times when much of the private sector is fast asleep and ministers are tucked up soundly in their beds.

“We all want urgent care at weekends and evenings to be of the same high standards as patients can expect on weekdays.

“But the calls we sometimes hear for a Tesco NHS, full service, 24/7, are just ridiculous when the health service can barely afford its current model.”

Dr Chaand Nagpaul, from the BMA’s Edgware and Hendon division, acknowledged that research had apparently shown the link between being treated out of hours and poorer outcomes for patients and this needed to be better understood.

But he said: “The unfortunate reality is that the NHS is cash-strapped, enduring austerity measures to save billions year on year, and struggles to meet the needs of its population.

“It’s utter folly to compare the NHS therefore with seven days a week supermarket opening and convenience.

He said the NHS was a public service with a fixed budget and unlike a supermarket it would cost money to open on a Sunday rather than making it.

“And of course staff working on Sundays will expect a premium rate of pay, magnifying the expense,” he added.

“And with no new money, the only other alternative would be to stretch the current service and workforce over seven days, resulting in a more thinly provided and staffed service each day.

“This will simply exacerbate the issues of quality and safety.”

Margaret Watt, chair of the Scotland Patients Association, said doctors should not dismiss a 24/7 working culture before it had been tested.

“The NHS is a public service and should operate as such and provide services at the time that patients need them,” she said.

A Scottish Government spokeswoman said: “NHS Scotland continues to evolve its flexible response to delivering quality services to our patients. It is evident that 21st century care requires 21st century working patterns.

“Extending the traditional five day working week has considerable advantages. It would allow fuller utilisation of facilities such as theatres and clinics, and be more convenient for patients and families. There is no suggestion that staff will be forced to work longer hours or extra days.”