Junior Doctor's contracts petition
Discussion
Dixy said:
The 2 day strike has been called off, despite all HMGs bluster of we will impose the contract, has HMG realized that the Junior Doctors have the winning hand and that HMG must negotiate.
That may be so, but how does it unerringly follow from the BMA calling off the strike? Is the essence of lack of increased conflict in these situations not a degree of compromise from both sides when moving towards an agreement, rather than the capitulation painted by this 'winning hand' spin? It's good news, but the obese female has yet to sing.
Coverage of the announcement on the beeb website said:
The BMA said the move did not mean a deal had been reached.
When the singing starts, we'll know 
968 said:
Turdobloke said:
In the hurly-burly of this busy thread it's easy to miss a lie or two. What are Hunt's lethally damaging lies, exactly? Evidence is needed on all counts not mere opinion.
Not including the disputed statement over stroke patient care as that's recent enough to remember.
It's only easy to miss what you haven't read or been bothered to read. Hunt has misled the public over weekend mortality and stroke deaths. His lies have, themselves resulted in at least deaths. That's about as serious as it comes.Not including the disputed statement over stroke patient care as that's recent enough to remember.
http://www.bmj.com/content/351/bmj.h4596/rr-52
"Weekend mortality statistics
The Government claim there is a 16% higher chance of dying if admitted to hospital at the weekend – this is misleading [1]. The actual data show there is a 16% increase in absolute risk of death if admitted on a Sunday instead of on a Wednesday. The figure for Saturday is 11% [2].
That is an absolute risk reduction on an absolute risk of death of 1.32%. Thus the risk of death is increased from 1.32% to 1.53%. The authors of the original study did not describe how the severity of patients’ illnesses were taken into account, potentially seriously confounding the results.
The figures above demonstrate an association but do not explain the cause.
There are likely to be many reasons for this difference in mortality, but these have not been fully explored. They may well include the fact that patients probably present with more advanced illness and so are more unwell at the weekend, though clearly more study is merited [3].
In fact the original study found that in patients who were already in hospital, the chances of dying on a Sunday were 8% less than a mid-week day. Ironically, they are more likely to be on longer stay wards and therefore much less likely to see weekend consultants than those newly admitted to acute care. Besides all that, using mortality is not an effective marker of care quality [4]."
References
1.McCartney M. The zombie statistic behind the push for seven day working. BMJ 2015;351:h3575
2.Freemantle N, Richardson M, Wood J, Ray D, Khosla S, Shahian D, Roche WR, Stephens I, Keogh B, Pagano B.
3.Weekend hospitalization and additional risk of death: An analysis of inpatient data. J R Soc Med. 2012;105:74-84
4.Mikulich O, Callaly E, Bennet K, O’Riordan D, Silke B. The increased mortality associated with a weekend admission is due to increased illness severity and altered case-mix. Acute Med. 2011;10(4):182-187
5.Hogah H, Zipfel R, Neuburger J, Hutchings A, Darzi A, Black N. Avoidability of hospital deaths and association with hospital-wide mortality ratios: retrospective case record review and regression analysis. BMJ 2015;351:h3239
Very good opinion article
http://www.economist.com/news/britain/21676793-jer...
barryrs said:
Dixy said:
The 2 day strike has been called off, despite all HMGs bluster of we will impose the contract, has HMG realized that the Junior Doctors have the winning hand and that HMG must negotiate.
The last strike only went ahead because 1 of 16 points couldn't be agreed with regards to weekend pay so it would seem that HMG have been negotiating to have come to agreement on the other 15 points with the BMA. http://www.independent.co.uk/news/uk/politics/seco...
Article in The Independent said:
The cancellation of the strikes comes a day after David Cameron warned in an interview that junior doctors could be unilaterally forced to accept a new contract if an agreement was not reached.
Somebody who wanted to put the opposite spin to that in Dixy's post could claim that the BMA called off the strike because they knew what would happen if next week's strike went ahead, i.e. imposition of the new contract, while putting out a face-saving statement around on-going negotiations and patient safety etc.That illustrates how easy it is for both sides to spin it their way. No more no less. Until the dispute resolves, who knows...
turbobloke said:
Somebody who wanted to put the opposite spin to that in Dixy's post could claim that the BMA called off the strike because they knew what would happen if next week's strike went ahead, i.e. imposition of the new contract, while putting out a face-saving statement around on-going negotiations and patient safety etc.
That illustrates how easy it is for both sides to spin it their way. No more no less. Until the dispute resolves, who knows...
There is no way that they can impose a contract, everyone knows that is not possible in reality. If they did try and the Junior Doctors refused to work it, the costs would be huge for everyone involved. That illustrates how easy it is for both sides to spin it their way. No more no less. Until the dispute resolves, who knows...
Cameron talks tough but he has realised that the public are in the vast majority in support of the Junior Doctors. It is clear some on here and the Daily Mail users have swallowed the Hunt message, but the truth is not that.
The BMA have clearly now thrown a card down, they have given the DOH negotiator, who himself was critical of Hunt, an opportunity of more time. I suspect that he probably understands the issue and will want an equitable solution, however he will have to come up with something that Hunt will accept. And to me one of the biggest blocks is Hunt wanting to come out of this looking good.
Cameron made a mistake appointing him to the task.
spaximus said:
turbobloke said:
Somebody who wanted to put the opposite spin to that in Dixy's post could claim that the BMA called off the strike because they knew what would happen if next week's strike went ahead, i.e. imposition of the new contract, while putting out a face-saving statement around on-going negotiations and patient safety etc.
That illustrates how easy it is for both sides to spin it their way. No more no less. Until the dispute resolves, who knows...
There is no way that they can impose a contract, everyone knows that is not possible in reality. That illustrates how easy it is for both sides to spin it their way. No more no less. Until the dispute resolves, who knows...
IroningMan said:
Sorry 968, but how does any of that support your statement that 'Hunt's lies have, themselves, resulted in at least deaths'?
http://www.bmj.com/content/351/bmj.h4596/rr-52It's a small scale study for sure but this has been a repeated effect noted by other consultants.
968 said:
IroningMan said:
Sorry 968, but how does any of that support your statement that 'Hunt's lies have, themselves, resulted in at least deaths'?
http://www.bmj.com/content/351/bmj.h4596/rr-52It's a small scale study for sure but this has been a repeated effect noted by other consultants.
Regardless of the point that you have a mission to discredit Hunt, whereas I consider both sides to be spinning like tops, it's stretching it to say Hunt is lying and thus causing deaths. When the earlier research was presented, with evidence for a weekend effect, I seem to recall that the authors offered caution and suggested more research was required. Either way, there is a problem.
I would consider the evidence at the link relates to speculation by Hunt (and others). If blatant lying rather than ill-judged speculation was a definite factor responsible for the 15% of life/limb threatening cases out of the 40 reported with 2 deaths "possibly linked", the authors would need to go further than this; and as they note "this study, like the study by Freemantle et al. cannot definitively prove causality" so my earlier recollection and view of the link content both appear to be accurate.
For what it's worth I agree with the authors that clarification is needed to prevent additional patients who notice worrying symptoms over the weekend from waiting until Monday before seeking medical attention. This could come from Hunt but need not await his attention.
Dixy said:
I am sure Turbo will be along shortly to say that is a political comment and this is a cheap shot, as he seams determined to have the last post.
http://blogs.channel4.com/victoria-macdonald-on-health-and-social-care/junior-doctors-strike-called-optimistic/3256Amusing. Hopefully result in more fruitful negotiations given the recognition of highly unhelpful rhetoric from SoS. Hopefully will result in his sacking.
Hunt will surely have known that he was for the chop; any politician that tries to make a difference to public organisations always is.
No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
Dixy said:
I am sure Turbo will be along shortly to say that is a political comment and this is a cheap shot, as he seams determined to have the last post.
???If something's political and a cheap shot then, well, it is; but what comment in particular is or isn't political and a cheap shot?
People post on some threads sometimes, not at others, the last word or last post nonsense is just another totally obvious personal angle game play. Boring.
968 said:
http://blogs.channel4.com/victoria-macdonald-on-he...
Amusing. Hopefully result in more fruitful negotiations given the recognition of highly unhelpful rhetoric from SoS. Hopefully will result in his sacking.
Amusing. Hopefully result in more fruitful negotiations given the recognition of highly unhelpful rhetoric from SoS. Hopefully will result in his sacking.
Article at the link said:
To this end, it has been felt wise to take this out of the hands of Jeremy Hunt...There is now an advisory group made up of chief executives, medical directors and workforce directors helping Sir David.
Hunt may well not last in his current post beyond the next reshuffle - not a bad thing if he's replaced in due course. Based on recent comments, the PM appears to be standing foursquare behind Hunt, historically this is a bad sign (for Hunt), behind the scenes could be another matter.barryrs said:
Hunt will surely have known that he was for the chop; any politician that tries to make a difference to public organisations always is.
No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down.
One way or another...Michael Gove was seen as the enemy but then John MacGregor was moved on after 'going native' with Geoffrey Howe providing the excuse and the opportunity.No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down.
barryrs said:
Hunt will surely have known that he was for the chop; any politician that tries to make a difference to public organisations always is.
No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
Possibly but I read he was appointed to the DoH to keep it out of the headlines after Lansleys disastrously timed and expensive reforms. An interesting theory has been that Osbourne has been manoeuvring to sideline Hunt to destroy his leadership aspirations.No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
It's curious that you think the government would want to appear to step down given their inflammatory rhetoric in this dispute, I'm not necessarily in disagreement but can't work out why they'd want to appear weak and incompetent.
968 said:
Possibly but I read he was appointed to the DoH to keep it out of the headlines after Lansleys disastrously timed and expensive reforms. An interesting theory has been that Osbourne has been manoeuvring to sideline Hunt to destroy his leadership aspirations.
It's curious that you think the government would want to appear to step down given their inflammatory rhetoric in this dispute, I'm not necessarily in disagreement but can't work out why they'd want to appear weak and incompetent.
One mans "weak and incompetent" could be spun as another's olive branch.It's curious that you think the government would want to appear to step down given their inflammatory rhetoric in this dispute, I'm not necessarily in disagreement but can't work out why they'd want to appear weak and incompetent.
968 said:
barryrs said:
Hunt will surely have known that he was for the chop; any politician that tries to make a difference to public organisations always is.
No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
Possibly but I read he was appointed to the DoH to keep it out of the headlines after Lansleys disastrously timed and expensive reforms. An interesting theory has been that Osbourne has been manoeuvring to sideline Hunt to destroy his leadership aspirations.No different to Micheal Gove; appointed Secretary of State for Education and became teachers public enemy number one then removed from office to give the appearance of a government step down. He has been rewarded by being appointed Secretary of State for Justice.
It's curious that you think the government would want to appear to step down given their inflammatory rhetoric in this dispute, I'm not necessarily in disagreement but can't work out why they'd want to appear weak and incompetent.
barryrs said:
One mans "weak and incompetent" could be spun as another's olive branch.
Indeed. It's a bit O/T but Gove was making friends (!) with the teaching Unions during the Coalition period because, he said, the education establishment was too ready to accept low aspirations and standards. He was moved, after introducing headline reforms, in the year before the General Election, generating a period of calm in the left-wing media that CMD appears to watch closely. Quite obviously it wasn't about competence. Gove knew exactly what he was doing and how to do it. He was one of the few Cabinet Ministers who successfully flushed his stables clean of a number of hangover left-wing senior civil servants who were said to be blocking reform at a time of leaky information, as well as moving on an Ofsted boss. In media interviews he tore apart Labour's lightweights, his dissection of Harman is a classic. http://www.pistonheads.com/gassing/topic.asp?h=0&a...
http://order-order.com/2011/08/10/gove-vs-harman/
As per comments in the above PH thread, there were rumours that Gove may have been looking at CMD's job and was moved partly for that reason but as per the Gideon and Hunt machinations, reality is likely to be more straightforward.
968 said:
It's curious that you think the government would want to appear to step down given their inflammatory rhetoric in this dispute, I'm not necessarily in disagreement but can't work out why they'd want to appear weak and incompetent.
Because Pastyface Cameron is quite spineless when push comes to shove and the JDs weren't a pushover as he'd hoped they'd be?spaximus said:
There is no way that they can impose a contract, everyone knows that is not possible in reality. If they did try and the Junior Doctors refused to work it, the costs would be huge for everyone.
This^^HMG: We're withdrawing your existing contract and imposing this new one on you.
JDs: We're not signing that. We are now out of contract and you have an NHS to run with no JDs. Good luck.
There is a one month notice period, then I give it 48 hours max before HMG had to move to staff the NHS.
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