Dear Prime Minister,
In the light of the leaked risk register drawn up by the Department of Health addressing concerns over the government’s current seven-day NHS policy, I am writing to ask you immediately to address the deficits in planning, funding and staffing of the policy exposed by that document.
Specifically, an inquiry is required that establishes transparently and independently precisely: (1) whether any demonstrable clinical benefits for patients will be derived from your seven-day policy and (2) whether said benefits will be a cost-effective way of spending NHS resources.
In formulating health policy, it is not sufficient merely to identify a problem such as the alleged weekend mortality in our hospitals (though even there, the evidence is contentious and not at all clear cut). What is required is an evidence base of objective, peer-reviewed data justifying any particular way of committing scarce NHS staff and resources. I note the Department has not yet conducted the impact assessments of the risks and benefits of the proposed policy on patients and yet it is already in the process of being implemented. This is wholly wrong, as Sir Robert Francis describes in his inquiry into the failing in the Mid-Staffordshire NHS Trust.
The obvious organisation through which to conduct this urgently-needed, independent appraisal of the clinical and cost-effectiveness of your seven-day policy is NICE, the National Institute for Health and Care Excellence. Prior to commissioning NICE however, the Department of Health should first describe the aims and objectives of the seven-day policy: as the leaked risk register clearly states, that first step towards producing an evidence-based health policy has not been undertaken.
In the absence of evidence, the seven-day NHS policy has nonetheless been used to justify imposition of a new contract upon junior doctors. That is wholly unacceptable, given the current paucity of evidence underpinning the policy. Therefore, until such time as the evidence base is demonstrated, no contract should be imposed upon any doctors, junior or otherwise.
The year-long dispute between doctors and government has been immensely destructive for the NHS – and cannot continue any longer in the absence of the evidence justifying the policy.
Imposition should be suspended and doctors allowed to remain on their current contract until such time as you can demonstrate the evidence justifying the policy.
Tom Watson MP
Deputy Leader of the Labour Party