One of the most absurd anomalies in the health service, and a frightening one for patients, is the existence of a “calendar lottery”. This means that sick people’s chances of seeing a consultant, and thus of surviving those first hours of serious illness, are far better if they arrive in hospital on a weekday than at the weekend. Don’t have a stroke on Sunday, in other words.
This Monday-to-Friday culture, which takes no account of illness, will hopefully change if NHS England accepts a 10-point reform package being put forward by its medical director, Sir Bruce Keogh. The proposals, up for consideration this week, and to which the BMA, the Patients Association and the Health Secretary, Jeremy Hunt, have lent strong support, include a patient’s right to obtain access to key diagnostic tests on any day of the week, and a pledge that all emergency admissions should be seen by a consultant within 14 hours.
The arguments in favour of a seven-day service are compelling, the most important being the very real difference it could make to outcomes. According to the Royal Society of Medicine, patients requiring urgent treatment are 16 per cent more likely to die if they arrive at hospital on Sunday than if they turn up mid-week. Moreover, this bold statistic probably conceals the true extent of the problem, as some patients left to the care of inexperienced staff at weekends survive in spite of receiving substandard or damaging treatment.
The main argument against a seven-day service is the usual one – cost – plus the fact that it may prove complex rewriting consultants’ contracts so as to remove clauses entitling them to refuse weekend work. The cost is not that prohibitive, however, at 1.5 to 2 per cent of the average hospital budget, and must be weighed against the huge potential gains.
So far, the shadow Health Secretary, Andy Burnham, has been only grudging in his support for these changes. His concern about where the money will come from is legitimate but he should get behind the proposals fully. Political rivalry should not be allowed to impede a change that will clearly save many lives.