But Dr Stein, who co-authored a 2013 NHS report which found patient outcomes were affected by the day of the week, said the health service still doesn’t provide a full seven-day service.
“The NHS will not function, we will not hit any target… until we work seven days a week, which would seem to me to be appropriate for a developed country,” he told BBC Radio 4’s Today programme.
The physical infrastructure? Or the staff? Do the staff need to be paid more to work on weekends?
That is, what’s the marginal cost of the weekend working?
My local hospitals provide Xray service at the weekends, which is excellent and they had a steady deman when I went last week.
Ward service though is doled out to agency nurses. Generally nurses work 3 days ( 12 hours) on and 3 off, but somehow this doesnt include the weekend.
The marginal cost is always staff. The buildings and equipment are already there: theatres stand empty at the weekend, machinery powered down.
But we’re quickly running into a supply problem. Even if you pay 30% or 50% extra for weekend working, that ultimately means taking nurses off weekday shifts. They’re only human, and medics working too many hours are liable to make mistakes (same with rules on lorry drivers’ hours). We can’t conjure up new doctors & nurses because we’ve put stupid limits on training numbers.
At best we might pull some of the 55+ doctors out of early retirement. Agency wages don’t count towards the NHS pension scheme, so they won’t fall foul of the lifetime allowance problems.
Lol:
The NHS will not function, we will not hit any target… until we work seven days a week, which would seem to me to be appropriate for a developed country…
I wonder why it might increasingly resemble a third-world effort?
Do not agree to an operation on the Friday before a Bank Holiday Monday: I speak from experience.
I don’t know what you can do about a procedure where the surgeon and anaesthetist bugger it up and you wake while they are still guddling around in your chest. I was not a happy bunny, I’ll tell you.
Also beware if you are told to take your own pills into hospital, especially powerful painkillers. A friend did; they were locked in his bedside safe and yet a nurse managed to steal them. And then the treating doctors refused to prescribe more of them, the bastards.
The solution to the NHS must include machine-gunners.
Andrew M
There are ever increasing numbers of medics working part time. Never used to be like this. We know why. The female quotient is one reason (that’s now done/no going back). Ever increasing regulatory crap is another reason. I can’t see any politicos culling the regulators, if anything it’ll only get worse? Hence, even if you can get them onto agency (for example, and you can be sure worthless polis would change the rules pdq if too many did?), is it really worth the ever-increasing grief for them?
It’s broken. Something new needs to evolve out of this, and let the old system die off as peacefully as possible – offer Midazalam to “ease the suffering”….
If i understand Tim correctly, the question is whether the infrastructure under utilisation cost is less than bonus required to get the workforce working weekends. If so then maxing out the infrastructure utilisation will only cost you more per unit of output. So even if you are more likely to die on the weekend at present, switching to 7/7 service will only use up the finite pot of money quicker and people would only die on another day. You’ve rearranged some deck chairs in other words.
Hallowed Be
“ . So even if you are more likely to die on the weekend at present, switching to 7/7 service will only use up the finite pot of money quicker and people would only die on another day. ”
Yes!
This is the salient point almost the entire population cannot/will not understand. The NHS, being State Leviathan in competition with other State-run organisms, is in competition for a total fixed amount of money and gets its share – an annual fixed amount of money.
The NHS is a cost centre, it generates no revenue, makes no surplus, cannot reinvest out of earnings to grow scale and scope of activity, cannot draw on capital from the global market as there is no RoI to offer.
The greater the patient throughput, the more expensive the treatments done, the sooner the budget is used up, the sooner it ceases operating until the next budget period.
Waiting lists are the means by which costs are pushed into the next budget period to ration resources since price rationing is not available.
As demand increases the cost rolled forward accumulates, waiting lists grow.
Added to this anything ‘free’ will be abused and oversubscribed.
It will never change whilst it is a State-run, State-funded enterprise, free at the point of delivery.
It’s all very well having ‘access to’ and ‘free at the point of delivery’, but access is not the same as getting, and if you can’t get, whether you can afford to pay or not is moot.
Access to and free is cold comfort if you are 7 millionth on the waiting list, condition degrading and quite possibly will die before it’s your turn.
Do the police, fire service and ambulance service get paid overtime for working scheduled weekends? The military in all its forms certainly doesn’t… So, if not, why should those comfortably employed by the health “service” be treated any differently? The NHS is really short of staff, it’s just hopelessly inefficient in the way it utilises them (and the distribution of “productive” v non-productive staff).
isn’t really short of staff..!!!!
“So even if you are more likely to die on the weekend at present, switching to 7/7 service will only use up the finite pot of money quicker”
But would it really ? If the NHS simply abolished the weekend and Bank Holiday as a concept and enforced a true 3on3off ( or whatever) structure that would be a more efficient use of resources and although there may be a higher initial cost it will eventually be a cost benefit.
For the same reason everyone else takes two days off a week. And actually, for better comparison to doctors and nurses, anyone doing changing 12 hour shift work will generally take more than 2 days off a week.
At the same time there’s a societal push for a four-day working week.
The NHS will do as it always has, and strip-mine foreign countries for staff. Nigeria, you think you want to develop a health service? How dare you, we need your healthcare staff.
The first thng that should happen is for the doctor chap to change his name from Andrew to Frank.
“The first thng that should happen is for the doctor chap to change his name from Andrew to Frank.”
And second name to Norman (if it isn’t already)?
NHS is terminally broken, ~6 mgt/admin for each doc, nurse. The only fix is break-up and privatise
Reasonable:
@Andrew M
At best we might pull some of the 55+ doctors out of early retirement
Not with high tax socialist Sunak & Hunt in charge: Pension Cap, Punishing taxes, IR35 plus all the mandatory Woke, H&S etc courses