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Question time

Seven-day services are a good idea, but they cannot be managed within current resources and staffing levels

Sid Dajani's tin hat takes a battering in a public debate about the junior doctor's strike

The season of flu vaccination is upon us and I have been busy doing my online refresher training, promoting the service, getting the staff trained up, checking and signing PGDs, notifying NHS England and ‘prepping’ the PR. Last year I alone did 800 NHS and private vaccinations and, although we can vaccinate right through until March 2017, the next two months without doubt will be our busiest – so busy that I envisage we will transmogrify from a community pharmacy into a ‘co-immunity pharmacy’!

Recently I was at a restaurant in Paris where I was invited to express an opinion about the future of pharmacy. In a rare moment of freedom I had decided to eat in a restaurant whose board publicised ‘Novel cuisine’. I’m quite an adventurous epicure and was intrigued as to whether this was an experimental kind of cuisine or a mis- spelling of nouveau. One thing was for sure, in the literary quarter that even Charles Darwin was rumoured to frequent, the French have great culinary expertise so I had plate expectations!

I wasn’t disappointed. Apologies for the pun, but there are more cons than pros to this political role and you learn to carry a tin hat around with you, which does take a battering. Mine has had to be frequently reshaped and remoulded.

The clinical gap

Someone at the BBC must have read this column when I was supporting the sentiments of junior doctors but stopped at supporting the strikes. Yes there is a clinical gap at weekends, and I have experienced first hand how I’m a patient during the week and a victim at weekends. When I needed seven stitches in my index finger recently, I waited four hours with only three people in front of me and when I was called in, it was as quiet as a morgue. I was in A&E for a total of five hours.

I agree that seven-day services are a good idea, but they cannot be managed within current resources and staffing levels. It is unrealistic to expect five-day resources to cover a seven-day service that would be exactly the same every day of the week. Priority must be given to those services that will enhance and speed the patient journey.

Where I disagree is the disproportionate strikes which are designed to cause maximum upset and mayhem, to make us beg for mercy and give them what they want.

The NHS does not have elastic sides and if you cause upset in one area it affects others. It upsets patients, their families, their work, their plans for recovery and that’s not even mentioning the poor staff and their suffering families working during those strikes who also must catch up with the backlogs.

I find it hard to marry up how junior doctors are saying their strike action is saving the NHS and protecting patients when they are putting lives at risk (even with non-emergency procedures) and bringing the NHS to its knees. The GMC and other medical royal colleagues are not supporting this further action and, the longer these strikes go on for, the worse it will be for the reputations of some of the brightest minds we have, and the more militant it makes the BMA look.

On air and in debate

Further strikes have made this issue topical again, and I was asked to give the opposing view. So with less than 12 hours’ notice, I found myself en route to London at 5am. Needless to say, I was in the usual minority of views.

Without warning, a microphone was shoved into my hand and I was the first to get the debate going. My sister said she hid behind the sofa when she saw me – worried that my seven stitches would be ripped open and used to cover my mouth!

The debate was always going to be passionate, but I felt misguided at times. Pro-supporters’ arguments weren’t about the imposed contract, but wider NHS austerity cuts. Junior doctors argued that they were overworked and stretched to the nth degree, sleeping in cars after 13-hour shifts, etc.

That’s nothing to do with the contract that’s being imposed, it’s about NHS cuts, that we’re all facing. I pointed out that we’re all under the cosh, as the government wants to close down 3,000 pharmacies without any evidence of saving or benefit.

No amount of spin with grin could cover the fact that the BMA had reached an agreement with the DH and their members opposed it. Either the BMA is out of touch, or its members don’t know what they want.

On privatisation

Somehow the debate moved on to privatisation, and even that was blamed for the strikes. Excuse me Contracting to private providers helps the NHS and is not the same as privatisation. Privatisation is the selling of ownership, assets or property. The fact that private contracting is being carried out by NHS commissioners and CCGs shows the government is very much still in control, and who’s in charge of private commissioning but GPs!

These services include mental health, public health screening and cessation programmes, supporting those with long- term conditions, etc. They have shown great benefit, so why oppose them?

During the break, a pro-striker shouted that Jeremy Hunt asked for the strike. I replied, “why give it to him then?” When I was asked to have the last word I suggested bringing care back to the patient, having an independent risk register to match resources fairly to need, and starting negotiations around that.

After the show I received mostly supportive messages. I even had a few total strangers try to add me as a Facebook friend while I sat during the show. But the nicest compliment came from a junior doctor who said he liked my shirt!

Clearly I was not winning many friends in the studio, and I dare say some would have preferred to cosy up to a viral infection. I can’t wait to get back to my pharmacy to do my own kind of flu eradication.




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