Nav: Home

The BMJ Editor unpicks row over Hunt's use of seven-day NHS data

March 03, 2016

Today, The BMJ's Editor in chief, Dr Fiona Godlee, unpicks the facts surrounding health secretary Jeremy Hunt's use of data to put his case for a seven-day NHS in England.

In the thick of this dispute is a paper published in The BMJ last year showing excess mortality in patients admitted at weekends.

Did Hunt, in a speech attacking senior doctors for resisting a new seven day contract, use data from the paper before it was published, asks Godlee? If so, how did he get the data? Who commissioned the study? And did the subsequent media attention subvert The BMJ's editorial process?

In order to understand who knew what and when, BMJ reporter Abi Rimmer reviewed emails obtained through freedom of information requests and spoke to the main protagonists: the authors of the BMJ paper, NHS England, the Department of Health, and the BMJ editor who handled the paper.

The picture was not always clear, but Rimmer concludes that the two main numbers used in Hunt's speech probably came from different sources.

The figure of 6,000 excess deaths seems to have been derived at NHS England from an analysis published in 2012, while the figure of 15% excess mortality in patients admitted on Sundays appears in the 2015 BMJ paper.

Godlee is not concerned that the authors shared their main findings with colleagues in other departments before publication. And as for whether The BMJ's editorial process was influenced by the media storm, Rimmer reports that the peer review process was all but complete by the time Hunt made his speech.

So the problem was not in the conduct of the study, commissioned as it was by NHS England; nor in the sharing of the information before publication, writes Godlee. It was in what Hunt chose to do next.

First, he used the information publicly without being clear about its source. "In doing so he may have breached the ministerial code and certainly caused damaging confusion," she says.

Second, he repeatedly attributed the excess deaths to doctors not being available at weekends. Yet the authors "had clearly warned that the study could not show causation nor to what extent the excess deaths were avoidable."

Thirdly, in misusing the data to beat up on doctors, "Hunt derailed NHS England's established program of work on improving services at weekends," she argues.

"Instead of working with doctors to achieve his stated aims, Hunt has pitted himself against them, characterising himself as a champion of the people despite the lack of a clear call from the public for a seven day service."

Hunt's approach "demonstrates either extreme political arrogance or an active attempt to destabilize the NHS," she adds. "Whichever, NHS staff and patients must deal with the fallout."

Even so, Godlee believes that Hunt "could redeem himself and leave the Conservatives with a truly lasting legacy."

As an able politician, "he should find a way to resolve the doctors' dispute as quickly as possible without either side losing face," she writes. He should then empower NHS England's board with real independence from government "and then step back and let those with long term accountability, expertise and experience get on with the job."
-end-


BMJ

Related Health Articles:

Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Generous health insurance plans encourage overtreatment, but may not improve health
Offering comprehensive health insurance plans with low deductibles and co-pay in exchange for higher annual premiums seems like a good value for the risk averse, and a profitable product for insurance companies.
The Lancet Planetary Health: Food, climate, greenhouse gas emissions and health
Increasing temperatures, water scarcity, availability of agricultural land, biodiversity loss and climate change threaten to reverse health gains seen over the last century.
With health insurance at risk, community health centers face cut-backs
Repeal of key provisions of the Affordable Care Act, combined with a failure to renew critical funding streams, would result in catastrophic funding losses for community health centers-forcing these safety net providers to cut back on services, lay off staff or shut down clinical sites, according to a report published today.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Tailored preventive oral health intervention improves dental health among elderly
A tailored preventive oral health intervention significantly improved the cleanliness of teeth and dentures among elderly home care clients.
Study finds that people are attracted to outward signs of health, not actual health
Findings published in the journal Behavioral Ecology reveal that skin with yellow and red pigments is perceived as more attractive in Caucasian males, but this skin coloring does not necessarily signal actual good health.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
University of Rochester and West Health Collaborate on d.health Summit 2017
In collaboration with West Health, the University of Rochester is hosting the third annual d.health Summit, a forum for health care and technology leaders, entrepreneurs, senior care advocates and policymakers to exchange ideas, create new partnerships, and foster disruptive technological and process innovations to improve the lives of the nation's aging population.
Study links health literacy to higher levels of health insurance coverage
The federal Affordable Care Act is intended to make it easier for individuals to buy health insurance, but are the uninsured equipped to navigate the choices faced in the insurance marketplace?

Related Health Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#513 Dinosaur Tails
This week: dinosaurs! We're discussing dinosaur tails, bipedalism, paleontology public outreach, dinosaur MOOCs, and other neat dinosaur related things with Dr. Scott Persons from the University of Alberta, who is also the author of the book "Dinosaurs of the Alberta Badlands".