“• Jeremy Hunt’s tweeted dismissal of Hawking’s article (How to solve the NHS crisis – scientifically, 19 August) is revealing: “Stephen Hawking is brilliant physicist but wrong on lack of evidence 4 weekend effect.2015 Fremantle [sic] study most comprehensive ever”.
If Hunt bases policy on a single publication (which no serious observer would do) then he should read it, and he would see Freemantle’s warning: “It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.”
Freemantle found that patients admitted over the weekend are more seriously ill and more likely to die. Nobody denies that the “weekend effect” exists, but one must not jump to the facile and unsubstantiated conclusion that it reflects quality of care.
Hunt cherrypicks not only the evidence but even the authors’ interpretation.
Dr Richard O’Brien
Jeremy Hunt accuses Stephen Hawking of ‘pernicious falsehood’ in NHS row
• Privately provided services, with their bank loan costs, dividend payments and management add-ons, cost far more than state-funded ones. The administration of privatisation, with the consultants, lawyers, accountants, billing agents etc involved in franchising NHS services, also add substantial costs. Hospital PFIs (private finance initiatives) have evidenced the billions that privatisation is costing the NHS and taxpayer.
Yet the government’s and NHS England’s “reconfiguring” of the NHS is using regional accountable care organisations (ACOs) which allow for extended involvement of the private sector in the running and provisioning of NHS services. This not only accepts the continuing financial burden of privatisation to the taxpayer, but allows further costs to that burden.
ACOs, and other NHS England plans such as the move from the family GP practice model to a system of commercially driven super-clinics called multi-speciality community providers, originate from the US’s notoriously costly and flawed healthcare system. The plans have been drawn up by business consultants with extensive US interests like McKinsey and Optum, a subsidiary of US private health provider/private health insurer United Health. NHS England’s CEO Simon Stevens is a former UnitedHealth senior executive.
Professor Hawking’s concerns about the privatisation and Americanisation of the NHS are therefore unsurprising. Removing all the privatisation apparatus from the NHS would allay such concerns, which are shared by many. The savings that this would make would cover the lion’s share of the costs of the extra demands facing the NHS (the ageing population etc) which are blamed for making the NHS “unaffordable”.
• I am 100% behind Stephen Hawking’s attack on the Tories over the plight of the NHS. As a nurse for the last 40 years, I think that the NHS is by far the best health system in the world and it is only surviving because of the deep commitment of thousands of medical and admin staff to a worthy cause. I know for a fact that after the referendum results, scores of foreign doctors and nurses started to leave our large local hospital, for fear that they would not be allowed the freedom to stay. This has left our hospital grossly understaffed and under tremendous pressure. Others have gone off sick with severe stress after all the extra hours they are expected to put in to care for patients.
The Tories’ recent promise to provide training for thousands of medical students and nurses in a few years’ time is of no use whatsoever. Something drastic is needed now and that is to give the nurses the pay rise that others are getting. With conditions and pay at such an all-time low, how else are they going to recruit any new nurses?
• What wise words from Prof Hawking and what a pathetic response from Jeremy Hunt. Hawking is right to draw attention to the vast amounts of public money going into the coffers of private organisations for services that could be handled better and cheaper in-house. The question of agencies providing nurses to fill gaps is analogous with those providing supply teachers. Previously hospitals relied on their own “banks” to provide cover for absentees, usually drawn from any of their own staff who requested extra shifts. The advantage of employing their known staff is obvious. Schools requiring temporary help could contact their local education authority (now sadly almost defunct) which kept a list of qualified teachers requesting temporary work. No money was exchanged, unlike today where in many cases the agency charges both the professional worker and the employer. How did we allow this to happen?
Potters Bar, Hertfordshire
• Stephen Hawking’s article is so wonderfully simple and beautiful it made me want to cry. How precious the NHS is and how much it means to us. Thanks to him for writing it and to the Guardian for printing it. It should be printed in all the newspapers.