The editor of the British Medical Journal has repudiated the Government's arguments on the 'weekend effect'
Fiona Godlee, editor in chief of the British Medical Journal (BMJ), has delivered a body blow to Jeremy Hunt’s claims about weekend mortality in an editorial published today.
The so-called ‘weekend effect’ has become the government’s key justification for its intractable approach to negotiations with the British Medical Association (BMA) over the junior doctors contract.
However, after Hunt alleged, in a speech to the Commons in July 2015, that ‘6,000 people lose their lives every year because we do not have a proper seven day service’, a reliable source could not be found for the claim.
Similarly, his suggestion that ‘you are 15 per cent more likely to die if you are admitted on a Sunday compared to being admitted on a Wednesday’ did not seem to have a clear academic basis.
It has now been established that Hunt was citing an as-yet-unpublished BMJ article, the details of which were obtained by his department because the authors shared their findings with colleagues before its publication.
According to Godlee, this sharing of information between departments neither violated commonly-accepted academic ethics nor interfered with the peer review process.
However, she puts forward three major criticisms of what Hunt chose to do next:
- Firstly, the statistics were used without clarification as to their source, a potential breach of the ministerial code that caused considerable confusion.
- Secondly, Hunt and his Conservative colleagues have consistently attributed the ‘weekend effect’ to a shortage of doctors. This clearly misrepresents the viewpoint of the authors, who emphasise that the study does not establish causation.
- Thirdly, by ‘misusing the data to beat up on doctors’, Hunt has undermined NHS England’s attempts to address excess weekend deaths and engineered an unnecessary government feud with medical professionals, leaving NHS patients and staff to ‘deal with the fallout’.
The government’s consistent implication that doctors are to blame for weekend deaths has been one of the most contentious issues in its dispute with the BMA, and is among the causes of extremely low morale within the profession.
This is particularly pronounced since, as Godlee argues, measures were already in place to reduce weekend deaths and, without the government’s aggressive intervention, ‘the clinically led process already in motion would have had us well on the road.’
Since this piece of research has been at the core of the Conservatives’ arguments on the junior doctors dispute, Godlee’s repudiation seriously weakens their case. But whether they will backtrack remains uncertain — they are not averse to knowingly deploying bad information.
What is certain is that both Hunt and David Cameron have already been guilty of gross misrepresentation of scientific evidence. They no longer have any credibility on this issue, and should be reminded of that at every possible opportunity.
Niamh Ní Mhaoileoin is editor of Left Foot Forward
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