Dr Dan Poulter and the 100-hour weeks
Could the new health minister please clear up his statement about his hours as a junior doctor?
By Pete Deveson Published 07 September 2012 11:34
With all the excitement over Jeremy Hunt's acceptance of the Poisoned Health Chalice, and the related stories about his pro-homeopathy and anti-abortion stances, you may have missed the news that former junior doctor Dan Poulter MP was appointed as Parliamentary Under-Secretary of State for Health.
Over the last couple of months I've been trying to get Dr Poulter, or "Dr Dan" as he prefers to be called, to clarify some statements he's made about the long hours he used to work as a junior doctor.
On Newsnight on Tuesday 19/06/2012 he said he "often used to do 100-hour weeks" (It's no longer on iPlayer but you can see the video here.
And he made a similar claim in a speech in the House Of Commons on 26/4/2012. I quote from Hansard:
"My hon. Friend said that we do not want to go back to the bad old days of 100-hour weeks. I worked those 100-hour weeks, and I am sure that the other medical doctors who are in Westminster Hall today did so, too. It was certainly not ideal to work 100-hour weeks; it was not good for patient care."
Now these comments have raised a few eyebrows in medical circles. Non-medics reading may wonder why; after all, everyone knows junior doctors work very long hours, right?
Well, kinda. As recently as the 1990s it was not uncommon for juniors to work very long continuous periods on call, and many older doctors can remember working a "one in two" rota (a regular working week, but staying up all night every second night, and working every second weekend continuously from Friday morning til Monday night - averaging 120 hour per week).
As Dr Dan says, "it was certainly not ideal", and that's why the BMA negotiated the New Deal for junior doctors, which was introduced around the time I qualified in 2000, and limited on call workers to 72 hours per week. Some hospitals didn't implement the terms of the New Deal until 2004, but were penalised by having to pay their doctors up to twice basic salary (that's how I managed to pay off my student loans). Hours were then limited further in 2004 with the introduction of the European Working Time Directive (EWTD) which specifies that no doctor should work more than 58 hours per week on average, and all workers were entitled to a period of 11 hours continuous rest a day. Many doctors are unhappy with the EWTD, as a lot of hospitals get around it with rotas containing weeks of up to 7 13-hour night shifts (91 hours per week for that week, but balanced out by random days off elsewhere). Having myself worked both the old "on-call" and new "shift" system, I can say that there are pros and cons to both, but the big pro is that new doctors no longer have to stay up all weekend without sleep.
Why am I telling you all this?
Well, Dr Dan only started work as a junior doctor in August 2006.
If Dr Dan was "often" doing 100-hour weeks in 2006-7, he (and, we must assume, his co-workers) would have been working in contravention of European employment law, and his hospital trust would be liable for fines of several thousand pounds for each breach.
This is where the raised medical eyebrows come in. The EWTD was enforced much more rigourously than the previous New Deal, because of the non-negotiable swingeing penalties threatened from Europe. As a result, I don't know of any 2006 graduate who's worked a 100-hour week, let alone on a regular basis. I'm not sure if it's even mathematically possible to squeeze 100 hours into the strict terms of the EWTD. The most I'm aware of is the 91-hour example above, but that would be an infrequent happening on a rota, maybe every 10-12 weeks; certainly nothing that could be described as "often". It's also worth noting that Dr Dan was elected as a councillor in Redhill on May 3rd 2007, and according to his website was Deputy Leader of Reigate and Banstead Council from 2008 until his election as an MP in 2010. When you factor in his hobbies, and the many good works he's undertaken in his spare time, I'm just struggling to see how the poor chap managed to fit it all in.
But, taking Dr Dan at his word, I felt it was important to find out where he was working, to avoid other junior doctors being exploited in the future. So, I emailed Dr Dan to see if he could shed some light on the matter. Unsurprisingly, I recieved a standardised reply: "Please note that there is a strict Parliamentary rule that MPs can only help their own constituents".
I'm not a constituent, but the Suffolk-based legal blogger @PME200 is. I understand he also contacted Dr Dan recently over his concerns that a local NHS trust may have been exploiting a junior doctor and breaching the law. It appears that Dr Dan point blank refused to confirm which trust employed him during the alleged 100-hour weeks. He effectively told his constiuent to mind his own business.
Why is Dr Dan so coy with the details of his 100-hour weeks? We can only assume that Dr Dan (unlike any junior doctor I've ever met or heard of) was genuinely "often" doing 100-hour weeks in 2006-10, but is so protective of his erstwhile employers he cannot bear the thought of revealing that they were serially breaking European Law.
Of course, there is an alternative explanation. It is possible that Dr Dan (like every other junior doctor I've ever met or heard of) actually WASN'T "often" doing 100-hour-weeks in 2006-10, but has chosen to pretend that he was, perhaps to try and carry some of that junior doctor kudos into his new role in one of the nation's least favourite professions.
If this was the case (and of course I'm not for one second suggesting that it is, merely enjoying a thought experiment while we await confirmation from Dr Dan of the names of the law-breaking hospital trusts concerned), would it really matter? After all, we accept that our politicians will somteimes give a different version of events to suit their own agenda.
Here's why I think it would matter:
1. Dr Dan isn't just an MP, he's a registered medical doctor like me, and society holds its doctors to a higher standard of probity than it holds its politicans. Specifically, the General Medical Council states in Good Medical Practice that:
"64. You must always be honest about your experience, qualifications and position, particularly when applying for posts."
If, (and again, I'm not saying this is the case, merely that it is one possible explanation of the facts we have while we await clarification from Dr Dan), if Dr Dan could be shown to have persistently and deliberately misrepresented his clinical experience in order to improve his standing as an MP, this would transcend politics and hurtle toward the realms of professional misconduct.
2. There's a thing called misleading Parliament. I'm not too familiar with this (hence the Wikipedia link), but apparently if you're making a speech in the House Of Commons, it's frowned upon if you start making shit up.
3. Whatever his many failings as Secretary of State for Health, Andrew Lansley was an absolute master when it came to completely alienating the medical profession. At the last election most doctors I know voted for one of the two coalition parties. With the twin pitchforks of NHS privatisation and pension cuts, Lansley has completely destroyed that support. One can imagine that Dr Dan was elevated to his ministerial position with at least a partial hope that having a doctor in government might go some way to winning back medical hearts and minds. Now, a doctor who could do such a thing would have to show themselves to be of impeccable character. They certainly wouldn't gain any friends if they appeared to be claiming experience they didn't have, or posturing to try and appear older and more battle-hardened than their CV could account for. If a shadow were to fall over Dr Dan's credibility and probity as both an MP and a doctor, it is hard to see how his addition to the government would be beneficial.
Why am I blogging about this now? My exchange of emails with Dr Dan was a couple of months ago, and while he remained a back bencher it seemed somewhat churlish to push the issue. Though I strongly oppose his government's privatisation agenda, I have no beef with him personally, and in fact admire his stance on expenses and his statements in favour of plain packaging for tobacco.
But now that he is a Health Minister, I'd like to know that he can be trusted.
Dr Dan can clear up the situation now by answering three simple questions:
-
Which Trust did you work for, for which consultant, and at which grade, duing the period when you "often used to do 100-hour weeks"?
-
Can you provide a copy of the rota so we can ensure future generations of doctors aren't exploited in this way?
-
What sanctions if any were taken against the employing Trusts for these breaches of employment law, and if none were taken, what steps will you take as Health Minister to amend this?
I hope Dr Dan comes up with the answers soon. I'd also be keen to hear from any medics who think they did work a 100-hour week rota as a junior doctor in 2006, particularly those who worked with Dr Dan himself! If Dr Dan doesn't respond, I suppose it might be possible for a journalist to apply under the Freedom Of Information act. Let's hope it doesn't come to that.
This post first appeared on Pete Deveson's blog here. You can follow him on Twitter as @PeteDeveson
Update, 21/09/2012: You can read Dr Dan Poulter's response, and Pete Deveson's commentary on it, here.
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13 comments
Good luck to Dr Dan. Let's hope he can put the slim pickings of his short medical career to good use in the Health Department. Let's also hope he will stop repeating this 100 hour nonsense because it simply makes him seem dishonest; not-unlike that Paul Ryan chappy who claimed to have run a marathon sub-three hours
Dr Dan did not work at a time when junior doctors were contracted to work 100 hrs week in, week out. That era had long passed when he first cut his teeth on the wards
If Dr Dan stayed on the wards beyond his contracted time in the late 2000's more fool him. It doesn't show him to be a dedicated doctor. Rather it implies he doesn't get a job done quickly and efficiently
Incidentally does the good doctor's preference to be called Dr Dan rather than using his surname reveal his career aspirations should he (have to) leave politics? Surely Dr Dan will join Drs Pixie, Christian and others on the TV show 'Embarrassing Bodies'
He is now fully qualified to understand embarrassment
it would be illuminating to have sight of a comprehensive CV from 2006 to the present day, in order to determine the provenance of 'Dr Dans' statement.
This is a very snide unpleasant article by Dr.Pete Deveson written purely to cause trouble for Dan Poulter. Deveson's claim that he has never heard of or met a doctor doing far more than the prescribed EWTD hours is frankly ridiculous, because, as he well knows, the Directive simply drove the problem underground and meant that many doctors ended up working dozens of extra hours for no pay at all.
The gap between 'theory' and 'practice' is therefore immense when it comes to the hours that doctors can actually put in. Perhaps Doctor Pete Deveson should try googling simple phrases like "junior doctors pressurized to work extra hours" and look at some of the results and some of the research done by the BMA.
And to avoid the need for googling, perhaps Dr Dan cOuld just answer the questions.
After all, Dr Dan appears to be boasting rather than complaining about the hours he was working.
While not a fan of Dan Poulter - he may well have still been doing 100 hour weeks. My husband was an NHS consultant over that period and was doing 1:2 on call in 2002 as were the juniors - but the hospital managers were and some still are engaged in all sorts of cover ups including bullying doctors to falcify their forms with the threat of suspension. You may remember during that time more than 50% of doctors who were suspended were suspended for whistle blowing. This raised questions in the House of Parliament and the Lords at the time. I could give you lots of examples of this type of bullying. My husband eventually resigned together with 5 of his consultant colleagues because of the management behaviour encouraged by Alan Milburn and New Labour. Also the Trusts forced doctors to sign confidentially agreements to prevent them from whistle blowing about the trusts.
But I am more excited by the fact you want verification of what doctors in politics claim to have done. Please will you ask Evan Harris why he has continuously lied about his qualifications and medical experience. He has marketed himself as a medical expert when he did not even pass membership and only did 2 years in A&E as a junior doctor following medical school.
Also why did he refuse to give any details about his medical experience during his time as an MP claiming 'parliamentary privilege' but still claimed in hustings and debates that 'hundreds of patients constantly wrote to him when he was in the NHS' (this was recorded). Do you know of any 2 year junior doctor who receives letters from patients especially in 1991/2? I don't - no one would know his name! All junior doctors in A&E do is clerk patients, take bloods and do what they are told.
A call to the GMC reveals he is not on the GP or the Specialist register so why does he allow BBC & Sky to introduce him as a 'GP' or as a 'Family Planning Specialist' to speak on the dangers of Abortion counselling? He also allowed himself to be introduced as an 'Aids specialist' to discuss a new Aids vaccine. Miraculously qualified in 3 separate specialities! Walter Mitty? It would not matter if he did not appear to have so much access. Maybe a call to the GMC on probity here is called for.
Over to you to apply the same scrutiny to Dr Evan Harris as you are to Dan Poulter. All the doctors in the John Radcliffe Hospital will be ever grateful as the rumour in the hospital during the election that the doctors were planning to vote for him to prevent him coming back to medicine! I thought this was a joke until I met 2 anaesthetists who claimed to have done just that.
RGN, MA Bioethics
Very few junior doctors in specialities were working anything like that number of hours in 2002, let alone 2006. Renal transplant specialist registrars are the one group that come to mind. Consultants on call commitment has always been more onerous in many specialities but Dr Poulter did not make it as far as a consultants post in his medical career.
Very interesting and detailed post. I suspect that Dr Dan is not quite as battle hardened as he would have us believe. Twice being quoted as boasting of his 100 hour week credentials and then being so coy about where he performed these Herculean tasks smacks frankly of bullshit.
Interesting article. I qualified in 1989, so 100 hour weeks were not unusual. By 2000, the most hours I would do as a Registrar in Renal medicine would average 70 per week - though officially, we were supposed to be working only 56 hours/wk, we'd all fibbed so we could stay on an on call rota. A few yrs later, my successors had to do shifts to be EWTD-compliant.
By 2006, when I was a consultant - and still working 60 hours per week in the NHS - we would be shoo-ing juniors off the wards to ensure their hours were compliant with EWTD.
Giving false evidence in parliament is the political equivalent of lying about your symptoms to a Dr. We can never make it better if we don't really know what's going on. So it's more than just little lie to make himself look good, it's a misrepresentation by someone who should be trusted above all, a doctor and an MP, regarding one of our countries most important public institutions. An institution that polititicians have been making a mess of for the last 30 years. Dr Poulter should be ashamed. He should clarify the situation and I if he did lie he should apologise.
This is certainly something that should be pursued. And for anyone who would know how to pursue this, perhaps this press cutting from EDP24 would be a helpful starting point in identifying his NHS trust:
"Possible successor to current MP Jacqui Lait include the Deputy Leader of Reigate and Banstead Council Daniel Poulter, who works as a doctor at the Princess Royal Hospital, Farnborough, in obstetrics, gynaecology and women's health, who was born in Beckenham."
I believe this hospital is part of Bromley NHS trust.
Hyperbole surely? After all, when I actually was (no really) working 100+ hr weeks in the late eighties I regularly claimed to be working more than a thousand hours every week...
At least he had a proper job before leaping onto the slippery pole, though I'm always suspicious of doctors that like to be addressed as Dr. Currently, I think it's safe to say that all those involved in the Health ministry should be regarded as a bunch of Hunts.
Part of that second paragraph should have read "...addressed as Dr Firstname." but the system didn't like my use of brackets!
Dr Dan sounds like Dangerous Dan to us. Let's hope that just like other Tory ministers he was being economical with the truth.
Painter