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?

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:

  1. 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"?
     
  2. Can you provide a copy of the rota so we can ensure future generations of doctors aren't exploited in this way?
     
  3. 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.  

Dan Poulter appearing on BBC News.
Getty.
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Just face it, being a parent will never be cool

Traditional parenting terms are being rejected in favour of trendier versions, but it doesn't change the grunt-like nature of the work.

My children call me various things. Mummy. Mum. Poo-Head. One thing they have never called me is mama. This is only to be expected, for I am not cool.

Last year Elisa Strauss reported on the rise of white, middle-class mothers in the US using the term “mama” as “an identity marker, a phrase of distinction, and a way to label the self and designate the group.” Mamas aren’t like mummies or mums (or indeed poo-heads). They’re hip. They’re modern. They’re out there “widen[ing] the horizons of ‘mother,’ without giving up on a mother identity altogether.” And now it’s the turn of the dads.

According to the Daily Beast, the hipster fathers of Brooklyn are asking their children to refer to them as papa. According to one of those interviewed, Justin Underwood, the word “dad” is simply too “bland and drab”:

“There’s no excitement to it, and I feel like the word papa nowadays has so many meanings. We live in an age when fathers are more in touch with their feminine sides and are all right with playing dress-up and putting on makeup with their daughters.”

Underwood describes “dad” as antiquated, whereas “papa” is an “open-minded, liberal term, like dad with a twist” (but evidently not a twist so far that one might consider putting on makeup with one’s sons).

Each to their own, I suppose. Personally I always associate the word “papa” with “Smurf” or “Lazarou.” It does not sound particularly hip to me. Similarly “mama” is a word I cannot hear without thinking of “Bohemian Rhapsody”, hence never without a follow-up “ooo-oo-oo-ooh!” Then again, as a mummy I probably have no idea what I am talking about. If other people think these words are trendy, no doubt they are.

Nonetheless, I am dubious about the potential of such words to transform parenting relationships and identities. In 1975’s Of Woman Born, Adrienne Rich describes how she used to look at her own mother and think “I too shall marry, have children – but not like her. I shall find a way of doing it all differently.” It is, I think, a common sentiment. Rejecting mummy or daddy as an identity, if not as an individual, can feel much the same as rejecting the politics that surrounds gender and parenting. The papas interviewed by The Daily Beast are self-styled feminists, whose hands-on parenting style they wish to differentiate from that of their own fathers. But does a change of title really do that? And even if it does, isn’t this a rather individualistic approach to social change?

There is a part of me that can’t help wondering whether the growing popularity of mama and papa amongst privileged social groups reflects a current preference for changing titles rather than social realities, especially as far as gendered labour is concerned. When I’m changing a nappy, it doesn’t matter at all whether I’m known as Mummy, Mama or God Almighty. I’m still up to my elbows in shit (yes, my baby son is that prolific).

The desire to be known as Papa or Mama lays bare the delusions of new parents. It doesn’t even matter if these titles are cool now. They won’t be soon enough because they’ll be associated with people who do parenting. Because like it or not, parenting is not an identity. It is not something you are, but a position you occupy and a job you do.

I once considered not being called mummy. My partner and I did, briefly, look at the “just get your children to call you by your actual name” approach. On paper it seemed to make sense. If to my sons I am Victoria rather than mummy, then surely they’ll see me as an individual, right? Ha. In practice it felt cold, as though I was trying to set some kind of arbitrary distance between us. And perhaps, as far as my sons are concerned, I shouldn’t be just another person. It is my fault they came into this vale of tears. I owe them, if not anyone else, some degree of non-personhood, a willingness to do things for them that I would not do for others. What I am to them – mummy, mum, mama, whatever one calls it – is not a thing that can be rebranded. It will never be cool because the grunt work of caring never is.

It is not that I do not think we need to change the way in which we parent, but this cannot be achieved by hipster trendsetting alone. Changing how we parent involves changing our most fundamental assumptions about what care work is and how we value the people who do it. And this is change that needs to include all people, even those who go by the old-fashioned titles of mum and dad.

Ultimately, any attempt to remarket parenting as a cool identity smacks of that desperate craving for reinvention that having children instils in a person. The moment you have children you have bumped yourself up the generational ladder. You are no longer the end of your family line. You are – god forbid – at risk of turning into your own parents, the ones who fuck you up, no matter what they do. But you, too, will fuck them up, regardless of whether you do it under the name of daddy, dad or papa. Accept it. Move on (also, you are mortal. Get over it).

Parenting will never be cool. Indeed, humanity will never be cool. We’re all going to get older, more decrepit, closer to death. This is true regardless of whether you do or don’t have kids – but if you do you will always have younger people on hand to remind you of this miserable fact.

Your children might, if you are lucky, grow to respect you, but as far as they are concerned you are the past.  No amount of rebranding is going to solve that. This doesn’t mean we can’t change the way we parent. But as with so much else where gender is concerned, it’s a matter for boring old deeds, not fashionable words.

 

 

 

Glosswitch is a feminist mother of three who works in publishing.