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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Here’s everything wrong with Daniel Hannan’s tweet about Saturday’s Unite for Europe march

I am Captain Ahab, and Dan is my great white whale, enraging and mocking me in equal measure through his continued political survival.

I was going to give up the Daniel Hannan thing, I really was. He’s never responded to this column, despite definitely being aware of it. The chances of him changing his views in response to verifiable facts seem to be nil, so the odds of him doing it because some smug lefty keeps mocking him on the internet must be into negative numbers.

And three different people now have told me that they were blissfully unaware of Hannan's existence until I kept going on about him. Doing Dan’s PR for him was never really the point of the exercise – so I was going to quietly abandon the field, leave Hannan to his delusion that the disasters ahead are entirely the fault of the people who always said Brexit would be a disaster, and get back to my busy schedule of crippling existential terror.

Told you he was aware of it.

Except then he does something so infuriating that I lose an entire weekend to cataloguing the many ways how. I just can’t bring myself to let it go: I am Captain Ahab, and Dan is my great white whale, enraging and mocking me in equal measure through his continued political survival.

I never quite finished that book, but I’m sure it all worked out fine for Ahab, so we might as well get on with it*. Here’s what’s annoying me this week:

And here are some of the many ways in which I’m finding it obnoxious.

1. It only counts as libel if it’s untrue.

2. This sign is not untrue.

3. The idea that “liars, buffoons and swivel-eyed loons” are now in control of the country is not only not untrue, it’s not even controversial.

4. The leaders of the Leave campaign, who now dominate our politics, are 70 per cent water and 30 per cent lies.

5. For starters, they told everyone that, by leaving the EU, Britain could save £350m a week which we could then spend on the NHS. This, it turned out, was a lie.

6. They said Turkey was about to join the EU. This was a lie too.

7. A variety of Leave campaigners spent recent years saying that our place in the single market was safe. Which it turned out was... oh, you guessed.

8. As to buffoons, well, there’s Brexit secretary David Davis, for one, who goes around cheerfully admitting to Select Committees that the government has no idea what Brexit would actually do to the economy.

9. There was also his 2005 leadership campaign, in which he got a variety of Tory women to wear tight t-shirts with (I’m sorry) “It’s DD for me” written across the chest.

10. Foreign secretary Boris Johnson, meanwhile, is definitely a liar AND a buffoon.

11. I mean, you don’t even need me to present any evidence of that one, do you? You just nodded automatically.

12. You probably got there before me, even. For what it's worth, he was sacked from The Times for making up a quote, and sacked from the shadow frontbench for hiding an affair.

13. Then there’s Liam Fox, who is Liam Fox.

14. I’m not going to identify any “swivel-eyed loons”, because mocking someone’s physical attributes is mean and also because I don’t want to get sued, but let’s not pretend Leave campaigners who fit the bill would be hard to find.

15. Has anyone ever managed to read a tweet by Hannan beginning with the words “a reminder” without getting an overwhelming urge to do unspeakable things to an inanimate object, just to get rid of their rage?

16. Even if the accusation made in that picture was untrue, which it isn’t, it wouldn’t count as libel. It’s not possible to libel 52 per cent of the electorate unless they form a distinct legal entity. Which they don’t.

17. Also, at risk of coming over a bit AC Grayling, “52 per cent of those who voted” is not the same as “most Britons”. I don’t think that means we can dismiss the referendum result, but those phrases mean two different things.

18. As ever, though, the most infuriating thing Hannan’s done here is a cheap rhetorical sleight of hand. The sign isn’t talking about the entire chunk of the electorate who voted for Brexit: it’s clearly talking specifically about the nation’s leaders. He’s conflated the two and assumed we won’t notice.

19. It’s as if you told someone they were shit at their job, and they responded, “How dare you attack my mother!”

20. Love the way Hannan is so outraged that anyone might conflate an entire half of the population with an “out of touch elite”, something that literally no Leave campaigners have ever, ever done.

21. Does he really not know that he’s done this? Or is he just pretending, so as to give him another excuse to imply that all opposition to his ideas is illegitimate?

22. Once again, I come back to my eternal question about Hannan: does he know he’s getting this stuff wrong, or is he genuinely this dim?

23. Will I ever be able to stop wasting my life analysing the intellectual sewage this infuriating man keeps pouring down the internet?

*Related: the collected Hannan Fodder is now about the same wordcount as Moby Dick.

Jonn Elledge edits the New Statesman's sister site CityMetric, and writes for the NS about subjects including politics, history and Daniel Hannan. You can find him on Twitter or Facebook.