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
Show Hide image

Misogynoir: How social media abuse exposes longstanding prejudices against black women

After decades as an MP, Diane Abbott finally spoke out about the racist and sexist abuse she faces. But she's not alone. 

“Which STD will end your miserable life?” “This is why monkeys don’t belong here.” “I hope you get lynched”. These are just some of the many messages Seyi Akiwowo, a Labour councillor in Newham, told me she has been sent over the past three weeks. Akiwowo has received reams of violent and racist abuse after a video of her suggesting former empires pay reparations to countries they once colonised (and whose resources they still continue to plunder) went viral. She doesn’t expect everyone to agree with her, she said, but people seem to think they’re entitled to hurl abuse at her because she’s a black woman.

The particular intensity of misogyny directed at black women is so commonplace that it was given a name by academic Moya Bailey: misogynoir. This was highlighted recently when Diane Abbott, the country’s first and most-well known black woman MP and current shadow Home secretary, spoke out about the violent messages she’s received and continues to receive. The messages are so serious that Abbott’s staff often fear for her safety. There is an implicit point in abuse like this: women of colour, in particular black women, should know their place. If they dare to share their opinions, they’ll be attacked for it.

There is no shortage of evidence to show women of colour are sent racist and sexist messages for simply having an opinion or being in the public eye, but there is a dearth of meaningful responses. “I don’t see social media companies or government leaders doing enough to rectify the issue,” said Akiwowo, who has reported some of the abuse she’s received. Chi Onwurah, shadow minister for Business, Innovation and Skills, agreed. “The advice from social media experts is not to feed the trolls, but that vacates the public space for them," she said. But ignoring abuse is a non-solution. Although Onwurah notes the police and media giants are beginning to take this abuse seriously, not enough is being done.

Akiwowo has conversations with young women of colour who become less sure they want to go into politics after seeing the way people like Abbott have been treated. It’s an unsurprising reaction. Kate Osamor, shadow secretary of state for International Development, argued no one should have to deal with the kind of vitriol Abbott does. It’s well documented that the ease and anonymity of social media platforms like Twitter and Facebook have changed the nature of communication – and for politicians, this means more abuse, at a faster pace and at all hours of the day. Social media, Onwurah said, has given abuse a “new lease of life”. There needs to be a concerted effort to stop people from using these platforms to spout their odious views.

But there is another layer to understanding misogyny and racism in public life. The rapid and anonymous, yet public, nature of social media has shone a light on what women of colour already know to be a reality. Dawn Butler MP, who has previously described racism as the House of Commons’ “dirty little secret”, told me “of course” she has experienced racism and sexism in Parliament: “What surprises me is when other people are surprised”. Perhaps that’s because there’s an unwillingness to realise or really grapple the pervasiveness of misogynoir.

“Sometimes it takes a lot of effort to get someone to understand the discriminatory nature of peoples’ actions,” Butler explained. “That itself is demoralising and exhausting.” After 30 years of racist and sexist treatment, it was only when Abbott highlighted the visceral abuse she experiences that politicians and commentators were willing to speak out in her support. Even then, there seemed to be little recognition of how deep this ran. In recent years, the Labour leader Jeremy Corbyn has been ridiculed for having a relationship with her in the 70s, as if a black woman’s sexuality is both intriguing and laughable; people regularly imply she’s incompetent, despite having been in Parliament for three decades and at the last general election increasing her majority by a staggering amount; she has even been derided by her own colleagues. Those Labour MPs who began the hashtag #PrayforDiane when she was off work because of illness spoke to a form of bullying that wouldn’t be acceptable in most workplaces.

These supposedly less obvious forms of racism and sexism are largely downplayed or seen as unrelated to discrimination. They might be understood through what influential scholar Stuart Hall called the “grammar of race”. Different from overtly racist comments, Hall says there’s a form of racism that’s “inferential”; naturalised representations of people - whether factual or fictional - have “racist premises and propositions inscribed in them as a set of unquestioned assumptions”. Alongside the racist insults hurled at black women politicians like Abbott, there’s a set of racialised tropes that rely on sexualisation or derision to undermine these women.

The streams of abuse on social media aren’t the only barrier people of colour – and women in particular – face when they think about getting into politics. “I don’t think there’s a shortage of people in the black community who put themselves forward to stand for office, you only have to look at when positions come up the list of people that go for the position,” Claudia Webbe, a councillor and member of Labour's ruling body the National Executive Committee told me. As one of the few black women to hold such a position in the history of the Labour party, she knows from her extensive career how the system works. “I think there is both a problem of unfair selection and a problem of BME [black and minority ethnic] people sustaining the course." Conscious and unconscious racial and gender bias means politics are, like other areas of work in the UK, more difficult to get into if you’re a woman of colour.

“The way white women respond to the way black women are treated is integral,” Osamor says, “They are part of the solution”. White women also face venomous and low-lying forms of sexism that are often overlooked, but at times the solidarity given to them is conditional for women of colour. In a leaked letter to The Guardian, Abbott’s staff criticised the police for not acting on death threats, while similar messages sent to Anna Soubry MP resulted in arrest. When the mainstream left talks about women, it usually means white women. This implicitly turns the experiences of women of colour into an afterthought.

The systematic discrimination against women of colour, and its erasure or addendum-like quality, stems from the colonial racial order. In the days of the British empire, white women were ranked as superior to colonised Asian and African women who were at different times seen as overly sexualised or unfeminine. Black women were at the bottom of this hierarchy. Women of colour were essentially discounted as real women. Recognising this does not equate to pitting white women and women of colour against each other. It is simply a case of recognising the fact that there is a distinct issue of racial abuse.

The online abuse women of colour, and black women specifically, is an issue that needs to be highlighted and dealt with. But there are other more insidious ways that racism and sexism manifest themselves in everyday political life, which should not be overlooked. “Thirty years ago I entered parliament to try and be the change I wanted to see,” Abbott wrote. “Despite the personal attacks and the online abuse, that struggle continues.” That struggle must be a collective one.

Maya Goodfellow researches race and racism in Britain. She is a staff writer at LabourList.