When he stepped through the door for the first time as Secretary of State for Health and Social Care, Wes Streeting knew to expect a full in-tray. There are no quick fixes to the issues facing the healthcare system, from waiting lists to the sustainability of social care. Lord Darzi’s subsequent report has laid bare the extent of these challenges.
Now, as the Labour Party gathers for its first party conference in government in fourteen years, the MDU is publishing its government priorities. These priorities look to address three major topics that the government may wish to start considering when parliament resumes in October, including:
- Reform of healthcare professional regulation
- Action on clinical negligence costs
- Supporting the health and wellbeing of the workforce
Reform of healthcare professional regulation
No one would design the current system of healthcare professional regulation, which is outdated and in need of reform. That is why doctors and dentists have been promised change for years. In 2022, a blueprint was published to do just this, with reform promised for doctors within the year. As we approach 2025, they are still regulated using the old system with no change in sight. Dentists have not even been given a commitment on when their regulator will be reformed.
Undergoing a General Medical Council (GMC) or General Dental Council (GDC) investigation is one of the most stressful experiences of a clinician’s professional life. The stress can have a devastating impact. Part of the reason is fitness to practice procedures, which are governed by outdated legislation. An investigation takes a significant amount of time too. A GMC investigation takes an average of 102 weeks or nearly two years, and a GDC investigation over 140 weeks or over two and a half years. A reset is clearly needed.
The government can change this. We are calling for the government to:
- Bring forward a Section 60 Order to enable doctors to get the reformed, fairer, more timely and proportionate model of regulation that they have long been promised.
- Do the same for dental professional regulation.
Action on clinical negligence
Patients harmed as a result of negligence must receive appropriate compensation. However, the law surrounding clinical negligence in the UK has failed to keep with the times and is now woefully out of date. Legislation enacted before the NHS was founded is still in force and means money is taken from frontline healthcare services, benefiting neither staff or patients.
NHS Resolution’s latest figures show that over £2.8 billion has been paid out in compensation and associated legal costs. Lord Darzi’s report highlighted that the NHS spends more on this than on GP services in the Midlands.
The status quo cannot carry on. We are calling on the government to:
- Repeal Section 2(4) of the Law Reform (Personal Injuries) Act 1948, which will allow courts to factor in the existence of the NHS when determining compensation.
- Tackle disproportionate legal costs by ensuring fixed recoverable costs in clinical negligence claims up to £25,000 is promptly enacted. This should swiftly be followed by a commitment to extend that regime to claims valued up to £250,000.
Supporting the health and wellbeing of the workforce
At some point we will all be treated by a doctor. We want those doctors to feel well rested and able to deliver optimal care. At present, however, this is not always the case. According to a recent survey conducted by the MDU of 331 doctors, only 7% felt able to deliver optimal patient care all of the time. 55% said they felt they were only able to deliver optimal care to patients’ half of the time or less. This is not a one off. A separate survey conducted by the MDU of over 530 doctors found that over a third felt sleep deprived on at least a weekly basis.
The government must tackle this situation. Small changes can make a big difference. Improving workplace facilities, such as access to hot food out of hours and staff rooms, were amongst the top issues that MDU members said they want parliament to prioritise. This is not an impossible barrier to overcome.
We call on the government to:
- Direct NHS employers to ensure that staff catering, and rest facilities are provided, including for those working out of hours.
- Direct NHS employers to establish key performance indicators for the NHS estate, to ensure that changes are brought in without delay and that initial standards are maintained or improved upon going forward.
- To commit, alongside the above, to continue funding for programmes and services that ensure support for doctors when they feel at risk of, or experience burnout – such as NHS Practitioner Health.