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Pressure grows on Health Secretary to justify citing of ‘weekend death rates’ paper

A senior medical editor has joined doctors in criticising the Health Secretary Jeremy Hunt’s use of an academic article on the deaths of patients admitted to hospital at weekends.

Fiona Godlee, editor in chief of The BMJ, has written to Hunt outlining concerns that he has misrepresented the findings of the article, published in the respected medical journal in September 2015, and asked him to clarify statements that he had made in relation to it.

The article, by Nick Freemantle, professor of clinical epidemiology and biostatistics at University College London, and colleagues, found that 11,000 more people die each year within 30 days of admission to hospital on Friday, Saturday, Sunday, or Monday than on other days of the week.

“What it does not do is apportion any cause for that excess, nor does it take a view on what proportion of those deaths might be avoidable,” Godlee said.

She said that despite this caveat Hunt had repeatedly told MPs and the public that these excess deaths were due to poor staffing at weekends. “This clearly implies that you believe these excess deaths are avoidable,” Godlee wrote to Hunt.

She asked Hunt to clarify the statements he had made in relation to the article “to show your understanding of the issues involved.”

The letter came after two doctors wrote to the Cabinet Office asking it to investigate Hunt’s claim that the 11,000 deaths were due to too few doctors being on duty.

In their letter, Drs Antonio de Marvao and Palak J Trivedi, both academic clinical lecturers, said that Hunt had breached the ministerial code of conduct by misrepresenting official statistics.

The letter, which was co-signed by thousands of fellow doctors and medical students, said: “It appears Mr Hunt deliberately and knowingly misquoted and misinterpreted the conclusions of a medical research publication in an attempt to mislead the other Members of Parliament and the UK public.”

The doctors, whose letter represented around 3,380 other doctors, have complained that Hunt is misusing the evidence to justify both the imposition of a new contract on junior doctors and turning the NHS into a seven-day service.

The Society for Acute Medicine has also written a letter to Hunt saying that forcing 53,000 junior doctors to accept inferior terms and conditions would have a catastrophic effect on the NHS by producing the biggest recruitment crisis the service has ever encountered.

The statistic has become an important – though disputed – piece of evidence because Hunt has been using it in the House of Commons, interviews and Department of Health responses to media inquiries about the junior doctors dispute.

Their complaint cites the ministerial code of conduct’s stipulation that “ministers [must] give accurate and truthful information to parliament”. Referring to statements Hunt made at health questions in the House of Commons on Tuesday, they also claim that “in misquoting and misinterpreting the data, Hunt is not accurate or truthful. Mr Hunt’s claim that ‘there are 11,000 excess deaths because we do not staff our hospitals properly at weekends’ is not supported by the evidence”.

They point out that the co-authors of the study, which include NHS England’s national medical director, Prof Sir Bruce Keogh, clearly warned in their paper that “it is not possible to ascertain the extent to which [of] these [11,000] deaths may be preventable; to assume they are avoidable would be rash and misleading”.

Hunt told MPs recently: “According to an independent study conducted by the BMJ, there are 11,000 excess deaths because we do not staff our hospitals properly at weekends. I think it is my job, and the government’s job, to deal with that, and to stand up for patients.”

The BMJ paper did highlight a lack of senior doctors and support services available in hospitals at weekends as causes of the “weekend effect”. But it also pointed out that the much greater likelihood that patients admitted at the weekend will be medical emergencies, and at higher risk of dying, were important factors too.

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One Response to “Pressure grows on Health Secretary to justify citing of ‘weekend death rates’ paper”

  1. mct.morrison says:

    It would appear that many politicians do not understand statistics – after all, a few years ago we had a Health Secretary who, on appointment, stated that he was going to ensure that “ALL hospitals would be above average”!

    This may be the reason why so many ‘misinterpret’ them; or, of course, there could be a more sinister reason – they set out, deliberately, to deceive for political reasons!

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