Letter to my (Tory) MP on Jeremy Hunt and the NHS

Tomorrow sees the first walk-out by junior doctors in the NHS’ history. My MP is a member of the Cabinet (Sec of State for DFID). I sent this to her today. I urge you to write something similar to your MP. My letter references a conversation she & I had about evidence in public policy, about which you can read more here. I will publish her response to this letter when it comes.

“Dear Justine [Greening]

I hope that you are doing very well.

I write to ask why the Conservative Cabinet is allowing Jeremy Hunt to destroy the NHS.

Tomorrow’s planned strike is unprecedented. It is in opposition to a contract which he yesterday refused to pilot in a few regions and have rigorously evaluated. I’m glad that of all MPs, you are mine, because you might be able to understand the craziness of that better than most MPs: DFID seems to understand better than most departments that the answers to tricky problems are not obvious and that experiments & rigorous evaluations can help us find – indeed, are often the sole way to find – the right answers. You and I talked about how DFID funds loads of rigorous evaluations of pro-poor programmes, and syntheses of them for that reason.

Indeed the Conservative-led coalition set up various What Works Centres precisely to gather and collate experimental evidence on social policies because ‘the right answer’ is rarely obvious. Why then is a member of a Conservative Cabinet allowed to rubbish the notion of finding out empirically whether his proposed contract will improve patient outcomes?

It’s particularly ironic that he’s doing this in *health*, because health, of all fields, has seen the greatest gains in outcomes precisely because of experimentation. And Britain was the crucible of that.

Furthermore, why is he allowed to introduce a new contract which even the DoH admits is discriminatory against women? (as discussed in the Telegraph, here).

Hunt’s plan for the NHS seems to be to deal with the ‘fact’ that deaths increase at weekends. Umpteen people have pointed out that that’s nothing to do with the staffing that he seems to be trying to solve, but instead largely due to the fact that the people admitted at weekends are more ill than those admitted in the week: a ‘selection effect’ rather than a ‘treatment effect’. Radio 4’s More or Less noted this, and no less a figure than the Editor of the British Medical Journal wrote to him publicly to ask/tell him to stop misquoting their study.

It’s all the more bizarre because the basic problem in healthcare isn’t weekend deaths or doctors’ contracts, but the fact that an aging population will vastly increase health- and social-care costs, for which Hunt seems to have no plan at all.

While we’re here, why is the Education Secretary allowed to impose a governance form on all schools when that hasn’t been rigorously evaluated either?

I’m genuinely confused because I thought that Conservatism was about freedom and choice, and intelligently using evidence, and rationalism and encouraging diversity/inclusivity in the workplace – and generally avoiding intuited centrist diktats.

I’d be grateful for your view / rapid intervention. And it’s fine to reply by email: MPs weirdly normally reply by letter – an unnecessarily expensive process now almost unique to them.

Caroline Fiennes”

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