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Jeremy Hunt arrived at the Department of Health three years ago, now he is weeks away from industrial action by junior doctors that will disrupt, and could endanger, patient care.
Doctors' pay is notoriously tricky.That is partly because doctors themselves are the workhorses of the health service.They are loved and admired by the public.In the British Medical Association (BMA), they have a tough and effective negotiating body with a membership that is notorious, at least among health secretaries, for its solidarity.When it comes to a standoff, no politician stands a chance.In this context, a wise health secretary should suppress all macho urges to embark on negotiations in anything other than a spirit of caution and conciliation.This is all the more important when the National Health Service (NHS) is facing the most acute financial squeeze in its history, after five years of below-inflation pay awards and with morale reported to be at an all-time low, while emergency departments in Australia and New Zealand are now often staffed by young British doctors.
It is the junior doctors who traditionally operate as a buffer between supply and demand. Changes to introduce flexible working for doctors left many newly qualified doctors feeling that their private lives were no longer their own, while at work—particularly at weekends—they were left carrying a heavy burden of responsibility alone.Worse, a series of investigations from 2009 on wards showed that outcomes for patients admitted at weekends were significantly less good than for those who went into hospital midweek.Part of the reason, it is now clear, is that patients admitted at weekends are sicker;but the shortage of backup or support services plays a role, too.
No one disputes that an NHS that never sleeps would be a wonderful innovation.It would also be unique in the world and expensive:it would add at least $3 bn to a budget that is already under-resourced.As analysis of the current excess mortality rates for weekends suggests, unless there is also money for all the backup services that are indispensable to patient care, there is little point in having more doctors on call.Nor has Mr.Hunt explained how the extra hours will be covered, without denuding wards of daytime medics;nor how young doctors working long hours under pressure and under-supported are supposed to learn the skills of their seniors.
Throw into this toxic brew cuts in pay for antisocial hours, and an erosion of control over the number of hours that they work, and it is no surprise that junior doctors are angry.The BMA now accuses Mr.Hunt of bad faith.It wants him to lift the threat of imposing the contract.And it wants him to promise that any contract will be fair to doctors and safe for their patients.Mr.Hunt has needlessly dug himself a large pit.He needs to work out an escape route before he is submerged—and patients are endangered by an unnecessary strike that may have considerable public support.
According to Paragraph 4, which of the following is true of a 24/7 NHS?

A Mr.Hunt will find a way to finance it
B Junior doctors will work longer hours
C It may accelerate skill accumulation
D It will be a supplement to daytime care

正确答案
B
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