Two leaked reports reveal immense skepticism about Tory plans for a “seven day NHS” from within the Department of Health. The Guardian has seen a “risk register” detailing concerns over feasibility of government plans. These are the same concerns that have been repeatedly raised by junior doctors.

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In the context of the reports, Hunt’s claims about the contract dispute seem hard to believe. Any assertion that the focus was on pay is undermined by the number and level of risks to patients that civil servants have outlined.  The report outlined 13 major risks, 5 in the gravest category, that face the government’s plan. These concerns largely mirror those the junior doctors dispute raised.

Echoing the doctors’ concerns, the biggest danger the NHS faces is apparently “workforce overload.” The report argues that there is a shortage of GPs, consultants and other professionals that would make covering the full seven days impossible. The only way to fill the gaps would be to require staff to work more hours, even though most are already on shift during the weekends.

Requiring staff to work more hours, and more weekends, is bad for both the doctors and the patients. “Tired doctors make mistakes” as the BMA placards read. The Tories are putting both staff morale and patient safety at risk to deliver on a manifesto promise based on a false claim. At best it’s reckless, at worst it’s criminal. It certainly confirms the worries, long voiced by striking doctors, that creating a seven day NHS through a reorganisation of timetables is not possible.

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The repeatedly debunked Tory manifesto claim of “6000 more deaths” at the weekend was the focus of the second report. Hunt’s insistence over “the weekend effect” has eroded trust in the Government’s ability to handle the NHS. The public seem to have a gut instinct that it cannot be true. An instinct that means the more it’s repeated, the more public support for the “seven day NHS” decreases.

According to his own civil servants, Jeremy Hunt’s comments “have not been helpful.” Perhaps because they contain a rather unsubtle subtext that Doctors are allowing patients to die on weekends. This has resulted in what the report refers to as “negative publicity” because the public were more likely to trust the junior doctors than the politicians.

Dr Mark Porter, leader of the BMA, considered the papers “alarming and disappointing.” His statement criticised the Department of Health for disregarding “its own risk assessment’s warnings about the lack of staffing and funding needed to deliver further seven-day services.” He went on to say that the papers proved the Government’s concern was not patient safety, it was to win votes.

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The report also mentions that staff “remain unconvinced of the case for change.” This is a rather euphemistic way of saying that the doctors are unconvinced that the changes will help. After months of government intransigence over the Junior Doctors contract it appears the doctors have been vindicated.

Hunt has previously pointed to the Government’s promised £10bn for the NHS by 2020 as a way to achieve increased service provision. However, the internal memos reveal that there is skepticism in the DoH that this figure will be sufficient to fund the plan. There is a further note in the risk register that because most of the funding will be delivered later in the term, there is a large risk of missed deadlines.

Labour has seized upon the leak. Shadow Health secretary Diane Abbott has echoed the BMA’s statement saying: “This is a shocking indictment of the Tory government’s plans. They pressed ahead with their proposals even when campaigners and NHS staff argued they were unworkable. It has now been confirmed by the advice the government received from its own civil servants.”

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