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Doctors' strike: it's time to calm down Doctors' strike: it's time to calm down
(35 minutes later)
The junior doctors’ dispute in England is a bit like the Brexit campaign, a conflict which wiser heads on both sides might best have avoided. It is now moving into dangerous territory where ever harsher words are being exchanged, words that will linger damagingly when the battle is over.The junior doctors’ dispute in England is a bit like the Brexit campaign, a conflict which wiser heads on both sides might best have avoided. It is now moving into dangerous territory where ever harsher words are being exchanged, words that will linger damagingly when the battle is over.
After Barack Obama’s intervention in the EU referendum the Brexiteers’ best remaining card is the widespread belief that voting to leave would be Britain’s best option for stemming the recent migration surge which puts pressure on jobs and services. It is a dangerous card to play, as more scrupulous Leave campaigners know. But desperate folk sometimes resort to desperate measures. After Barack Obama’s intervention in the EU referendum, the Brexiteers’ best remaining card is the widespread belief that voting to leave would be Britain’s best option for stemming the recent migration surge which puts pressure on jobs and services. It is a dangerous card to play, as more scrupulous leave campaigners know. But desperate folk sometimes resort to desperate measures.
The medics’ dispute has been going on longer and is further down the destructive path. Today’s second all-out strike is about as big an escalation as the junior docs can manage, short of an indefinite walkout – surely unthinkable. It won’t force the government to capitulate, but it carries obvious risks with patients and public opinion. Tuesday’s contingency plans seem to have held the line. Thank goodness. The medics’ dispute has been going on longer and is further down the destructive path. Wednesday’s second all-out strike is about as big an escalation as the junior docs can manage, short of an indefinite walkout – surely unthinkable. It won’t force the government to capitulate, but it carries obvious risks with patients and public opinion. Tuesday’s contingency plans seem to have held the line. Thank goodness.
The health secretary, Jeremy Hunt, has been fairly circumspect for the most part, but anonymous voices in Whitehall – the Department of Health is just across the street from No 10 past the Red Lion – have been muttering about a “political strike” and a “miners’ moment” when militants must be seen off as Maggie did Arthur Scargill in 1984-85. The health secretary, Jeremy Hunt, has been fairly circumspect for the most part, but anonymous voices in Whitehall – the Department of Health is just across the street from No 10, past the Red Lion – have been muttering about a “political strike” and a “miners’ moment” when militants must be seen off as Maggie did Arthur Scargill in 1984-85.
That’s not really true of the British Medical Association (BMA) and its junior doctors. True, they have the support of the usual suspects, Marxoid splinter groups who probably have a few doctors among their number, and the political innocents in the National Health Action party which helps fragment the progressive vote. That’s not really true of the British Medical Association (BMA) and its junior doctors. True, they have the support of the usual suspects, Marxoid splinter groups who probably have a few doctors among their number, and the political innocents in the National Health Action party, which helps fragment the progressive vote.
The other soft-spoken Jeremy, Labour’s Corbyn J, also popped up on Tuesday to voice his support and attack “NHS privatisation”. It will provide useful footage for Lynton “dog whistle” Crosby at the next election campaign, if not sooner if something awful happens in an understaffed ward. Corbyn is quite an innocent too.The other soft-spoken Jeremy, Labour’s Corbyn J, also popped up on Tuesday to voice his support and attack “NHS privatisation”. It will provide useful footage for Lynton “dog whistle” Crosby at the next election campaign, if not sooner if something awful happens in an understaffed ward. Corbyn is quite an innocent too.
Trade union leaders, which is what BMA leaders really are, get boxed into corners by their members – new to all this kind of excitement and all fired up – and by government pressure coming the other way. Opinion polls seem to support the juniors, which further buoys them, though polls don’t really mean diddly squat, as Mayor Boris would say.Trade union leaders, which is what BMA leaders really are, get boxed into corners by their members – new to all this kind of excitement and all fired up – and by government pressure coming the other way. Opinion polls seem to support the juniors, which further buoys them, though polls don’t really mean diddly squat, as Mayor Boris would say.
Do we rate doctors more than politicians? Of course we do, but doctors as politicians is a different matter. The BMA is letting this dispute drift, as is Hunt who would have been wise to accept the compromise – to pilot the controversial weekend rota scheme in limited areas – to see if it does reduce mortality rates.Do we rate doctors more than politicians? Of course we do, but doctors as politicians is a different matter. The BMA is letting this dispute drift, as is Hunt who would have been wise to accept the compromise – to pilot the controversial weekend rota scheme in limited areas – to see if it does reduce mortality rates.
Pressure from No 10 probably squashed any such thoughts and Hunt let it be known that four years as health secretary – he was previously the culture secretary who survived the BSkyB affair – has cured him of further political ambition. This is his “last big job in politics”, he is now saying. It’s too rough a body contact sport nowadays.Pressure from No 10 probably squashed any such thoughts and Hunt let it be known that four years as health secretary – he was previously the culture secretary who survived the BSkyB affair – has cured him of further political ambition. This is his “last big job in politics”, he is now saying. It’s too rough a body contact sport nowadays.
Many of his senior colleagues at NHS England, who will have to clean up the mess after he is gone (David Cameron won’t sack him, of course), are clearly unhappy with some of their ministers’ stances – is it so important to impose weekend rota reforms at such political cost? – but not thrilled by the BMA position either.Many of his senior colleagues at NHS England, who will have to clean up the mess after he is gone (David Cameron won’t sack him, of course), are clearly unhappy with some of their ministers’ stances – is it so important to impose weekend rota reforms at such political cost? – but not thrilled by the BMA position either.
But if voters ever concentrate hard on this one, Hunt is able to point to points of intransigence on the other side. He appointed the respected David Dalton to broker a deal in November and made up to 74 concessions. He’s holding firm on his promise/threat to impose the new contract this summer, further angering more militant medics.But if voters ever concentrate hard on this one, Hunt is able to point to points of intransigence on the other side. He appointed the respected David Dalton to broker a deal in November and made up to 74 concessions. He’s holding firm on his promise/threat to impose the new contract this summer, further angering more militant medics.
It’s basically about pay rates for weekend work. Strikes are usually more about money than safety or other more disinterested claims. But I don’t share Polly Toynbee’s suspicion that ministers are provoking a showdown with the juniors in order to further humble other public sector unions.It’s basically about pay rates for weekend work. Strikes are usually more about money than safety or other more disinterested claims. But I don’t share Polly Toynbee’s suspicion that ministers are provoking a showdown with the juniors in order to further humble other public sector unions.
The BMA is not the Scargill-led NUM and, even if it was, ministers know voters tend to mistrust the Tories on the NHS. “Keep it off the front pages” was Hunt’s mandate when he took over from the doomed Andrew Lansley. Not that the BMA should ever respond as recklessly as Scargill did to provocations (pit closures) at the end of the winter of 1983. You don’t have to jump off a cliff just because someone suggests it.The BMA is not the Scargill-led NUM and, even if it was, ministers know voters tend to mistrust the Tories on the NHS. “Keep it off the front pages” was Hunt’s mandate when he took over from the doomed Andrew Lansley. Not that the BMA should ever respond as recklessly as Scargill did to provocations (pit closures) at the end of the winter of 1983. You don’t have to jump off a cliff just because someone suggests it.
In any case, doctors have more options than miners. Most of those who say they will emigrate to Canada or Australia probably won’t. But plenty already do, taking their expensive UK training with them. More will follow them, adding to pressure on the NHS, its staff, its budgets and its patients. The sunshine of Brisbane must look very attractive this April. I know a Scottish doctor and his nurse wife who went there. We visited their lovely home.In any case, doctors have more options than miners. Most of those who say they will emigrate to Canada or Australia probably won’t. But plenty already do, taking their expensive UK training with them. More will follow them, adding to pressure on the NHS, its staff, its budgets and its patients. The sunshine of Brisbane must look very attractive this April. I know a Scottish doctor and his nurse wife who went there. We visited their lovely home.
But Brisbane too faces problems shared by healthcare systems all over the world. Britain’s is not the fastest ageing population, older people having more chronic conditions and high levels of need. Nor are its people the most obese, though its dirty health and diet habits are bad enough. Its funding system, the NHS paid for from taxation, not insurance, has been squeezed hard since the financial crisis – “ringfenced” is Cameron’s euphemism for saying “it could have been worse” – but it’s relatively cost-efficient. Poor outcomes (ie too many people with cancer etc die) are still its achilles heel, though we are making progress. But Brisbane, too, faces problems shared by healthcare systems all over the world. Britain’s is not the fastest ageing population, older people having more chronic conditions and high levels of need. Nor are its people the most obese, though its dirty health and diet habits are bad enough. Its funding system, the NHS paid for from taxation, not insurance, has been squeezed hard since the financial crisis – “ringfenced” is Cameron’s euphemism for saying “it could have been worse” – but it’s relatively cost-efficient. Poor outcomes (ie too many people with cancer etc die) are still its achilles heel, though we are making progress.
So health ministers and their Svengali, NHS England’s CEO, Simon Stevens, are right to argue that more efficient working practices must be squeezed out of a fairly unresponsive system (how good is your local hospital’s IT?) and voters persuaded to lead healthier lives, without recourse to pointless pills or antibiotics they don’t need.So health ministers and their Svengali, NHS England’s CEO, Simon Stevens, are right to argue that more efficient working practices must be squeezed out of a fairly unresponsive system (how good is your local hospital’s IT?) and voters persuaded to lead healthier lives, without recourse to pointless pills or antibiotics they don’t need.
The sense you get from doctors’ spokesfolk on radio and TV sometimes that it’s all about money is illusory – here and in Brisbane. The current battle over the NHS’s pharmaceutical bill gets very little attention, but is arguably more important. The National Institute for Clinical and Care Excellence (Nice) is widely admired but also criticised – by cancer lobbies and their tabloid allies – by being too cautious in approving expensive drugs.The sense you get from doctors’ spokesfolk on radio and TV sometimes that it’s all about money is illusory – here and in Brisbane. The current battle over the NHS’s pharmaceutical bill gets very little attention, but is arguably more important. The National Institute for Clinical and Care Excellence (Nice) is widely admired but also criticised – by cancer lobbies and their tabloid allies – by being too cautious in approving expensive drugs.
It’s also holding back the very important UK medical research industry, commercial and academic. The situation is made worse for them by austerity and the eternal struggle to prevent Big Pharma squeezing excessive profits from the dear old NHS. A review on “accelerated access” to groundbreaking drugs is under way, but won’t be published until after the EU referendum in June.It’s also holding back the very important UK medical research industry, commercial and academic. The situation is made worse for them by austerity and the eternal struggle to prevent Big Pharma squeezing excessive profits from the dear old NHS. A review on “accelerated access” to groundbreaking drugs is under way, but won’t be published until after the EU referendum in June.
It all comes full circle when Brexiteer Michael Gove claimed this week that a Brexit vote would free up more money for the NHS and give those struggling doctors a pay rise. That’s one more daft utterance in these two disputes which the person uttering them will come to regret. Time to calm down and talk.It all comes full circle when Brexiteer Michael Gove claimed this week that a Brexit vote would free up more money for the NHS and give those struggling doctors a pay rise. That’s one more daft utterance in these two disputes which the person uttering them will come to regret. Time to calm down and talk.