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Reading the early reports of the apparent resolution of the junior doctors dispute, you could be forgiven for thinking there was little left to argue about apart from overtime percentages and time off in lieu.
Already the lines are being drawn between Jeremy Hunt’s pig-headed recalcitrance and the doctor’s apparent concern about the size of their packages. It’s being played exactly like a 1970s hairy-backed industrial dispute, with everything but the beer and sandwiches. I imagine smoke filled rooms were out of the question on medical grounds.
Whatever the financial settlements – and it does appear the BMA have accepted reductions in most areas – characterising this dispute as being purely about money has always been disingenuous spin on behalf of those looking the discredit a group of people whom we trust with our lives to on a daily basis.
Many of the concessions that are to be put forward for agreement by the 40,000 doctors, who will be asked to vote on the settlement in June, have little to do with remuneration and more to do with quality of life outside of work. Something we surely all aspire to.
Regardless of salary, most of us wouldn’t want the responsibility and the day to day stress faced routinely by junior doctors in their working lives, even less the erratic, extended hours where life and death decisions have to be made through a haze of sleeplessness and overwork.
So it was little wonder that, when faced with a potential ramping up of those pressures, they finally broke ranks and entered into the unprecedented round of industrial action we’ve all been open-mouthed witness to.
Yet throughout that process, the BMA and the doctors themselves have sought dialogue and compromise, which has mostly been met with abject dismissal by ministers who claim to want to improve the NHS that we, but probably not they, rely on.
Indeed this whole process was kicked off by Jeremy Hunt’s back-of-an-envelope ideas about a 24/7 NHS service. Something that most of us believed we had already. This argument was bolstered by spurious and, eventually comprehensively discredited, statistics about the likelihood of dying in hospital over a weekend.
None of the doctors I’ve seen interviewed have shown any objection to the idea of 7 day week, full-on medical services. I doubt any of us would argue that the principle was a good one. But as with so many ideas proffered by this headline hungry administration, the idea hadn’t been properly thought through.
Amidst a culture of public service cuts, Hunt somehow had to make his grand plan stretch from a pocket handkerchief to a king-sized duvet. Using characteristic cock-eyed economics, presumably borrowed from the Osborne book of batsh*t fiscal rectitude, he decided it was possible to provide more cover with less resources.
And the gaping holes in this plan are still there. Even if the doctors agree this deal, there’s still no allowances being made for the support and ancillary staff that will be needed to keep hospitals running at full capacity every day of the year.
He still has no extra money to fund the nurses, radiographers, technicians, administration staff, cleaners and a whole raft of other vital personnel and operational services that will be needed. If he has, he’s keeping awfully quiet about it.
He may have got away with this bit of dodgy dealing if it wasn’t for the fact that he was trying to sell his snake oil to 40,000 of the most intelligent and highly educated people in the country. Moreover a group of individuals trained to diagnose a pain in the backside when they saw one.
So, no, the doctors principle problem with these new proposals wasn’t the lack of moolah, it was the lack of common sense and above all concern about the safety of those patients they care more about than the number of zeroes on their paycheque.
They saw that the 24/7 NHS ideal was really about political manoeuvring, stretching available cover without providing additional resources so that Hunt could claim to have got a quart out of a pint pot.
Moreover they recognised that, in much the same way that Thatcher gelded the miners in the 80s, once a knock-out blow had been dealt to the junior doctors, the rest of the medical and ancillary staff would be easy meat. As any pay frozen nurse will tell you, first they’ll come for the doctors, then they’ll come for us.
True, some of the savings now being talked about in the doctors’ contracts could cover a proportion of these costs, but it’s unlikely they’ll be able to provide more than a fraction of what’s needed.
In the end, the compromise that’s now on the table is more about pulling Hunt’s gonads out of the autoclave than it is about furthering his 24/7 project. Having realised that he couldn’t ‘impose’ a new contract as he planned, he had no choice but to talk to the doctors and agree a settlement, something that could have been achieved weeks ago, before a single syringe or pair of rubber gloves was downed
It’s arguable that this has been a major salvo in the battle-plan to undermine the NHS before flogging it off to private healthcare companies. If so the junior doctors have proved to be our thin blue line ranged against these dark forces.
If nothing else they have forced a climb-down by Hunt in the guise of pragmatism, and we’ll need to be ready for any face-saving daft ideas and outright attacks the government may now go on to launch against the NHS.
But if the doctors do agree this settlement next month we shouldn’t let Jeremy off the hook too easily. We now need to see a fully operational, fully staffed and fully funded 7 day week NHS, just like we’ve been promised. Or we need to ask why not.
Anything less will show this whole episode up for what most of us realise it has been all along. A misguided and ill-conceived attempt by an incompetent minister to buy himself a place in history at the cost of our lives and the good will of thousands of dedicated, caring professionals.