The Tories messed up with junior doctors. Here’s what they should have done

Here is an article on the Junior Doctors strike from John McTernan, he  was Tony Blair’s director of political operations from 2005 to 2007. He was also a former chief of staff to Jim Murphy. Published in the Spectator. however it makes little mention of the need to ensure that extra resources would be needed to run a 7 day service ( the current staffing levels of nurses and juniors are skeletal hence the high levels of burnout and sickness) ,£53k … tube driver £49k…. enough said. I agree go after the consultants but beware they are a global commodity and their value is respected elsewhere ….. ” Come to Queensland … weekend working! “, as for the idea that the way people work has changed should affect doctors is a complete nonsense , doctors have worked flexibly and taken advantage of technology wherever possible ( the vast majority of technological hold ups are due to Government big IT projects reinventing the wheel). However there is an element of truth in the notion that the correct battleground is over what is needed to run a 7 day service and not over salary , most Juniors would probably be persuaded against strike action if they had the slightest  shred of faith in this Government unfortunately is speaks with a forked tongue and has probably lost their confidence forever.

I t would seem the vast majority of  Junior doctors and the  majority of consultants already work weekends usually for very little extra in terms of salary , so lets have an honest debate about 7 day working and the resources it will require …… or watch our very expensive to train medical workforce emigrate or retire. Trying to stretch resources that struggle with  5 days into 7 may prove impossible  , the Junior doctors strike may be just the beginning  of  discontent and industrial action in the Health Service.

The Tories messed up with junior doctors. Here’s what they should have done

12 January 2016

It takes some skill to turn the BMA into the NUM – but Jeremy Hunt has done just that. It takes nearly as much skill to persuade the public that people on £53,000 a year are scions of the oppressed working classes – but the BMA, aided by Hunt, have done that too. …….

First, they have told the wrong story. The government are making this about patient safety – they say that a move to a seven-day NHS is needed because too many people die at the weekends when they shouldn’t. This they attribute to the lower levels of staffing and assert that the solution is a change to junior doctors working patterns. There is a fundamental problem to this position. On the one hand, while there are what are known in medical jargon as ‘excess deaths’ related to weekend admissions, there is no evidence they are a consequence of staffing levels. And to complicate matters further, the ‘weekend’ for these purposes includes Fridays and Mondays. On the other, who do you suppose the public trust on matters of patient safety – doctors or politicians? Well, only one group of workers wears a white coat to work.

The better argument would have been the unassailable one that the world of work has changed. Mobile phones, tablets and laptops mean that for many white collar workers the boundaries between work and home life have blurred. Service industries offer seven-day access. And the millions of self-employed workers in the UK – a group now larger in size than all public sector workers – do not have traditional nine to five, five-day-a-week jobs. They work when the client wants or when the job comes through. The dividing line should have been modern life – that would have put junior doctors on the old-fashioned, protectionist, trade union side of the argument. They would have been portrayed as luddites, much like the rail unions who are trying to stop the 24-hour Tube.

Second, the government have chosen the wrong fight with the wrong enemy. You don’t need to make junior doctors work at weekends; they do that already. The staff who are actually needed at weekends to provide the same cover on Saturdays and Sundays are all the others – the staff who run diagnostics, do the blood-work and, of course, the consultants. The last of these groups are the ones who will fight against a seven-day NHS to the very last – the very last junior doctor. Why are consultants so anxious to back their junior colleagues? Because, as cruel NHS leaders put it, consultants want to spend more time playing golf. The government should have picked the fight with them. A change in their working patterns is essential to seven-day working. There are fewer of them, and they would have very little public sympathy.

Third, the government have made this a dispute between themselves and the junior doctors. This is a schoolboy error. The NHS is an independent arms-length body. The Tories have an electoral mandate for a seven-day NHS but they should simply have passed that on as a condition for the extra cash the NHS has received. The outcome should have been prescribed but the means left open to NHS England Chief Executive Simon Stevens, who has already made great strides in modernising the health service by allowing a range of variation across the country. If you can’t win a big fight then make it a series of smaller fights. If this was a hospital-by-hospital dispute rather than a national one, it wouldn’t make the headlines. There would be local battles not national demonstrations. And local solutions too.

The government are losing, and losing badly, because they have picked the wrong fight on the wrong grounds with the wrong people. If they seriously want to win they need a wholesale change in strategy and tactics.


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