Rattan Bhorjee
Naked Politics Blogger
The relationship between the British Medical Association (BMA) and any Government since the inception of the NHS by Labour Health Secretary Aneurin Bevan in 1948, has never been an entirely happy one. Every Health Secretary, Conservative or Labour; traditionalist or reformist, has faced an uphill battle with one of the most fearsome unions in Britain, to push through their legislation, to balance the needs of both NHS staff and patients and have grappled with being responsible for the world’s fifth largest employer, and arguably Britain’s most prized possession. The NHS constantly needs to evolve and change, yet that is exactly what the public are so afraid of.
In spite of all of this, it’s fair to say that the conduct of the government and its Health Secretary Jeremy Hunt in terms of the Junior Doctor’s contracts has been nothing short of woefully incompetent and aggressively underhand.
The contract negotiations themselves involve many complex issues. At the forefront: Junior Doctor’s pay. This fluctuates depending on their various working environments and what time of the day or week they’re working, with particular grievances over out of hours work.
Additionally, it involves wider NHS issues such as the culture of working long hours for consecutive days on-end, patient safety, and the staff shortages that are common in so many parts of the NHS. The government’s desire to significantly expand the NHS’ urgent and emergency medical care services over the weekend by 2020, a significant pledge which David Cameron has promised to deliver, is also a crucial component of the negotiations for the Department of Health.
All sides agree the old contract was unfit for purpose. It used a complex system of bands to compensate doctors for overtime and so-called unsociable hours. This led to unpredictable pay packets and doctors working longer or more unsociable hours, sometimes being paid the same amount as those working fewer hours. So far then this looks like just another dispute between government trying to reform and the BMA effectively protecting the interests of its members. Nothing new here then. However, what makes this so different is the aggressive and frankly disrespectful tactics that the Department of Health chose to adopt in the negotiations which began in 2012 and ultimately broke down in October 2014. The BMA has complained of “heavy handed attempts to force through a new contract without meaningful negotiations”, and this was before the Government announced it would forcibly impose the contract upon Junior Doctors. Prior to this the BMA made clear their views in a statement:
“We urge the government not to impose a contract that is unsafe and unfair. We will resist a contract that is bad for patients, bad for junior doctors and bad for the NHS.”
Jeremy Hunt has shown what I believe to be a breath-taking lack of understanding of both how revered doctors are in comparison to himself and those in his profession, but also of the needs and concerns of junior doctors, instead prioritising his party’s and his own concerns. His imposition of the junior doctor’s contract shows how he was never really willing to make concessions through negotiation, and undermines the whole mechanism of negotiating with Unions for the benefit of the workers and society in general. His plans to pay Junior Doctors their normal rate from 07:00 – 17:00 on a Saturday is utterly hypocritical, considering his own surgery is closed on a Saturday and he as a minister is paid a premium for working weekends.
Knowing many who work in the NHS, as junior doctors and in other sectors, what perhaps pains me most is to see the right-wing press unabashedly demonising Junior Doctors and their decision to take industrial action. Nobody from any profession wants to lose pay and strike on a whim, especially junior doctors who haven’t taken industrial action in over thirty years, showing how a decision like this was never taken lightly and there was no other real option for them to convey their discontent at the government’s farcical attempts to negotiate.
But who am I to be saying this? If you don’t take my word for it, just listen to the daughter of former Tory Chief-Whip Andrew Mitchell, junior doctor Hannah Mitchell, who in an open letter to The Guardian, stated:
“What Jeremy Hunt has managed to achieve is nothing short of spectacular. Health secretaries have come and gone, imposing new measures of varying unpopularity on the NHS, but not one has managed to so completely unite doctors in their dislike and alienate healthcare workers across the board in the way he has.”
Clearly, I am not in a minority when I think The Simpsons character Dr Nick could most likely do a better job than Mr Hunt, and have less people mispronounce his name. Even by the ‘Nasty Party’s’ standards Jeremy Hunt couldn’t do a worse job. It seems the genius and inspiration of Aneurin Bevan that created the NHS has long gone, and with its archaic, almost Thatcherite policies and out-of-touch Cabinet, will never be found under this current Government’s mandate.