At some point, we have to talk.

As the impasse over junior doctors’ contracts rumbles on, the BMA have announced the first three dates of potential industrial action.  Whilst the ballot is still ongoing, it is widely expected to provide a decisive mandate for full strike action.  I am enormously proud of my colleagues and friends who have acted with such strength, resolve, stoicism and eloquence during this enormously stressful and uncertain time.  They have acted as a source of both support and inspiration.  Thank you to all of you who are fighting, shoulder-to-shoulder.

Jeremy Hunt’s “firm offer” of November 4th remains deeply flawed.  It is a contract that is #notfair and #notsafe, and until Hunt withdraws the threat to impose it, no negotiation will be possible.

  • It remains open to abuse by employers who are understaffed and under pressure, and would lead to doctors working dangerous numbers of hours.
  • It remains discriminatory against women and LTFT trainees; NHS Employers even admits that they haven’t properly assessed this yet.
  • It remains financially-detrimental to those who work the most antisocial shifts, and those medical students and doctors who won’t benefit from pay-protection.  Even if it is “cost-neutral” in the short term, the future pay-envelope will not be protected and is certain to shrink.
  • It remains a contract that will be detrimental to training, as more and more doctors are dragged away from teaching and training opportunities.

The first industrial action date is only 18 days away, but I still hope that there will be an opportunity to avert a strike.  I trust my consultant colleagues to keep our patients safe during a strike, but there will certainly be patients and families who are inconvenienced by industrial action.  Sadly, until Jeremy Hunt concedes some ground, I can see no other way.  I hope that this is a dispute that we can “win”.  A protracted fight helps nobody; uncertainty for doctors, political damage for Hunt, disruption for patients.  But what would “winning” look like?

Firstly, we mustn’t consider a strike to be “victory”.  It can only ever be a means to an end.  If it gets us closer to resolving this dispute, without causing harm to patients, then it is worth it.  However, a strike is not, and never can be, our ultimate goal.

Some would consider it a victory if Jeremy Hunt were to lose his job over this.  Again, this cannot be our final aim.  I honestly believe that it would help to resolve this crisis if Hunt were removed from it; his behaviour, language and rhetoric has been divisive, inflammatory and unhelpful.  His use of spin and the media has brought me to a point where I don’t feel that I could negotiate with him in good faith.  He has obliterated any sense of trust that may have existed between the Department of Health and BMA, and I believe that a new person would be in a better position to rebuild the relationships that are needed.

A satisfactory resolution to the situation can only ever be achieved by negotiation.  We will not achieve a safe, sustainable, fair contract by strike action alone.  It may be the stimulus needed to trigger proper negotiations; perhaps the prospect of it alone will be enough.  But we need open, face-to-face talks, not quips and barbs traded via The Times or Twitter.  Resolution through talking, not press releases.  If the threat of imposition is withdrawn, and we can start with a blank piece of paper, I’d be around the table in seconds.  It’s up to the Secretary of State for Health as to when this next stage starts.  For our part, we must be alert and prepared, to take the olive branch when it is offered.  Mr. Hunt, we await your next move.

“The greatest victory is that which requires no battle.” – Sun Tzu


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