The confirmation that resident doctors will strike over Christmas was entirely predictable, as Roy Lilley has noted in his NHS-related daily email today.
An 83.2 per cent vote to continue action, on a solid turnout, signals confidence and discipline.
But what is also clear is that this is not just a labour dispute, as Wes Streeting is trying to claim, or a disgrace, as Keir Starmer would have it. This is a dispute about who is responsible for a system already stretched close to breaking point.
Doctors are very clear that it is not them, and with good reason.
They are equally clear that the failure is on the part of successive politicians, all of them sharing the same austerity culture.
The public has no difficulty deciding who to side with in this case: doctors are not the problem, and are the ones seeking the solution to it.
The public blames politicians who are now trying to pin the blame on doctors for an NHS crisis of Labour's own making, which attempt is backfiring as a result.
Wes Streeting has compounded the problem. He has chosen belligerence over negotiation, framing a pay dispute as a test of authority and repeatedly warning of NHS collapse, winter crisis and patient harm. Christmas was supposed to concentrate minds. It has not. Instead, each supposed “final” position he has suggested has quietly expanded, revealing successive weakness on his part rather than strength. The doctors know they have him on the run.
This is ultimately a credibility failure. Exaggerated threats, shifting red lines and hostile briefings may win headlines, but they corrode trust. Once trust is lost, negotiations become endurance contests rather than problem-solving exercises. That is where this dispute now sits, and the BMA has outmanoeuvred the government as a result.
The NHS will almost certainly muddle through the strikes. Trusts are well rehearsed. Elective work will be cancelled, rotas simplified, and Christmas capacity reduced as it always is. If the apocalyptic scenario does not materialise, as is likely, Streeting's authority weakens even further, and for all the rhetoric, there is no clear indication as yet that the UK is suffering a serious flu crisis this year; it may be nothing more than normal, but just earlier than usual.
Doctors are, admittedly, consciously trading public goodwill for bargaining power, judging pay erosion to be the greater threat. But this dispute is no longer really about Christmas or even pay. It is about who runs the NHS, how fragile it has become after years of neglect, and how quickly Number Ten realises this needs to be resolved through respect, negotiation and competence and not confrontation.
The problems are that:
- No.10 can't sack Wes Streeting right now, even though he is hopelessly out of his depth and has grossly mismanaged this dispute by making it personal.
- No.10 has also made it personal, which was a gross error of judgment on their part.
- Labour has, as a result, nowhere to go but lose, as they are bound to do.
What a mess.
And we, and doctors, are paying the price for yet another government that has no clue how to negotiate anything.
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All Wes Streeting has done is shine a light on the gross inadequacies of the political class. He has no real world experience, embarks on naked self-promotion and is nothing more than the current frontrunner in the political class’s latest race for the keys to Number 10, boosted by his mates in the client media (which is just another branch of the political class). His close association with the private health care sector must call into question his approach to the doctors and the government’s plans for the NHS. The political class is so out of touch with the general public and this is becoming ever more apparent to the public with time. Personally I have not witnessed any loss of public goodwill towards doctors and the NHS although I do appreciate that NHS staff face rising hostility from some patients but that is different because other professions, like my own, also feel under threat from certain members of the public (often fuelled by right-wing media and politicians). Today’s politicians appear oblivious to the growing public dissatisfaction with them and the policies they pursue and spend more time concentrating on focus groups and lobbyists. This is the outcome of a highly careerist political system where personal ambition triumphs over principles and competence. It would be laughable if it were not so serious.
Much to agree with
The way Streeting is treating these doctors in training is despicable. You would think he was being asked to pay their wage demands with his own money. You would think “Don’t pay the danegeld” was public policy rather than a quote from a poem published in 1911 containing wisdom for the ages. You would think that the BMA was a socialist trade union rather than one that stands up for its members and you would think trainees in any profession should not be striking when asked not to by the people we elected.
The only way to get rid of Streeting in any kind of electoral timescale alas is to see him punted upwards to the office of Prime Minister. The future does look bleak and I see little reason for hope.
Maybe we need an extremely articulate, experienced, competent and principled ‘junior doctor’ to make it known that he will stand against Streeting as an independent MP at the next election — ie, do a Martin Bell!
And guess what: Unlike our political class, there is no shortage of articulate, experienced, competent and principled medics.
And perhaps we can get the greens (or other like minded parties) to agree not to contest. It’s really about getting Streeting out and to make an example……..
🙂
I would rather not divide the opposition though: he is already very liklel;y to lose hios seat. He only just held it last time.
On the topic of ‘doing a Martin Bell’ ….. Richard, how would you fancy getting yourself a white suit and suggesting that you’d reluctantly stand against Rachel from Accounts in Leeds West and Pudsey until there is a proper discussion?
This was initially suggested slightly tongue in cheek — but it might at least provide you high profile platform to discuss an alternative to the neoliberal nonsense and to explain to viewers that there are completely different choices available — rather than a constant stream of the ‘there is no money’ variety?
But I might win, and I do not wish to be an MP, so standing would be dishonest.
Getting No. 10 involved too early is always a mistake. They are the last chance to climb down if things need changing…. but they have allowed themselves to become too closely aligned with Streeting.
Of course, internal politics protects Streeting but they don’t have to sack him – they could sack Rachel Reeves and “promote” Streeting to Chancellor! But does No. 10 actually want him to fail so that his leadership credentials are damaged?
At the risk of dissent, the one area where the BMA is failing is about “pay restoration” – using RPI and a particular point in the past does give a false picture and I think many folk look at their claim and feel instinctively that it is too much, too fast (when they look at their pay over the same period). Where the public really supports them is that without more resources the NHS is clearly struggling. Everyone is either a patient or knows a patient; is an employee or knows an employee. Wes Streeting can say what he likes….. the public knows better.
Interestingly, as the BMA points out, doctors’ student loans are indexed to RPI, so the state is content to use RPI when it is protecting the real value of money owed to it, yet when doctors highlight that their pay has not kept pace with rising costs, RPI is suddenly judged inappropriate and CPI is preferred.
Not crowing, and by no means saying that either the S.N.H.S, nor indeed the Scottish Government are perfect, far from it, but certainly over the Xmas period there are no strikes in our Health Service. Just saying.
🙂
When I think of all the unemployed doctors and of all those sitting in pain on waiting lists I know who I blame.