Little doubt it’s going to get worse before it gets better …
This morning the first of what may end up becoming several junior doctors’ strikes over the issue of what has been called ‘the 7-day NHS’ will end.
Industrial disputes generally tend to pass me by and this one certainly has. I’m not entirely sure why. It could be because I’m too thick and disinterested to absorb all I’ve read or seen in the media about it, or perhaps because there’s been so much detail, off-the-record briefing and deliberate misrepresentation of each other’s positions being bandied about by everyone involved that frankly it’s all become too confusing to actually bother about.
It seems to me that nobody would deny that the UK’s National Health Service is a major national problem that urgently needs addressing – but for various reasons ever since it was launched by the Labour Government in 1948 – our politicians have been excessively wary of taking it on. Nobody denies that in theory the concept of an NHS is a ‘good thing’. The Tories in particular ‘tread on eggshells’ whenever the subject comes up because – universally regarded as the cost-cutting, pro-private enterprise party – they dare not risk conceding a soft guaranteed-Election-losing ‘own goal’ by being characterised as the ‘nasty party’ which doesn’t care about ordinary people.
Even the guiding principles behind the NHS are a source of disagreement. You might think that a ‘national health service free at the point of delivery’ is a laudable and straightforward enough concept, but even this has been challenged.
Did the NHS’s founding fathers actually intend that simply as it reads? Some hold that even Aneurin Bevan, credited as being the chief architect, didn’t actually intend completely ‘free’ – rather, he intended that everyone should contribute towards to it according to their wealth via their taxes (and not that UK medical treatment should be available gratis to anyone who visits, or happens to find themselves on, these shores). I’m not sure where the truth of this point lies but maybe it’s just a matter of semantics anyway.
The point is that, for decades now, the NHS has been a bottomless pit for public money. Whether that was always going to be a product of the concept, or has emerged because of the inevitable tendency of public services to become bloated in terms of bureaucracy, red tape, numbers of non-medical administrators and various unionised labour forces or units, I’d hesitate to guess.
Nevertheless, I do sympathise with those politicians who, from time to time, do dip their toes into these fraught muddy waters – for me, there is no reason why tough questions cannot/should not be raised. Everyone seems to agree that the UK cannot afford the all-encompassing, all-singing, all-dancing NHS for much longer. At least, not without significant reforms and efficiencies. Well, unless the nation opts to commit to signing a permanent blank cheque and just pours more and more of our tax £s into it ad infinitum.
But how to change the NHS to improve it and/or limit the cost? It seems to me that – though everyone agrees ‘something must be done’ – too few are prepared to put their heads above the parapet to propose any solutions, and not enough are prepared to discuss them when they do, still less get around a table to thrash out an agreed solution in some form or another.
In situations like the current junior doctors’ dispute over working hours at weekends, it’s damned difficult for anyone looking on to know where the truth – and, if you like, the right – of the matter lies. The doctors rarely strike – the last time was four decades ago – and I do believe them when they say they are resorting to striking as a last resort.
Where I part company from the junior doctors is their apparent stance that they know better that anyone else and that, by definition, nobody can suggest improvements to their current method or system of working. This comes across as a classic case of ‘defending the status quo’, another example of “Hello, the Luddites!”.
That was the problem with the Miners’ Strike in the Maggie Thatcher era. The miners, particularly their leaders, had convinced themselves that they had an absolute right to work, whatever the costs and irrespective of whether or not their ‘trade’ was loss-making, or indeed whether there were other, cheaper and more efficient ways of producing the energy the nation needed. They loved their way of life, the community spirit it engendered, didn’t want anything to change, and opted to confront the Tory government of the time head-on when it tried to challenge that viewpoint.
There’s also so much spin-doctoring and patent rabble-rousing going on by all sides in the junior doctors’ dispute that you barely know where to start. The government seems to be convinced that the BMA has been taken over by a Corbynista-style cabal of left-wing loonies and moved from being a non-political representative body to a rabid trade union which has now hi-jacked the junior doctors’ genuine concerns to pursue a radical, anti-government, anti-austerity agenda.
I could be ‘outed’ as a closet Tory for suggesting this, but in the bulk of junior doctor spokesman interviews I’ve seen, the barely-disguised glee with which the speaker sets out to attack the government and the ‘7 day NHS’ concept has begun to grate. The other thing that comes across as ‘iffy’ in these interviews is the degree of apparent confusion as to why the junior doctors are taking industrial action. One half of the spokes-people I’ve seen seem to say it’s solely and exclusively about ‘patient safety’ and that to work at all, the ‘7 day NHS’ needs more doctors (not the same number of doctors working harder) … whilst the other seems to major on the thrust that, by changing rosters so that doctors work for ‘normal time’ money at weekends (rather than ‘overtime’ of some sort or another as now) they will lose out in the money stakes.
I’m confused. Is the dispute about money or not? Even the antagonists don’t seem to know. I certainly don’t.
My hunch is that, at the end of the day, the ‘winner’ (if there can ever be one in a dispute with respective positions so deeply entrenched and opposed to each other that a compromise seems totally impossible) will be the protagonist which ends up winning the battle for the public’s hearts and minds.
Right now it looks as though the junior doctors are about 10% ahead in the poll surveys [but can any of them be believed after the General Election fiasco?] and, of course, by the nature of these things, that could change very quickly indeed if the dispute goes on and on without any sign of resolution … or indeed willingness to seek one.