Solving the junior doctor dispute: reconciliation requires grace and candour


Years ago, on catching my university boyfriend in the act of giving his ‘tutorial partner’ some extra-curricular, under-duvet tutelage, I experienced wrath so ferocious I wanted nothing more, for quite some time, than to surgically detach him from his offending parts.

But what, you might ask, is the relevance of someone’s youthful betrayal to a seemingly insoluble industrial dispute? Well no, it’s not that I want Jeremy Hunt’s crown jewels on a platter – although, as a junior doctor, I cannot deny the potency of that image. The connection, of course, is that this dispute, like all the most intractable conflicts, has become, at its heart, an emotional one.

I do not mean that the terms and conditions of our new contract are uncontentious – far from it – but that, for junior doctors, the bitterness, distress, anger and dejection in which Hunt’s infamous contract is now steeped threaten permanently to derail any prospect of peace. Ignoring this obvious truth can only prolong the conflict.

Yesterday’s high-profile intervention from NHS insider, Chris Hopson, who speaks on behalf of the UK’s hospital trusts, inflamed doctors’ emotions anew. He stated live on the BBC that the government’s much-vaunted seven-day NHS was ‘impossible’ to achieve, given current funding and staffing levels. Worse, patients face ‘draconian rationing’ unless the government confronts head on the consequences of NHS underfunding. Social media erupted in fury as junior doctors, who for a year have been accused by the government of striking for their Saturday overtime, fiercely pointed out that this has always been their main concern with the new contract.

As someone who, over the past year, has variously likened Jeremy Hunt to Daenerys Targaryen, Vladimir Putin, Jordan Belfort, Don Draper and Pikachu, I can only confess my guilt when it comes to letting my emotions, at times, get the better of me. And the more we all rage in this dispute, the more the prize of resolution recedes into the distance. We need to end this now. All sides owe it to NHS patients to do everything in our power to avoid subjecting them to another industrial action. And if – in the three week window before the next scheduled strike – the government and BMA continue to go at it hammer and tongs, promising and promising that they put patients first while careering headlong into another full walk out, I really will long to get surgical. Mutual de-escalation, a defusing of tensions, is the only way truly to prioritise patients. And that means concessions – and, ideally, an admission of culpability – on both sides.

The blame game clearly serves no-one, but equally a refusal to take responsibility for one’s role in perpetuating a conflict keeps anger and resentment alive. Would it so dearly cost Jeremy Hunt – whose needlessly aggressive language against junior doctors reached a nadir when he chose to threaten us with his ‘nuclear option’ – to apologise for the distress his linguistic warfare has caused? Is the BMA junior doctors committee really unable to concede that calling for extreme industrial action in the absence of clear goals and objectives was a step too far?

Personally, I cannot support further strikes when so confused about what their aim is. But nor will I stop feeling angry unless the government acknowledges – and acts upon – the truth of Chris Hopson’s words. Theresa May, Jeremy Hunt, NHS England, the Academy of Medical Royal Colleges and the GMC all know full well that seven-day spin without substance is specious and, at root, potentially dangerous to patients. Even the Department of Health knows it: their own recently leaked risk register exposed a 5:5 severity risk that there simply isn’t enough money or staff to deliver the seven-day soundbite. Anyone who works on the frontline knows that we can barely deliver a safe five-day service. Rota gaps – missing doctors and nurses – are already crippling the NHS. Emergency, paediatric and maternity departments are already closing through lack of junior doctors. And the whole country and its cat know that five does not, cannot and will never equal seven.

If the Prime Minister and her Department of Health actually faced up to these hard truths, instead of endlessly squirming to deny them, imagine how powerfully she could lay the foundations for a cessation of hostilities, for genuine reconciliation. Yes, these issues are ‘extra-contractual’, and yes, a new contract cannot fix doctor under-staffing and life-threatening rota gaps – but Theresa May can. Right now, for the benefit of future patients, she could announce, for example, an expansion of medical school places. She could address junior doctors’ genuine fears of overstretch by guaranteeing they will not work increasing numbers of weekends than currently. Most fundamentally, if truly wedded to her predecessor’s vision for a ‘truly seven-day’ NHS, she could do what David Cameron singularly failed to: she could actually fund it.

And perhaps she might even acknowledge that she has in junior doctors the most dedicated, committed and emotionally engaged workforce she could ever hope to work with. Is it really so hard to treat them as an asset, not the enemy?

3 thoughts

  1. Fantastic piece. Of course our liberal capitalist government has no desire to fund the nhs. Just destroy it. I fear all we can really do is document this process and our concerns. Even that is hard with the uk media machine.


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