His stubbornness could pay off—or it could backfire catastrophicallyby Peter Kellner / February 12, 2016 / Leave a comment
Read more: Junior doctors’ strike—will Corbyn miss an open goal?
Were Harold Macmillan alive today, he would surely update his famous injunction: “There are three bodies no sensible man directly challenges: the Roman Catholic Church, the Brigade of Guards and the National Union of Mineworkers.” These days it would make far more sense to substitute the British Medical Association for the virtually defunct NUM.
The Government’s dispute with junior hospital doctors looks like an exercise in political madness. Polls show that voters sympathise with the strikes. Jeremy Hunt, the health secretary, no doubt hoped that cancelled operations would turn the public against the doctors. If anything, it is Hunt who is losing ground. He, not the BMA, is being blamed for the disruptions and delays in our hospitals.
However Hunt should not be surprised. Every time YouGov asks people how much they trust different groups to tell the truth, doctors come near the top and politicians near the bottom. I doubt whether many people really understand the details of the proposed new contract, and whether the typical junior doctor doing a typical amount of weekend work will end up better or worse off, and by how much (I certainly don’t: be honest, do you?) But when it comes to winning over public opinion, that is beside the point. When a news bulletin shows Hunt saying one thing and a calmly-spoken striking doctor saying the opposite, it is plain who viewers are more likely to believe.
That’s the bad news for the health secretary. Here’s the potential good news. His decision to impose the new contracts may work. It’s possible that the strikes will peter out in due course and that when doctors receive their new pay packets they may decide the terms aren’t that bad after all. In that case, the threats of mass resignations may not materialise. If that happens, the current dispute will fade in the public mind; and, if patients end up receiving a better weekend service, the Government may start reaping electoral rewards for its stance.
On the other hand, things may not work out so well for Hunt. If strikes and resignations start to cripple the NHS, and the Government gets blamed, ministers may be forced into an ignominious retreat. It could even affect the coming EU referendum. If even a relatively small proportion of voters, say one or two million, decide that they want to weaken David Cameron, they might switch from “remain” to “leave” as a means of protesting against the Government.
All of which makes me wonder why on earth Hunt is taking such a huge risk with his imposed-contract strategy. I’m with him on the problem of weekend mortality rates, and I suspect the BMA has been unduly intransigent. The mystery is why this is being dealt with as a national negotiation. Would it not be better to instruct every hospital to provide a top-class seven-day service, and leave local managers to decide how best to make this happen, including the way doctors are paid?
A still-relevant lesson from the 1990s debate about “reinventing government” is that national politicians should steer, not row. That is, they should set overall objectives, but then give the managers of each service the freedom and responsibility to deliver them. Hunt should stop rowing and stick to steering.
Now read: The great social care dilemma