The Health Secretary has attempted to make his latest move in his row with junior doctors a pacifying one, by writing to 50,000 junior doctors to outline his plans to increase their basic pay by 11 per cent under their proposed new contract. Timed to go public just days before the British Medical Association (BMA) sends out ballot papers on the possibility of strike action over the contract, Hunt is clearly trying to tempt junior doctors towards his side. Temptation could be the maximum he will achieve though – the new proposals still seem to be a long way from comforting junior doctors.
The proposals are an improvement on previous offers: new doctors’ basic pay would rise from £22,636 to £25,500, meaning approximately 75 per cent of junior doctors could receive pay rises. Also, the controversial plan to reclassify Saturday working from 7am to 10pm as normal hours has also been downgraded to classing 7am to 7pm on Saturdays as normal working hours. But according to junior doctors, these concessions don’t go far enough. Guaranteed annual pay rises are being removed, and there is still weight behind the argument that changing how evening and Saturday working hours are paid will exacerbate recruitment difficulties in A&E departments.
What’s more, the new offer proposes to allow the Care Quality Commission (CQC) to include checks on doctors’ working hours and training schedules in their hospital inspections, to try and alleviate fears about the safety risks posed by doctors working too many hours. But with rumours circulating that the CQC may be asked to deliver savings of up to 40% in the Spending Review, junior doctors will probably be questioning whether entrusting a cut-back CQC with this additional responsibility will really protect them from being overworked.
Realistically, Hunt is now stuck in a quagmire with no chance of persuading junior doctors that he is offering them a reasonable contract, because of his steadfast commitment to deliver the Government’s manifesto promise of a seven-day NHS. When contrasted with doctors’ concerns about the ability of the NHS to deliver those services, it shows the two sides have utterly irreconcilable aims.
“I cannot negotiate about a promise we made in a manifesto” does not chime well with “you need to actually address the concerns that junior doctors have”. Unless one side is prepared to back down, this game of rhetorical ping pong will continue and his relations with the BMA really could go past the point of no return.
If an agreement that pleases both sides cannot be reached, Hunt may have to concede the goal of a seven-day NHS for a while longer, as the Government will struggle to “win” against NHS frontline staff in the eyes of the public. There will not come a point when a majority of public opinion believes that the Government’s intentions are more honourable than those of doctors – the NHS is simply too beloved by the British public. As convenient as a seven-day NHS would be, if staff maintain it cannot be delivered under current strains, the Government will not benefit from pushing its implementation.
The irony of the situation is that if Hunt did put aside his political pledges – even if it meant not delivering on a key manifesto commitment – and offer the NHS what its staff are asking for, it would score him many more brownie points in the public eye. Without reaching some serious compromises soon, Hunt’s reputation could forever be tainted by the junior doctors’ row.