If you see a slightly frazzled middle-aged person by the side of the road, it’ll be a Conservative Party member, hitching a ride back to the metropolis…

… their train cancelled in the strikes. HS2 cancelled in the foreseeable.

I’m not sure what to make of the Manchester conference and I’m not sure the Tory Party members do, either… apart from the fact, Keir’s flip-flops were sold-out!

Bully-Boy? He had a go at wokery but said nothing about The Equality Act 2010 and the implications it has for the NHS in the way it conducts itself and delivering statutory and mandatory training.

He announced; more dosh-for-data and innovation that I think I’ve heard before. 

He announced; three new training uni’s for doctors, that aren’t new. 

And…

He denounced; the ‘striking militants’ in the BMA, shouting the odds, outside the conference hall.

He’s right about the BMA. 

The group @Doctors_Votes have taken over most of the key committees and leadership positions and managed to wake up a pretty dozy union, that’s allowed the value of doctor’s wages to erode.

Make no mistake. The BMA is not the 'old-geezer’s club', as the Romney Review described it, that it once was.

They have redefined themselves. Edgy, hard-nosed and truculent. No more apparent than in the exchanges between the Union and NHSE.

NHSE say; on strike days, Christmas Day cover is OK for Christmas but this ain’t Christmas. Demand is higher and will get even higher as winter draws us in.

The BMA boss, Philip Banfield, a Welsh Obs&Gynae honorary prof, who as far as I can tell has never run for a bus, never mind run a hospital… apparently, knows-all and knows-better. He says Trusts should plan better.

Faced with this level of ignorance and obduracy, there’s not much NHSE can do.

HMG have no intention of giving in ‘to the militants at the BMA’. Sunak's 'get-to-know-me' speech made that clear.

Thatcher’s government rode-out miner's strikes and resorted to a three-day working-week, to keep the lights on. The ghost of Thatcher looms large over the Sunak administration… Thatcher tea towels a popular souvenir in the conference shop!

Expect NHSE to recalibrate waiting lists. A sheep from the goats exercise.

The majority are waiting for a diagnostic, probably 60%. Of those it’s likely only 20% will need inpatient care. 

I can foresee DH+ doing a massive deal, effectively privatising diagnostics…

… leading to a huge expansion in the sector and an exodus of NHS people who’ll enjoy better working conditions and less agro.

The reality is, we need to think about the appalling state of industrial relations in the NHS. 

Not least the Confed, who represent Trusts and whose own people are striking against Matthew Taylor’s proposed wage cuts… gimmestrength… something must be done!

The NHS is characterised by neglect and tension. 

Governments make poor employers, they exploit their sector dominance. That has to stop. And, we have to find a way to stop strikes.

Legislation, wending its way through Parliament is not the answer. Another layer of law is the wrong way to do it. If you take away a person’s right to strike you must give them something in return.

There is another way. There has been a no-strike deal in the NHS. I know because, a million years ago I was part of it.

It’s based on pendulum arbitration.

An arbitrator, in my case ACAS, chooses one of the parties' proposals. 

For example; a trade union demands a wage increase of 7% and the management offer 3%. 

The arbitrator has to choose between awarding a 3% or a 7%.

This procedure is opposed to conventional ‘interest arbitration’, in which the parties present evidence and the arbitrator acts as fact-finder and crafts an award…

… rather like the pay review bodies do now.

This has the effect of moderating each side’s opening position. 

The decision is legally binding, within the meaning of Section 178 of the Trade Union and Labour Relations (Consolidation) Act 1992, avoiding recourse to strike action.

A commitment is made to an annual review on an agreed timetable. Ensuring renumeration never gets out of sync with the economy.

All sides in this strife are in the wrong place. 

Doctors in a place that risks their careers, reputation and professional standing. 

HMG's place risks public opprobrium and tenure. 

The BMA placed where their reputation as a union is at risk, with their legacy laziness exposed and new-found militancy a turn-off. 

The patients placed in a wilderness of waiting and risk.

Finding somewhere, in place of strife...

... behoves us all.