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I was hopeful…
... I'd sort of packed up for the week and expected, on Monday, to write that the doctors' strikes had been settled.
I had heard a little whisper that the negotiating people were close to getting a deal over the line and the resident doctors’ strikes would be called off.
That was confirmed in a £walled article in the Times yesterday. Alas, nothing came of it.
Now, we are in the macho period...
... were the DH+ is hellbent on making the situation worse by threatening overtime bans for strikers… so they can’t profit from their absences and generally talking like they are students of the King Herod school of human relations.
Their latest bonkersness…
... on the one hand they say the absence of doctors is making the NHS dangerous...
... but on the other hand, turn up for your operation as usual, as the absence of doctors is not a problem and presumably, not dangerous.
Is there anyone in charge of this addlement?
Threats don’t work. Bullying doesn’t work… and pretending the problem will go away if we just ‘stay tough’ is wishful thinking.
Frustration is taking over and the tone will get more aggressive. Advice to both sides…
... share an ice cream and start talking, keep talking. Talk about talking. Talk about the fact there is nothing to talk about but keep talking.
Talking creates an environment where relationships can be kindled. Relationships build trust, respect and understanding… out of that will come a solution.
In the meantime back to first principles, five-step pathway:
1. Make the Full Offer Public
Let’s start with some sunlight. Publish, in full, the government’s offer to junior doctors. Not a summary. Not spin. The actual offer, with all the clauses, figures and fine print.
Let the public judge. Let other doctors see what’s really on the table. Not through the filter of the BMA.
Negotiate with the BMA but talk directly to the doctors. Email them individually with the deal.
Transparency won’t end the strike, but it will end the suspicion... and it might just shame both sides into reason.
2. Reset the Tone
Before anyone can sit around a table, someone has to take the heat out of the room.
That means ministers publicly recognising the contribution of junior doctors. No more offhand jibes about overpaid or militant medics.
Just a simple, visible act of respect. These are the people who staff our wards at 3am. Let’s start by acknowledging that.
3. Bring in Independent Mediation
Negotiations have failed, Streeting is too full of testosterone. Time to bring in a White Knight… someone trusted, neutral and serious.
ACAS? Possibly.
Or maybe a senior figure with clinical credibility. Someone both sides can respect. Mediation doesn’t mean weakness. It means grown-up politics. A way for everyone to move without losing face.
4. Agree a Roadmap to Fair Pay
Let’s be honest, pay restoration, in full, probably isn’t affordable in one gulp. But a multi-year settlement? Tied to inflation, workloads, and proper consultation?
That’s doable. Junior doctors don’t want fireworks. They want fairness. A structured deal with stages, targets and transparency could unlock compromise… what
ever is on offer, always put it in the public domain.
5. Link Pay to Reform
Talk about rotas. Supervision. Burnout. Exam-fees, student debt, car parking, food... everything. The DH+ sort of promised this last time but it seems to have fizzled our.
Make this strike the trigger for something bigger. A shared reform plan that improves working lives and patient care.
Set up a joint task-force: doctors and government, together. Tie elements of reform to each phase of, say, a three year pay deal. Mutual gain, not mutual pain.
There is a way through this. But only if both sides decide to take it.
The public are growing anxious. Patients are caught in the middle. Resident doctors are demoralised. The NHS doesn’t need more standoffs...
... it needs settlement.
And no, it won’t be solved by threats, soundbites, or silence.
Neither by antediluvian doctors bellyaching about ‘it wouldn’t happen in my day’. It is in their day that the BMA went to sleep and various governments took advantage of their Lethe.
It’ll be solved by grown ups and five sensible steps.
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