The ante has certainly been upped in the increasingly acrimonious dispute
between junior doctors and the government in England .
Wednesday sees medics stage a walk-out for the third time - with two more
stoppages to follow next month - while lawyers prepare a legal challenge to
fight the imposition of the new contract.
Now that may seem pretty far-fetched given the row has dominated the
headlines in recent months.
But there's good reason to think it will succeed. Firstly, the chances of
the judicial review the British Medical Association is pursuing actually
stopping the imposition is, by all accounts, slim.
And with Europe dominating the media's
attention, the government's spin doctors seem pretty confident the issue won't
be given the airtime it has had to date.
There's also a belief that as the strikes continue and the backlog of
patients waiting for operations rises, public support and the appetite of
doctors to continue will drop away.
What is more, behind the scenes, efforts are being made to get the other
two key pillars of the medical profession onside in the drive for more
seven-day services.
An announcement on more support for GPs to help pave the way for
seven-day services is expected soon, while renewed attempts are being made to
reach an agreement with consultants about weekend working (talks have been
going on since the autumn).
Of course, the government's chances of success in both areas is by no
means guaranteed. But it's not that much of a stretch of the imagination to see
how this dispute could slowly fizzle out bit by bit over the coming months
before the new contract starts being rolled out from the summer.
But even if that happens, the government's strategy is incredibly risky.
Why? By winning this battle, ministers could well end up undermining
their long-term strategy as the ripple effect of the dispute could be toxic.
It is a point made by Mark Britnell, a man who knows a thing or two about
health systems.
He worked in the NHS for 20 years, rising to become one of its most
senior executives before leaving in 2009, going on to become head of global
health for KPMG.
"It makes no sense," he told me. "Junior doctors will be
crucial in making the changes the NHS needs to cope with all the challenges it
faces, but they will be demoralised.
"You can't improve services without bringing the staff with you.
This could really set the NHS back."
But it is not just about intangible things such as morale and attitude.
There is a risk this dispute could have a real impact on the numbers staying in
the NHS in England .
Already many junior doctors' posts are not being filled. Last year one in
10 GP trainee posts went unfilled. The situation was little better for A&E
and paediatrics.
Even a small increase in these numbers prompted by medics choosing locum
work, the pharmaceutical industry or working abroad (or just elsewhere in the
UK as the contract is only being introduced in England) has the potential to
cause havoc when more and more is being asked of the health service.
Source: BBC
No comments:
Post a Comment