Yesterday was a very sad day and one I never thought I'd see as a doctor. Many have called it the beginning of the end for the NHS. For several months, the junior doctors have been locked in heated dispute with the Health Secretary, Jeremy Hunt, regarding proposed changes to the junior doctors contracts – which involves changing Saturdays, Sundays and evenings to normal working hours. Hunt claims this will form a seven-day NHS but the reality is that the NHS has always had a seven-day service, with full staffing for emergency and in-patient work. What Hunt is asking for is routine work, such as non-urgent procedures and outpatient appointments, to be done at the weekend. Doctors have never been opposed to this, but they are very concerned that taking staff away during the week to cover the weekend will result in unsafe staffing levels and poor quality of care. The ideal solution would be to increase numbers of staff, but this would not be possible on the current budget. Hunt initially refused negotiations but after the public backlash, returned to discussions. Then yesterday, he announced that as negotiation had not succeeded, he would unilaterally impose a contract on junior doctors against their will. What worries me most about these events is the conspicuous silence of our Prime Minister. Despite being well acquainted with what the NHS has to offer, the PM has been entirely happy to let Jeremy Hunt take all of the blame for the current crisis. Hunt is an ideal pantomime villain with his comedic facial expressions, consistent refusal to acknowledge that the "weekend effect" he keeps quoting is scientifically inaccurate, and his mockable use of invented terms such as "danger money" that no one, not even the NHS workers who supposedly receive these funds, has ever heard of. But this little pantomime has a very stealthy puppet master. It seems to me that the Conservative government have bided their time in their longstanding agenda to privatise the NHS. Having seen off the Miliblands and apparently confident that Jeremy Corbyn is simply too left wing to win voters, now was the ideal time to unleash an unpopular attack against one of the central pillars of UK equality: our free health system. The junior doctors will of course appeal. Some will leave the NHS but most have families to support and have little choice. They are hurt, demoralised and feel attacked as a caring profession.
The contract will no doubt result in reduced applications to medical school and an even smaller number of junior doctors in the next few years.
The contract will undoubtedly result in reduced applications to medical school and an even smaller number of junior doctors in the next few years. The staffing crisis will only intensify. Next they will presumably attack the contracts of the nurses, physiotherapists, paramedics and so on; the student nurse bursary is already under threat. Finally, having alienated all front line staff, it is my belief that they will declare the NHS a failure and champion private health care. And the contract imposition has even greater implications. Forcible imposition of a measure widely described as 'not fair and not safe' on NHS staff is a crime against democracy itself. Rather than decision by referendum or parliamentary vote, it seems we are back to the dictatorship model of 'one man, one vote'. Personally, I think the Prime Minister has a lot to answer for. He has ignored a heartfelt plea from the consultant body at Great Ormond Street and he has dismissed countless warnings from the frontline NHS staff. There's also been a conspicuous absence of coverage in right-wing newspapers of the junior doctors strike, and a blatant focus on individual stories of patients whose routine appointments were disrupted by the strikes. It remains to be seen if this puppet master has the integrity to come out of the shadows and acknowledge his true plans for the future of our health system.