It’s good to talk – are the BMA playing into Hunt’s hands?

The junior doctor contract pantomime has now been running for a few months, without much progress in the plot.

The BMA calling a strike ballot polarised what is a complex issue. Of course I voted yes-yes, because to vote no would have been tacit agreement with Hunt’s plans.

But that’s not to say that I’m in awe of the BMA’s positioning. Quite the opposite. They have found themselves up against a master politician in Jeremy Hunt, and they’re being quietly maneuvered into an ever-weaker position.

In summary, they withdrew from negotiations many months ago and state that they will only return to the table if the threat of a contract being imposed is lifted.

This makes Hunt’s life easy.

Firstly, it’s an unreasonable demand. The BMA can’t honestly expect him to agree that a contract should only be implemented when both parties agree on all aspects of it. This would effectively give the BMA a veto on everything and a license to make unlimited demands. It’s the employer’s prerogative to implement contracts. The employee’s prerogative is to strike if they don’t agree with the content, but not to strike about the possibility of them being imposed.

Secondly, it leaves him an ultra-easy rebuttal. He can just smile sweetly, ask us again very nicely to come and talk it over like adults and such an enforcement probably won’t be necessary. But if we refuse to talk, he’s oh-so-sorry but the great British public voted for a 7-day-NHS, so changes will have to be made without our help.

All our other demands, the genuine contractual concerns, are totally neutralised by Hunt waxing lyrical about his (minor) concessions so far and the fact that ‘anything is up for negotiation’ if we talk.

We will end up looking like we’re striking against the possibility that a contract might be enforced at some point in the future, while refusing to talk to the man who will have to, as is his right and only option if we refuse to meet with him, do just that. Which is frankly weird. And the public will not understand it.

Wouldn’t it be a better tactic to find a reason to return to negotiations that saves face (perhaps a huge strike mandate?) then use those negotiations to push Hunt, again and again, for the changes we so reasonably want?

This would give us the upper hand. Instead of looking sulky and unreasonable, we’d be giving Hunt a good, solid chance to refuse fair contractual compromises. The public could understand this. Then and only then would it be fully effective to strike.

If Hunt imposes a contract, fine. We can strike about that. And keep striking while negotiating, watching the heat slowly build around him as he refuses again and again to make compromises fair to one of the most trusted professions in the land.

If the BMA could add in some proactive PR – some widely-accessible soundbites on how Hunt’s demands will cause the weak, sick and vulnerable irrevocable damage due to thousands of doctors burning out or flying off to Oz, then all the better. We need to hammer home the narrative that doctors are the NHS, we are all the NHS, and how dare Hunt, that outsider, pick on us when we’re trying to look after eachother. We have to make it look like striking is our last resort to desperately protect those we love from a vicious swindling.

But right now, I’d just settle for standing on a picket line knowing that my representatives were talking to the man able to make changes to my situation – even if just to continually prove that he won’t budge.

 

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About Alex Langford
I am a psychiatrist (now an SpR) based in Oxford after 3 years working in South East London. Before I went into psychiatry, I used to be a general medical doctor, and I also have a BSc in psychology. I'm particularly interested in improving the public face of psychiatry, evidence based medicine, teaching and patient rights. Don't mention cricket unless you've got the next fortnight free to discuss it.

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