For Junior Doctors, Striking Today Is an Act of Desperation

26/04/2016 08:28

At 7.59 this morning, there was still a minute's grace. Even then, the eleventh hour, Jeremy Hunt still had it in his power to avert today's industrial action. If he'd picked up the phone, told me he'd return to the negotiating table, I'd have called off the strike in a heartbeat. Literally, all we needed was words. Conflicts are defused by talks - we all know this - yet the Secretary of State has persistently dismissed my urgent and repeated appeals to talk. He chose strikes above a conversation. And of all the choices he's made in the last nine months, this, for me, is the most inexcusable. A wilful refusal to explore face-to-face how to resolve the worst crisis that has engulfed the NHS in generations. From a man who insists he cares about patient safety. Talk isn't cheap, burying your head in the sand is.

Jeremy Hunt, as so often in this mess, has again this week used words as weapons, when they are so clearly our only route to resolution. He has insisted over and over that the country's junior doctors are striking for one reason alone - their Saturday pay. He implies today's strike is about grubby self-interest. Worse, he insinuates that the junior doctors you meet in hospital are so self-interested, so money-motivated, that they will deny you care on strike days to bump up their future pay packets.

That is as spectacularly insulting as it is far from the truth. If junior doctors cared about getting rich quick, they'd have chosen a life in the City, not medicine. Like everyone who works on the NHS frontline - our nurses, physiotherapists, midwives and more - junior doctors give their all at work, because their all is you - our patients. Everyone knows that the NHS, battered and broken by underfunding, runs on the goodwill of its staff. Everyone, except perhaps the Secretary of State, who for the last nine months has thrown that goodwill right back in the faces of junior doctors.

Let me be crystal clear. Contrary to Jeremy Hunt's spin, 90% of the contract is not agreed. Saturday pay is not the only sticking point. The Secretary of State has virtually admitted that over the weekend in his letter to Mark Porter. The contract is riddled with problems from top to bottom. With inadequate safeguards against punitive hours, it puts doctors at risk of working excessive hours - which in turn puts you, our patients, at risk. With no additional funds or staff to deliver new weekends services, it stretches a workforce already on its knees even more thinly still. With no concept of what life is like on the frontline, it generates rotas of rapidly-cycling nights and days that will leave doctors too tired to think straight. In short, the contract is a dog's dinner, dressed up in fine words, that threatens patients and doctors like.

But perhaps most destructive and dangerous of all, is the government's act of imposition upon junior doctors whose opposition to the contract, as Jeremy Hunt well knows, is based on their deep-seated convictions that it will in the long term harm the NHS and threaten their patients. Imposition is not how to manage a group of highly-skilled professionals. It serves only to alienate and demean.

The most basic principle of industrial relations, when making institutional change, is to try at all costs to bring your workforce with you. That is particularly true when the institution in question is infused from top to bottom with compassion, kindness, generosity and goodwill. Governments rarely quantify what really makes the NHS tick. There are no performance indicators for compassion. But caring is priceless, and utterly essential for the NHS's future. You stamp out caring at your peril.

A lesson that will hopefully be learned for a generation to come, when dealing with a workforce, the opening gambit of your nuclear option underpinned by questioning their professionalism and commitment, is not the way to deliver reforms. It is not the way to motivate and it is not the way to deliver anything but the worst industrial dispute the NHS has ever seen.

Doing battle with the junior doctors, smearing them, ignoring them, trying to silence them, is the perfect way to obliterate goodwill and turn kindness into jaded disinterest. A generation of junior doctors is desperate here. Striking is an act of desperation. Jeremy Hunt claims he supports NHS whistleblowers. Yet now, faced with 54,000 of them, he's using every trick in the book to silence them. The hypocrisy is breathtaking.

Johann Malawana is the chair of the British Medical Association's junior doctors committee