If you inherit an organisation which operates on goodwill you have hit the lottery. If your staff routinely start earlier, finish later and work harder than they are remunerated for, you have lucked out. If those people are some of the most qualified and capable in society, who have sacrificed immeasurable personal wealth and time for their careers, you'd better pinch yourself.
Your first point of order should be to whisper thanks to the gods and then do nothing whatsoever to jeopardise your extraordinary advantage. Surely any manager would appreciate this? Not, apparently though, Secretary of State for Health Jeremy Hunt.
Mr Hunt has been in post for three years and in that time has taken a workforce famous for unquestioning allegiance and stamina, who have not balloted for strike action in four decades, to the verge of a mass walkout. He has humiliated them, berated them, misrepresented them, provoked them and still refuses point-blank to negotiate on 22 of the 23 points in his crippling and dangerous new contract.
The group to which I refer are Junior Doctors. We are the 53,000 strong backbone of trainees approaching Consultancy, singled out for vilification by the Health Secretary. We are blowing our whistles en masse with heads of Royal Colleges, Consultants and the BMA, for honest negotiations on the new measures, but Hunt will not concede.
You have probably heard the spin. Hunt wants the NHS to run seven days a week. I can almost imagine people nodding along to that logic. Doctors larking about instead of saving lives at weekends. It might have seemed like the NHS was buckling under the strain of overuse and underinvestment but low and behold it was this all along- apparently all the NHS needed was a further stretch.
We already have a seven-day NHS. Trust me- my patients know, my colleagues know, and my one-year-old daughter knows.
The government claims death rates increase at weekends due to insufficient junior doctor presence. This stems from the fudged analysis of research attempting to correlate staffing with mortality which does not stand up to scrutiny.
Hunt plans to take doctors off full-swing midweek shifts, leaving elective operating lists and clinics dangerously understaffed. Instead, they will work weekends, where without allied services, their capabilities in facilitating elective care are largely ineffective.
Add to this the fact that pilots indicate vast non attendance rates for weekend appointments. That's right- build it, but they won't come.
Training opportunities are primarily sought midweek, so the threat of an under-qualified next generation also awaits. All in all, hardly a safety first strategy.
Earlier this week Hunt announced he was giving us an 11% pay rise. This 11% applies to the first 2/3 of our wage, and the remaining 1/3? He's taken that away. So that's actually a vast pay cut and another grotesquely thumping insult to the intelligence of the British public.
Doctors starting a family or undertaking research will feel further force of Hunt's financial penalties. This is an abominable degradation of all that we value in society. Our longevity is the value for money the taxpayer deserves and we endeavor to serve the public to the age of 68. The new rotas negate the possibility of the 35% of us married to each other arranging regular childcare. This will cause a nauseating lunge as further droves disembark the Kafkaesque merry-go-round that our careers have become under Hunt's watch.
There are a myriad of reasons why Jeremy Hunt needs to think again about this destructive strategy. This roving eyed health secretary will move on, but understaffed marketised hospitals will be his bitter legacy.
He inherited something quite remarkable that shouldn't work, that doesn't add up, but yet has become the envy of the world, in no small part because of that intangible goodwill quality. Goodwill is not some sort of fortuitous adjunct to the NHS, it is its bone marrow. The goodwill is symbiotic and public support categorically serves to minimise litigation, which could otherwise cripple the entire system.
Mr Hunt dilutes this goodwill at his peril. He has transgressed the first rule of being a Health Secretary and its high time he remembered it.
First, do no harm.Suggest a correction