Sunday, 15 January 2017

Dear Mrs May ... We need to talk about the NHS



 This letter is sent to you with good intent, with no political bias. Although I have been a Tory voter for most of my adult life, when I was working in the NHS during the 2010 election, I felt that a labour victory would have been poor for the economy but preferable for the NHS. I believe that the two previous Labour Health Secretaries, Alan Johnson and Andy Burnham understood our state funded health system while their two Tory successors, Andrew Lansley and Jeremy Hunt, have done more harm than good.
 
I fear that during your short tenure as Prime Minister so far, you are getting it terribly wrong when it comes to a service genuinely under severe pressure and I have some very simple advice for you – so please take note:
 
Avoid mixed messages: In your first speech outside No.10 just after accepting the Queen’s direction to form a new government you channelled a mix of Mother Teresa and the three musketeers with your commitment to make Britain a ‘country that works for everyone…. Do everything we can to help anybody, whatever your background..’ Maybe you were trying to emulate Margaret Thatcher as she quoted St Francis of Assisi’s prayer when she came to power, but like Maggie, you appear to have quickly turned from school welfare officer to Headmistress. This is not always a bad thing – as long as you still have the welfare of our community well in hand but this doesn’t seem to be the case.
 
There is no quick fix for the NHS: But something does need to be done as a matter of urgency. You need a short, medium and long term plan. It is vital that primary, secondary, tertiary care and social services are all linked but we know this is a highly complex process that will take time. Resources need to be increased at every stage of the patient pathway (including prevention to stop them becoming a patient in the first place) as each area is of equal importance. In the short term you must..
 
Admit there is a crisis: If you don’t believe doctors, nurses, NHS managers or even patients and their relatives – look at the statistics. The targets for  Accident and Emergency departments and hospital waiting lists are reasonable and achievable in an appropriately resourced facility  but if a hospital is short of staff (clinical and administrative), beds, equipment or places to safely transfer patients within the community, they will start to miss targets as a matter of routine and this is happening. Now.
 
   Austerity and a state funded health system don’t mix:  Service improvement and efficiency
   measures can help but they are not enough. Choose your metaphor – the dead horse has been   
   flogged, the blood has been squeezed out of the stone, the NHS has streamlined its services and
   yes there is room for further improvement, but additional resource (funding) must be made
   available. We are already lagging behind many of our neighbours on % GDP spent on health and
   last year in his article on health spending the Kings Fund’s Chief Economist, John Appleby placed
   the UK at 13th out of the original 15 EU members. Like it or not – we may have to accept an
   increase in tax to allocate additional resource where it is vitally needed.
 
   Don’t ignore private healthcare: Subcontracting to local private facilities is already assisting
   some NHS Trusts with capacity issues and are a realistic option to be considered by clinical
   commissioning groups. As I am sure you are aware, for example, hip replacements undertaken in
   a nearby private hospital with spare capacity can be a cost effective way of freeing up local NHS
   beds  for trauma cases and ease pressure on A&E. This is not privatising the NHS and is not a long
   term fix but it can certainly help in the short term. And how about reducing insurance premium
   tax on health insurance subscriptions – do you really want some of the 10.6 million people with
   private health insurance to relinquish their cover and put even more pressure on the NHS? It is
   their right after all.
 
If you don’t trust your Health Secretary, choose a new one: It seemed strange that when forming your cabinet last year you missed an opportunity to remove an unpopular Health Minister and introduce a new era of cooperation with a carefully selected individual who could build bridges and work with key decision makers within the NHS. Instead you seem to have taken on the role of health spokesperson yourself, unhelpfully berating GPs and making sweeping statements that suggest that you don’t really understand the key elements of the service. I would assume that you will be pretty busy with ‘Brexit means Brexit’ and would respectfully suggest that you either give Jeremy Hunt back his mandate or pick a new Minister. If you are going to continue to make statements about the NHS then please…
 
Listen: …To those that are in the know, even if you don’t like what you hear. Organisations like the independent think tank, Kings Fund, people like Simon Stevens, Head of NHS England, Clare Gerada, and Helen Stokes Lampard, former and current chairs of the Royal College of General Practitioners, Janet Davies, Chief Executive of the Royal College of Nursing. The list is endless – and these people know what they are talking about. Trust them
 
Watch: Forget Sherlock or Call the Midwife, if you only watch one series this year I beseech you to tune in to BBC2’s exceptional documentary, Hospital. The first programme provided a level, calm but absolutely no-holds-barred view of what it really is like to work in a major Hospital Trust. After I watched the programme, I wept tears for not the patients – who without doubt received excellent care, but for the wonderful clinical staff, managers and administrators who work under almost unbearable pressure every day. On second thoughts – maybe you should watch Call the Midwife which shows how health and social care was before the state system was properly funded..
 
 
And finally…
 
Apparently you want your legacy as PM to be more than overseeing Brexit. Please make sure that your legacy is not that you were in charge when the NHS finally ceased to be fit for purpose.
 

Friday, 25 November 2016

The prudent should be rewarded, not penalised.



I was at The Association of Medical Insurance Intermediaries (AMII) summit just a stone’s throw from The Houses of Parliament when the news about the 2% increase in Insurance Premium Tax (IPT) broke. A financial journalist told me – but I didn’t believe him and thought this must be a rather poor joke. Three increases on a tax on essential services in 15 months? Surely not! But yes – Philip Hammond with his Autumn statement has hoodwinked the public into believing that this increase will have little personal impact on them. This is without doubt a major stealth tax.

Even the BBC played down this tax in their evening news bulletin stating that IPT applied to ‘cars, homes and some possessions’ A bit more than that I fear.

Let’s start general insurance. Motor insurance is mandatory so when then increase comes into force it will have an immediate impact on all drivers and owners of vehicles used for personal and/or commercial purposes. What isn’t mandatory is the level of cover required as long as the minimum third party liabilities are insured. Likewise with home and contents insurance, some mortgage providers insist on buildings cover but the rest is down to the owner/tenant’s discretion. Theresa May’s government purports to supports the JAMs (those ‘just about managing’ – an unfortunate acronym for so many reasons) but these are the very people who could be hit hardest by increasing insurance costs. Insurance is not a luxury – it is a necessity and ‘JAMs’ may be tempted to scrap cover or purchase inadequate levels which could ultimately lead to significant hardship. Insurance roulette is a game that no-one should have to play.

It would appear that Mr Hammond is penalising the very behaviours that he wishes us to emulate – prudence. Instead of being encouraged to forward plan and avoid risk, the prudent who take appropriate insurance cover will end up with lighter pockets thanks to this uplift in tax– not good.

But the area that is being ignored is the impact of increased IPT on private medical insurance (PMI).  Yes – it does apply to corporate and personal PMI premiums and no – the government does not offer any incentive to those who contribute to the cost of their own health care threefold – once through taxation to fund the NHS, once through their premiums if self-paid (or through benefit-in-kind taxation if company funded), and again through IPT.

At the AMII conference on Wednesday insurers, intermediaries and the well-informed were all reeling at the shock announcement. Ironically just a couple of hours previously we had been discussing the role of private healthcare in the UK and the value it can deliver in supporting the NHS. The levy on PMI premiums had been described by one speaker as an ill-conceived taxation.

Currently 10.6% of the population in the UK are covered by some form of private medical insurance. Yes – 10.6%. The independent healthcare sector is worth in excess of £40bn annually – not to be overlooked. Putting political shenanigans aside such as comments on ‘the privatisation of the NHS’, detractors of the private healthcare industry should consider the support that the sector can and does provide to the NHS. While the vast majority of us want to see additional investment for the state funded system, in the meantime capacity issues and waiting times within the NHS are now increasingly alleviated by subcontracting into the private sector. The reduction of waiting time for ‘cold’ but nonetheless essential surgery such as hip replacements can make a huge difference to NHS patients.

Any increased taxation on the insurance that funds the majority of private patients can only have a negative effect on this industry sector as a whole. But there could be a more immediate and potentially catastrophic impact of this increased taxation. While I have faith that the PMI industry is sufficiently robust to cope with this latest setback, there can be no doubt that a 2% uplift in tax applicable to premiums will send some individuals and corporate customers to decide that their PMI is no longer affordable. Indeed one insurer I spoke to said this could be their ‘tipping point’ for individual PMI.

And who will be the individuals who opt out of private cover due to rising costs? They will be the over 50’s – those who are starting down the slippery slope to increased healthcare needs. These healthcare needs will have to be met by the already creaking NHS which could potentially face a flood of patients who previously would have been treated in the private sector. Add to this the number of corporate PMI schemes that may shrink – possibly only covering management or senior staff, and Philip Hammond may be creating a perfect storm to further compromise an already bloodied and bowed public offering.

Sadly, after many discussions with Members of Parliament and political commentators over the past few years, I must accept that there would have to be a huge shift in public opinion before any government would risk supporting investment by individuals and companies in private medical insurance. In these troubling times of ‘pitchfork politics’ unfortunately no political party has the courage to adopt this wise and pragmatic approach. Instead, by missing the bigger picture, the Chancellor has inadvertently dealt a potentially highly damaging blow to the much loved NHS.

A sustainable solution for healthcare in the UK must include an understanding of the fine balance to be achieved between the public and private sector, along with an appreciation of the insurances required to facilitate access to paid care.

 

 

Sunday, 9 October 2016

Frailty thy name is woman?



There were two significant stories about attitudes towards women in the news yesterday. The first most newsworthy reportage was regarding the ever charming (not) Neanderthal US presidential candidate Donald Trump’s tactics for hitting on attractive women.  (*shudder*) The other, less sensational report hidden in the middle pages of yesterday’s Daily Telegraph was the comments by Lady Barbara Judge, who stated that long maternity breaks are bad for women as they may lose their jobs.
Although the thought of Trump as president chills my blood, it was actually Lady Barbara’s comments that caused me far more offence. Lady Barbara is the current Chairman of the Institute of Directors (IoD). The IoD website proudly states that their new chairman was once described as the best-connected woman in Britain, …… has had a long and very distinguished career in law and banking before becoming the IoD's first female chairOh dear - it does bother me when any report uses the phrase 'first female' - when will the powers-that-be rate an individual on who they are and not the number of X or Y chromosomes they sport?

I am a member of the IoD and am also proud to be in their Policy Voice group which is canvassed regularly for views on current legislation, business issues and working practice. These views are shared with the relevant government ministries and I gain great satisfaction from knowing that my opinions are noted in the corridors of power. Never does the questionnaire ask me my gender – as quite rightly this simply is not significant.
 
The article in the Daily Telegraph was reporting on Lady Barbara’s keynote speech at The Wealth Management Association’s Women in Wealth Forum when she claimed that she took just 12 days maternity leave when her son was born. She should be neither proud nor ashamed of this fact but grateful that she had choice. And this is the key point – despite Lady Barbara’s view that maternity policies in the UK mean that women may ‘come off the tracks’ – paid maternity leave gives mothers choice. They can choose to take the paid benefit, they can choose to extend the period of leave further and they can then choose to return to work. This choice is not always driven by financial need but also an emotional and personal decision. Yes of course any absence from a job for any reason has its risks –the highest being that the absentee may not have the appetite to return to their respective coal face. However in my experience, although re-integration can be challenging and the pull of a small person at home heart-rending, many women return from maternity leave with a renewed vigour for their role and a pragmatic approach to business that can have the net effect of improving performance.
The article goes on to report that Lady Barbara believes that American law where companies with more than 50 employees are only obliged to pay 12 weeks of unpaid leave is better than the British system. Lady Barbara may believe that current employment law allowing up to a year off, with 39 weeks paid absence is over-generous to women but is she really advocating that we go back to those dark days when a woman had to choose between being a mother or having a career? As she is the ‘front man’ for the IoD, I truly hope this is not the case.
 
It is interesting to note that the Women in Wealth Forum, where this controversial view was aired, make no mention of these comments in their press release outlining Friday’s event. Instead and perhaps even more surprisingly, they focus on Lady Barbara’s comments regarding appearance: “70 per cent of first perceptions is based on how you look, 20 per cent is how you sound and only 10 per cent is based on what you say. When you walk into a room, you can't make a second first impression and so you want to take charge of other people's impressions’. I have seen and heard this charismatic, intelligent woman speak and she gives off an air of wealth and privilege, which in itself is not necessarily a negative thing, but she also possesses the sheen of a bygone era and sadly it would appear that her views echo this impression.
 
I admire Lady Barbara’s courage in voicing a potentially unpopular view but feel that this does not help the case for family friendly workplace policies. The biggest challenge facing most businesses is finding and retaining the best skill mix to keep the business moving forward. Appropriate employee benefits and fair workplace practices are absolutely crucial in maintain this skills base with their associated intellectual property.
 
Interestingly again – the Wealth Forum’s purpose is stated as ‘Perception, tackling unconscious bias and creating a flexible culture discussed as key issues for Women in Wealth Management’. ‘Flexible culture’ resonates….
 
Apparently Lady Barbara quoted her mother who, (in the 1950’s I suspect) said ‘When a baby is born it needs to be fed, bathed and diapered. An 18-year-old girl can do that. Your job is to get the money to pay the 18-year-old girl. When you have to be there is when the child gets smarter than the nanny’.  Ouch
I believe that the most important message for any woman (or man for that matter) in business is to aim high, do your best and believe that you can achieve anything you put your mind to. This is irrespective of whether you take a career break for whatever reason. This was the message that my mother gave me and the one I have passed in to my daughter.
I very much hope that the progress that women have made over the last few decades in achieving work life balance, raising families and pushing through the glass ceiling (yes – I admit it still exists) will not be hindered by the archaic views of a minority.
 
 

Saturday, 9 July 2016

Motherhood,business and politics


Motherhood, business, politics.
I can identify closely with each of the above, yes, I’m a mother, a businesswoman and I am fascinated by politics. But there are other, possibly equally important aspects of my being –sports fan, widow, comic (I think I’m very funny sometimes), writer, friend….

Tory leadership candidate Andrea Leadsom’s faux pas in trying to attack her opponent Theresa May on her childless status in her recent Times newspaper interview is at best tactless and insensitive and at worst (hopefully) political suicide.

Or will it be political suicide? How many ‘yummy mummies’ will see this as a good enough reason to favour an apparently inexperienced chancer with a flexible attitude to truth over a heavyweight cabinet minister with nearly two decades in top tier politics.

I have had the privilege during my career to have met and worked with some phenomenal women, and their motherhood status has never been a consideration. Please judge us by what we do, how we behave and not our fertility or desire to reproduce.

I am becoming increasingly weary with the martyr approach to motherhood. Firstly being a mother is a gift – a precious gift – but not a badge of honour. There are hordes of women who ache to be mothers but for a variety of reasons this has just not happened. Most of these women live fruitful, fulfilling and happy lives. There are equally as many women who have chosen not have children yet find themselves unreasonably having to explain their decision – often to strangers who have no right to ask the question in the first place.

Leadsom’s premise that having children makes her care more than her opponent about the future of the country is, in my opinion, offensive and erroneous.
The motherhood mafia is epitomised by the website Mumsnet. While I concede that this site offers support and help for many mothers, the core of this concept is that motherhood is especially challenging. Yes, it can be tough, but no tougher than climbing the greasy pole in the workplace, managing a difficult relationship with your partner, caring for an elderly relative, coping with a needy friend, juggling finances and every other rose petal or thorn in the pot pouri that is life.

A quick glance at Mumsnet today offers the following headline,  ‘Does anyone else not enjoy the newborn stage?’ Duh? Does anyone enjoy interrupted nights, your precious little bundle regurgitating his or her food over your shoulder just as you’ve changed into your best top, stinking nappies etc etc? But does anyone enjoy that first smile, gurgle, giggle, look of wonder at the world around them? Of course you do – it all goes with the territory – it is nature and it’s nothing new. So please get over it.
Another section of this site for mothers advises the readers how to ‘survive’ a car journey with toddlers. Survive? Are we being just a touch dramatic ladies?

Possibly the most annoying section of the motherhood community is those mums in cafés and restaurants who feel that it is necessary for some reason to speak to their little darlings just a few decibels higher than is really necessary, while parking their designer buggies right in front of the exit or route to the loos. Loosely translated their high pitched meanderings come across as ‘look at me – I’ve pro-created’

I don’t care if the next prime minister is male or female, married or single, gay or straight. What I do care is that they are the best person for the job, that they will have integrity and demonstrate the ability to negotiate and lead. Most of all, the successful candidate should not try to take personal credit for some good fortune that nature has bestowed upon them.

And a final word for Ms Leadsom – if you are successful in leading the Tory party – you’ll need to build a good relationship with one of the most powerful and respected women of this millennium so far – Angela Merkel, Chancellor of Germany. Oh – and you might want to take note – Ms Merkel has no children.
 
 


Sunday, 10 April 2016

Employee engagement is all about Love.


‘Employee engagement’ has graduated well past jargon to an acceptable and valuable measure linked to productivity in the workplace. But what does ‘engagement’ mean – and how can it be quantified?

If you are seeking awards or hope to tick the engagement box then there is a plethora of questionnaires and benchmarks to use. But employers should really go deeper to assess not only engagement but the emotional intelligence and culture of the company. In short – employee engagement should not be measured in isolation and employers should be clear not only what they are measuring but how they intend to use the information gathered to achieve ideal relationships.

The CIPD (Chartered Institute of Personnel Development) has produced a variety of papers on the subject and quote a definition from Utrecht University stating that work engagement has three elements:
  • vigour (energy, resilience and effort)
  • dedication (for example, enthusiasm, inspiration and pride)
  •  absorption (concentration and being engrossed in one’s work)
mmm – not sure how helpful that is..

The CIPD also states that ‘positive relationships are evidenced with profit, revenue growth, customer satisfaction, productivity, innovation, staff retention, efficiency and health and safety performance’. Perhaps this is a little more helpful definition– but it doesn’t really reach the heart of the matter. A company can measure highly on all of the above but may not necessarily have a team of ‘engaged employees’. You can have accompany car park full of high performance cars owned by a successful sales team – but could they be even more successful or maybe the performance is unsustainable? How much do they actually care about their customers and colleagues?

At the risk of sounding fluffy – I believe that true employee engagement is about love. Passion for your job, care for your colleagues, love for the company and an emotional investment in your customers. And this is where the measure of engagement should start – with your customers – do they feel the love?

Kevin Kruse, a contributor to Forbes magazine refers to employee engagement as ‘a feeling’ and he compares corporate relationships with ‘the quantity of love you may have for your spouse’ He goes on to say that although you cannot truly quantify love, maybe you could use the five point Likert scale (1- strongly disagree to 5- strongly agree) to rate the key relationships. For example: A person deeply in love is …

Ø  More likely to brag about their partner (employer) than someone who isn’t in love
Ø  More likely to tell their friends (colleagues and customers) how good their relationship is
Ø  Less likely to fantasise about ‘hooking up intimately’ with another person or think about divorce (talking to a head hunter or seeking employment with a competitor)
I would add another measure to this list – they are more likely to act in ‘loving ways’ (helpful, positive) with their customers and colleagues.

I have been reminded of the damaging the lack, or loss, of love can have on relationships with customers twice over the past couple of days. A friend of mine was referred to the Accident and Emergency department of an NHS hospital the other day. Heavily pregnant, she was in a potentiallybut not imminently urgent situation and accepted that a certain amount of delay and hanging around would be involved. But what she wasn’t prepared for was the ill humour of the doctors. She was seen by several of them during her 7 hour stay during which time they were professional and undertook the medical investigations required but, in the words of my friend, ‘all had faces liked slapped a*ses’. Yes – they are royally p*ssed off with the current contract debacle and the lack of love they are feeling from their employer is translating directly into the emotional intelligence of the group and therefore the customer (patient) experience.

How sad that so much goodwill has been lost and I wonder how long it will take for that group of employees to become re-engaged. In the meantime, patients may not suffer clinically but they certainly won’t have such a good customer experience because of this lost love.

A more trivial example of poor employee engagement was clear at the restaurant I visited with my family for a birthday celebration on Friday night. One of the top veggie restaurants in London and only Michelin-listed one around, we were expecting exemplary service and great food. Alas we had neither. Luckily we were in good enough spirits (both metaphorically and literally) not to let the unhelpful and grumpy waiting staff spoil our evening. But on refection the lack of warmth we encountered was shocking. One of our group does not like dairy but every one of the main courses involved whey, curd, yoghurt or even ‘sheep’s milk’. When we asked if she could perhaps order two starters, and maybe have a larger portion of one as a main course she was told ‘No’. And no alternative was offered. There were plenty of staff around so we can assume that this waitress was not over-worked but she just didn’t care enough about her job, her employer and certainly not about the customer, to make any effort to enhance our experience. Maybe the employer doesn’t even care enough about the customer either to ensure that the staff offer good service. So there was very little love around (apart from our table of course).

I was sufficiently disappointed to be galvanised into placing a negative review on trip adviser in an effort to avoid other customers being disappointed. A clear example of how lack of caring for the business or the customer could have a detrimental effect on the bottom line.

An employee’s relationship with their employer is one of the most important relationships they ever encounter and companies should make every effort to ensure that this is healthy and positive and two-way.

The best way to ensure great customer satisfaction and employee engagement is to make sure that in the words of the song, each team member should… ‘Love the one you’re with’.

 

 

 

Saturday, 2 April 2016

The living wage – it's not just about salary.



Increasing the minimum wage payable in the UK for those of 25 years and above must be a good thing. I’m not convinced by the age criteria though – how can it be right for a 20 year old and a 26 year old to be doing the same job but not earning the same income? I do wonder if age discrimination could apply here – a test case just waiting to happen methinks.

But minutiae aside – how is the legislation making a 'living wage' mandatory going to affect the employment landscape in the UK? Employee benefits consultants and healthcare advisers will have some larger clients operating in a variety of sectors, some of whom may feel a significant financial impact of this uplift in their wage bill. Who will ultimately pay for this?

This new legislation reminds me of the introduction of the Patient Protection and Affordable Care Act (PPACA or ‘Obamacare’) in the US in 2010. I attended several conferences across the pond where employers and benefits providers discussed this in great detail. The difference between PPACA in the US and ‘Living wage’ in the UK are that the first introduced a mandatory level of health care benefit to be funded by employers and the second is a mandatory level of pay. Both initiatives have the effect of compromising funds available to be spent on a section of the workforce.

As ‘Obamacare’ was introduced there was much bluster for the food and beverage industry – with one spokesman stating ‘This could bankrupt America’ – of course it hasn’t.

In the US, employers found ways of getting round this increased benefits bill which was estimated at being between a 6% and 10% uplift in costs. After Supreme Court challenges against the Bill failed, industry bosses changed employment practices – swapping full time employees for more part time staff (to avoid the minimum number of full timers required for the Act to apply). Salaries were subjected to downward pressure to offset the healthcare benefit costs. One study undertaken 6 months after the introduction of the PPACA showed that rather than charge the cost of the uplifted benefits bill on to customers, 46% employees found a way to pass the increased expense to the employees and only 9% companies absorbed the costs via their profit margin.

Interestingly, in another survey, a large number (44%) of enlightened employers actually planned to increase their health management and wellbeing programme spend in an effort to reduce the claims on the mandatory health insurance, and therefore reduce premium cost.

This brings me back to the UK and my main area of concern regarding the living wage which is the impact on employee benefits. While of course supporting a living wage for all, I fear that something else will be sacrificed to balance employment costs.

Corporate healthcare benefits such as cash plans (offering reimbursement of a range of health related services) has enjoyed a period of dramatic growth over the past decade – 12% in 2014 - as companies provide this low cost, but much appreciated benefit to entire workforces including ‘lower paid’ staff. It is estimated that there are currently well over three quarters of a million employer paid plans currently in place. Company paid private medical insurance schemes account for over 75% of the UK PMI market and corporate dental plans continue to be highly popular. Those covered by a company paid life insurance, critical illness and income protection schemes has also grown by 1.25 million over the past five years.

Put simply – good health is good business. A well-designed healthcare benefits plan protects the health, wellbeing, and engagement of employees –and therefore productivity of the workforce.

So employers please take note. Cutting employee benefits to offset the increased wage bill due to the living wage could be false economy. Investment in health is money well spent.

 

Monday, 28 March 2016

Jeremy Hunt may win the battle but he will lose the war with the Junior Doctors


 Come on Jeremy – take a leaf out of George’s book.

One good thing has come out of the recent welfare budget debacle. George Osborne   demonstrated how a government minister can quickly change their mind in the face of irrefutable arguments against a bad decision.
 
Oh if only Jeremy Hunt would do the same thing. The junior doctor’s opposition to the Health Secretary’s new contract has now reached a previously unthinkable stage as they plan a ‘full withdrawal of labour’ between 8am and 5pm on April 26 and then 8am to 5pm on April 27. This conflict must stop – and it is down to Hunt to make the pain go away.

I use the word conflict advisedly – this is much more than a dispute  now – it is more akin to a bloody civil war – where the blameless victims are anyone who may need the state health service now or on the future. And maybe the doctors are victims too. When the arguments started in earnest around this new contract in 2014 I felt sure that clinicians wouldn’t jeopardise the wellbeing of their patients, and as a healthcare professional myself, felt that I could never condone strike action. But two years on – no-one can doubt the strength of feeling among these doctors and their desperation that has lead us to this sorry state.
 
Hunt insists that the doctors ‘don’t understand’ the contract. Come on Jeremy – it may have escaped you, but you actually have to be pretty intelligent to become a doctor. The British Medical Association doesn’t just employ doctors, they will have had lawyers look at the contract too – and I am confident that they do understand it. And they don’t like it. Never will.


I have been privileged to have worked alongside many junior doctors and have been treated as a patient by several too and I have never come across a lazy doctor. They work their butts off. They care about their job, they care about their patients and they always do more than their contracted hours. Yes, there may be some need for cost cutting and reshaping in the NHS but if you are going to bash anyone- do not bash the doctors.

 
 
Savings must be found elsewhere and the planned changes to the NHS working week must be reformulated. If the doctors do finally give in - which is clearly what Jeremy Hunt believes they will do – he won’t have won. The battle will be momentarily over but the war will still wage. In a great little memoir on power – Robert Greene states ‘Any  triumph you think you have gained through argument is really a Pyrrhic victory: the resentment and ill will you stir up are stronger and last longer than any momentary change of opinion. It is much more powerful to get others to agree with you through your actions, without saying a word. Demonstrate, do not explicate’
 
 
So Mr Hunt, take heed. Please do not beat these hard working, dedicated decent human beings into a grudging submission. Less of the explanations, more of the demonstration. Withdraw the contract – redraft another one in close association with the BMA – and then everyone can get on with what they do best – looking after patients.