Jeremy Hunt is delusional- his response to the junior doctor strike action ballot proves it

Junior doctors have just voted overwhelmingly in support of strike action in response to the new Department of Health contract.  98% have advocated for proper strike action, and 99% have said they would support everything up to it. And yet, in an interview with BBC News, Jeremy Hunt still places the blame firmly on a militant BMA being unwilling to negotiate over terms:

This is the result of a very regrettable  campaign of misinformation by the BMA over the Summer that’s tried to scare doctors about these proposals, suggesting that they’re going to have big pay cuts. I would urge every doctor before they participate in this strike to actually look at the government’s offer: we are bringing down weekend rates in order to improve cover at weekends, but we’re increasing basic pay by around 11%.

Source: BBC News

In a web worthy of the most hardened conspiracy theorist, the Right Honourable MP has positioned himself as the spider, trying to hold the strands together against the onslaught of brainwashed BMA flies flying towards it. “Don’t worry, I won’t suck the life out of the health service,” he seems to say, “I won’t be cutting your pay, I will just be readjusting how it is delivered into a format that I find preferable. Oh, the professionals don’t agree? They’ve found that none of what I am saying adds up? They must be out to get me.”

Jeremy Hunt has also rejected any notion of conciliatory talks through the Advisory, Conciliation and Arbitration Service (ACAS),  saying that his ‘door has been open for talks since June, and the BMA have refused to engage at any stage with talks’. He tweeted recently that any pre-conditions that the BMA are referring to are completely fabricated, even having the gall to post a link to the letters to the Junior Doctor’s Committee (JDC) Chair in which the preconditions are described.

Back on the 4th November, the JDC Chair Dr Johann Malawana released a statement saying that:

To get back around the negotiating table we have repeatedly called on the government to remove the threat of imposition and provide us with concrete assurances on a safe and fair contract. Today’s announcement falls short on both counts as, once again, the headlines do not match up to reality.

Crucially, the proposals fail to deliver safeguards with real teeth to protect safe working patterns and, with it, patient and doctor safety. Furthermore, the proposals on pay, not for the first time, appear to be misleading. The increase in basic pay would be offset by changes to pay for unsocial hours – devaluing the vital work junior doctors do at evenings and weekends. While, in the short-term, existing junior doctors may have their pay protected, protections will only exist for a limited time.

Source: BMA

So, the JDC was willing to negotiate.

So, there were preconditions to the contract negotiations, including an imposition of the terms regarding pay, which I might again emphasise are laid out in the letters Mr Hunt posted online.

So, despite Mr Hunt’s insistences, there would be substantial effects on doctor’s pay.

So, it’s not all about pay in the first place, there are genuine concerns about the risks placed on patient safety by the new contract.

And he wonders why doctors have exactly zero trust in him?

hunt_2329078b
Clueless. Source: Geofff Pugh (The Telegraph)

I would prefer to give him the benefit of the doubt on this one. All of the evidence points towards a campaign of misinformation, not on the part of the JDC, but rather orchestrated by Jeremy Hunt and the Department of Health. This would all seem to indicate he is being wilfully dishonest; however, I suggest another option.

He genuinely believes everything he is saying, and he genuinely believes that the backlash given to him at every turn over his policies from people in the know is simply because he is poor old Jeremy Hunt, just trying to make the world better. In simpler terms, he is delusional, to the point where it is interfering with his job. He is caught up in the collective Tory delusion that by implementing private sector business practice everywhere, the country can be saved- even when it is demonstrably not working, it is just an element of militant doctors or left-wing malcontents trying to stir up trouble.

I prefer to believe this, because I’d rather he was delusional and incompetent, a man with fingers in his ears, than  to think for a second any of this was done intentionally. Either way, it is completely and utterly apparent that he is not fit for office- just remember that the petition to call a a vote of no confidence in Mr Hunt has, at current, over 225,000 signatures, more than twice the 100,000 for a debate to be held (which consisted of debating the ‘underlying issue in the petition which was started’, i.e. the contract conditions of NHS staff).

In response to Jeremy Hunt rejecting talks through ACAS, the BMA have released the following statement:

It is clear that trust has broken down between junior doctors and the government, which is why we are offering conciliatory talks via ACAS. If it is true that Jeremy Hunt has refused our offer, all he is doing is entrenching himself even further.

This is not just one or two junior doctors who believe that his proposals are unsafe for patients and unfair for doctors. The fact that today’s ballot result is near unanimous should be a wake-up call for the government. Instead of continuing to ignore the views of tens of thousands of junior doctors who, in the health secretary’s own words, are the backbone of the NHS, he should, if he really wants to avoid industrial action, accept the BMA’s offer of conciliatory talks.

Source: BMA

One can only hope that even the upper echelons of the Tory party must eventually take note of the catastrophic failures in the Department of Health, and reshuffle accordingly.

But it’s entirely possible that they are all delusional too.

Why are young working class pupils’ medical aspirations being strangled in the cradle?

The BMA has issued a warning that students from deprived areas in the country may be ‘held back from a career in medicine’, because most medical schools require a GCSE in Triple Science in order to apply. This award was found not to be offered as often in deprived areas, and when it is offered, lower numbers of students applied for it. The BMA have called for all secondary schools to offer Triple Science as a course, for medical schools to consider contextual data (like details about the applicant’s school or where they live) in their admissions, and also for outreach schemes between medical schools and secondary schools to spot possible talent early on.

The Beveridge Report was published in 1942, and laid the basis of the push for adequate social welfare and greater social mobility in post-war Britain. It proposed support 'from cradle to grave'. Source: Wikipedia
The Beveridge Report was published in 1942, and laid the basis of the push for  social welfare and greater social mobility in post-war Britain. It proposed support ‘from cradle to grave’. Source: Wikipedia

I must admit, I don’t remember my own Triple Science classes being that under-subscribed. I went to school  in the Warwickshire town of Nuneaton. Nine areas in Nuneaton are featured in the 10% most deprived communities in the country, according to a report from Warwickshire Observatory from 24th March, 2015. For clarification, I don’t live in any of those nine areas, and I would not refer to myself as deprived by any stretch; however many of the people from my school came from these areas. Students at Higham Lane School (which I attended 2005-2010) were- and still are, as far as I know- offered the chance to do the Triple Science GCSE. Several people I know from school have gone on to medical schools and are currently in training to be doctors, although I would estimate that most of these people did come from middle-class households.

Higham Lane School's website says that they are amongst the top 100 performing non-selective state schools in the UK. Source: Higham Lane School
Higham Lane School’s website says that they are amongst the top 100 performing non-selective state schools in the UK. Source: Higham Lane School

That disclaimer aside, it is important to remember that one anecdotal case does not a rule make. The BMA’s report, ‘The Right Mix: how the medical profession is diversifying its workforce’, found that in the areas of Hull and Newcastle, less than 65% of schools offer the Triple Science course. In Newcastle, only around one in five students were taking the course (18%); in Hull, this was significantly lower, at around one in ten (11.4%). Compare this to Rutland, an area significantly more well-off than those mentioned, in which over a third of students (36.2%) study the subject, which is taught at all schools in the area. 80% of applicants to medical qualifications in the UK come from 20% of the schools, so one must cross their fingers and hope that the next Sir Alexander Fleming hasn’t had the misfortune to be born in Hull (sorry, Hull).

A possible problem is the perception of medical schools by people of lower socioeconomic class. A 2004 study published in the BMJ and co-authored by Professor Trisha Greenhalgh found that opinions of medical school didn’t change much when considered by gender (over half of medical students in 2013 were female) or by ethnicity. Class on the other hand had a significant effect:

Pupils from lower socioeconomic groups held stereotyped and superficial perceptions of doctors, saw medical school as culturally alien and geared towards “posh” students, and greatly underestimated their own chances of gaining a place and staying the course. […] Pupils from affluent backgrounds saw medicine as one of a menu of challenging career options with intrinsic rewards[.]

Source: PubMed Central

The study also found that while both groups were concerned about the costs of study, only the poorer pupils saw it as a factor of constraint.

There is a clear and obvious problem in the country today with the perception of the medical profession. With the current crises of under-staffing in hospitals across the country, it is also a potential time-bomb for the NHS. The recent furore over junior doctors and their salary cuts, along with Jeremy Hunt’s push for an ill-planned 24/7 NHS (as many infuriated medical staff have already pointed out, doctors already work weekends) will likely turn people off the profession, especially potential future doctors from lower socioeconomic backgrounds who, even back in 2004 according to the Greenhalgh study, already considered the profession to require ‘prohibitive personal sacrifices’.

A push needs to be made to attract as many people to the profession as possible from all backgrounds. An anti-propaganda campaign to the Tories’ poisonous rhetoric and restrictive policies towards the poorer community’s ability to study needs to be orchestrated. As well as this (as the BMA rightly says), there needs to be a effort to make these opportunities available and viable for everyone. This involves being outraged by the fact that many students can no longer afford their own rent while studying; this includes providing as much support for reforming the student loan system as possible; this means providing an information campaign directed at pupils in deprived areas to educate them that careers in medicine are in reach, that they are attainable with hard work and dedication, and that the rewards from such endeavours stretch far wider than just financial incentives.

It’s saving lives, at the end of the day, in the most literal sense.