In this junior doctors row, even real doctors can become spin doctors.


Dr Sarah Wollaston is Conservative MP for Totnes and Chair of the Commons Health Committee. She is a former GP and teacher. Her daughter, a junior doctor, left the NHS last year with 8 of her friends to go to Australia. She has consistently voted in favour of easing restrictions on private companies to deliver healthcare in the United Kingdom:

Dr Wollaston has penned a “balanced” piece for The Guardian, looking to apportion blame for the junior doctors strikes on both the government and junior doctors:

This attempt is about as impartial as Bill O’Reilly’s “No-Spin Zone” programme on Fox News, with a combination of subtle spin and phony ignorance.

Here is a dissection of some key points in her article:

“Sick people seem an afterthought as the government and the BMA pursue an unnecessarily toxic debate”

No they don’t, the BMA and junior doctors’ entire motivation is to safeguard the future of care in this country.  The BMA are well-supported, but if anything much less powerful than other doctors’ unions around the world.  This has come about following years of erosion and in-fighting. If anything, junior doctors are upset that the BMA have not been going far enough:

“Many of my daughter’s colleagues are not planning to join her on the journey home next year and there has been a marked increase in the numbers applying for certificates to work overseas.”

I wonder why?

“The dispute looks set to erupt into a dangerous full walkout by junior doctors. The British Medical Association claims that the contract will harm patients by stretching doctors too thinly across seven days while reducing their take-home pay. The government insists that patients are being put at risk by understaffing at the weekends and that the contract reduces doctors’ maximum hours and consecutive shifts while increasing basic pay by 13.5%.”

She knows better than anyone that net pay will go down for many, yet uses the same smoke and mirrors technique used by her colleague Jeremy Hunt meant to fool the public – “increasing basic pay by 13.5%”. She is being disingenuous here because anyone who has looked at the contract knows that out-of-hours pay is cut significantly so net pay is down for many fields, especially emergency ones.

And how could the government set up the world’s first and only routine national health service when it has been reducing funding for the NHS since it took power?


“It seems to me that the contract is more about the manifesto commitment to a seven-day NHS and the perceived barrier of premium Saturday pay rates”

Well no argument here.

“Mine was the last generation of doctors to endure crushingly unsafe 120-hour working weeks and I have no romantic nostalgia for the 72-hour shifts commonplace in the late 1980s”.

But we have her on record insinuating that “doctors today shouldn’t complain, we had it worse in our day” and this is the crux of her emotion when it comes to this issue – she doesn’t think these unsafe hours are “all that bad” compared to what she went through. A former doctor who has this kind of attitude should not have this role, because they are using their own personal experiences to influence their judgment. There are many doctors much more experienced than her who had it a lot worse and know that this logic is at best irrelevant (the world is different now), at worst dangerous.

“Pressing ahead with a full walkout however, will serve only to harden attitudes and solves nothing. Most importantly, it will be disastrous for patients”.

New Zealand had a full walkout for 4 days a decade ago – patient waits were shorter, and emergency outcomes were better when staffing was only done by consultants and staff grades. It achieved the desired effect perfectly as New Zealand vastly improved its junior doctor contract, halting an exodus to Australia and attracting hordes of British doctors (when the net flow was previously the other way round).


“How can it be argued that patients will be safer only if all Saturdays are paid at the premium rate, however infrequently worked? Given the scale of concessions and protections on maximum hours and consecutive shifts, the BMA could have declared victory and moved on to focus on the deeper and longstanding causes of discontent.”

More spin – No one is saying this. And also this isn’t about some childish notion of “victory”. Furthermore, do you not think protections against tired doctors aren’t a worthwhile concession? Or do you want your daughter returning from her jaunt in Australia working unsafe shifts?

“Many more of their duties could be shared with others such as pharmacists, physician associates and admin staff”

Well in many hospitals we are seeing physician associate posts advertised (with salaries twice those of junior doctors) but the erosion of junior doctors’ work to become what it is today has happened over two decades now so this is going to take a long time to fix, and people like you who have taken roles in politics should have been coming out a long time ago.

“In some hospitals, such as Salford Royal in Manchester, electronic patient records are finally reducing the scandalous waste of time and resources that come with duplication and paper trails.”

In other hospitals such as Addenbrooke’s in Cambridge, electronic patient records have cost hundreds of millions and effectively bankrupted the hospital, introduced too quickly and with many, many glitches, effectively slowing down and losing continuity for patients.


“A constructive relationship between doctors and government will take time to rebuild; it cannot be imposed and it will not happen unless both sides put patients first and start listening. Saving lives must take priority over saving face.”

And as someone who is a former doctor and part of this government, you should practice what you preach and not keep coming out with this spin (feigned under the guise of a balanced inbetweener of two warring factions), when you know how much of a disgrace these proposals have been, you know how much the NHS has been wilfully under-funded and you personally have sanctioned the many Private Finance initiatives popping out like fungus on a damp corpse.


Jeremy Hunt’s 7-Day NHS lie


Jeremy Hunt wants the world’s first 7-day routine health care service.
This is a hollow manifesto promise. It is as fantastical as baby unicorns for all 9 year-olds.

He is using this as his fuel to put pressure on frontline healthcare staff, which is already causing many to leave, and will render the NHS unsustainable.

This will open the sluicegate for wide-scale privatisation of the NHS. The evidence of his intentions is clear for all to see.

Please don’t let this happen.

Please tweet in support:

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What if the government were negotiating with the NZRDA rather than the BMA?


by Nima Ghadiri

The government is currently locked in a dispute with junior doctors over a proposed new contract.  The organisation representing junior doctors is the British Medical Association (BMA), a trade union which was founded in 1832 and represents all United Kingdom doctors, not just Junior Doctors.  The chair of the BMA’s junior doctor’s committee  is  Johann Malawana.

Chief areas of contention in the contract are: removals of national safeguards (fixed financial penalties) for organisations when Junior Doctors work long hours, cutting out minimum break requirements,  re-designation of the normal working week leading to an added day when hospital resources are lacking, and disadvantages to doctors who work less-than-full-time and have families.

Jeremy Hunt, the Secretary of State for Health, has stated that the British Medical Association (BMA) have misrepresented Junior Doctors and has targeted the union aggressively in a bid to win public opinion.  This has been echoed in much of the tabloid press, who have used social media photos of the BMA Junior Doctors’ committee in order to portray them as wealthy manipulators of the Junior Doctors that they represent.

Indeed, The BMA has had a tumultuous relationship with Junior Doctors lately. Many felt that the union did not fight hard enough following various events which have taken place over the last decade: Loss of House Officer Accommodation, shortages of training posts, the ill-received Medical Training Application System (MTAS), pay increases below inflation and consistently increasing GMC and examination fees.

Nevertheless, in this battle, Junior Doctor consensus (based on a Facebook group which is 63,000 strong) is that the BMA is working hard and representing the position appropriately, but is simply underpowered. Junior Doctors who have worked abroad, in particular New Zealand, will know just how underpowered the BMA is.


The  New Zealand’s Resident Doctor’s Association “NZRDA” was founded in 1985. It represents only Junior Doctors, rather than all doctors.  British doctors who move to New Zealand tend to be surprised about the power of this organization, which is very proactive and consistently anticipates future problems.

Over time, the NZRDA have (chiefly through their firebrand negotiator Deborah Powell) negotiated a number of improvements on an annual basis by means of their Multi Employer Collective Agreement “MECA”. These have included: consistent increments in pay, final year medical students being given a salary, free canteen food during working hours, training and membership costs being covered, presence of cross-cover and relief doctors to cover short-term absences, ease in going out-of-programme for family or travel.  There is even a motivation for hospitals and clinics to ensure that their junior doctors claim all of their annual and study leave, as the amount not used becomes “cashed out” as a payment.


The NZRDA have been aggressive in the few instances when conditions have deteriorated.  In April 2008, the NZRDA gave notice of a nationwide 48-hour strike over pay, conditions and ongoing issues of retention, as 40% of Kiwi doctors were moving to Australia.  At the time, a first year house-surgeon in NZ earned 88,000 NZD (£40,000) on average.  Junior doctors sought a 10% pay rise over three consecutive years ( twice that of other health service workers) rather than two rises of 4% over two years.


The strikes were widely seen as a success which brought the desired outcome for the doctors, caused no harm to patients (indeed, emergency department waiting times were markedly reduced), has improved retention of doctors and made New Zealand a very attractive destination for British and other doctors.  They have also empowered the NZRDA to fight annually for better conditions.


In a hypothetical situation, what would happen If the NZRDA were transplanted to the negotiating table in the United Kingdom?  Based on their track record, they would be keeping the government on their back feet.  In particular, they would not hesitate to legally challenge the government, for example Jeremy Hunt’s assertion that we do not already have a seven-day emergency NHS has led to well-documented patient harm.


Unfortunately, the BMA may simply not have the strength to attack on all fronts in order to secure a fair and safe contract this time round. However, a Union is only as strong as the will of its members, and for the Junior Doctors this is currently very strong indeed. One outcome of the current dispute will be a galvanised and stronger British Medical Association. Which is precisely what the government don’t want.


Who is Jeremy Hunt?


by Nima Ghadiri

Jeremy Hunt is the United Kingdom’s Secretary of State for Health.  He is currently engaged in a colossal dispute with junior doctors over a new contract proposal which he states is better for junior doctors and will make the hospital a safer place at weekends.  His detractors believe that the new contract is in practice less safe, spreads doctors too thinly over the week and is already resulting in an exodus of doctors from the health service.  Many have observed that he has wilfully misinterpreted cause-and-effect in quoting data about weekend mortality rates, and that a routine 7-day health service is a noble goal, but needs to be matched with an increase in spending – when in practice the opposite is happening in the United Kingdom.

In anger over this proposed contract, Junior Doctors went on strike for the first time in forty years on Tuesday 12th January, providing emergency care only.  This is to be followed by a further 48-hour strike on Tuesday 26th January and a strike of all services (including emergency) on Wednesday 10th February.  Jeremy Hunt believes that junior doctors are being misinformed by their union, and has threatened a “nuclear option” of introducing a contract regardless of whether doctors agree to it.

But who is Jeremy Hunt, and what is his pedigree? He was born from aristocratic lineage in London and raised in Surrey. His education took place at the prestigious Charterhouse boarding school, where he became head boy, and he went on to get a first-class honours degree in Politics, Philosophy and Economics at Oxford University (a degree infamous for its association with the establishment).

Subsequently, he worked as a management consultant for two years, before moving to Japan to work as an English language teacher.  On his return to the United Kingdom, he embarked on a number of business ventures, chief amongst these a failed effort to export marmalade to Japan.

In 2000, Jeremy Hunt established an educational publishing business called Hotcourses with his friend Mike Elms, funded for seven years by the taxpayer-funded British Council via an intermediate company called Sheffield Data Services (based in West London).   Hotcourses was a monopoly supplier for the British Council, which by happy coincidence was vice-chaired by Jeremy Hunt’s cousin and confidante Baroness Virginia Bottomley (former secretary of state for health).  In 2014, Jeremy Hunt missed out on a potential £17 million windfall after private equity firm Inflexion pulled out on a deal to buy Hotcourses. Nevertheless, he remains well-remunerated (earning £960,000 in 2015 from the company) and the fact remains that for a decade the British taxpayer helped set up and sustain a
monopolistic arrangement which proved to be highly profitable.

Indeed, Jeremy Hunt has shown that that he is adept at personal financial management. In April 2010, he managed to avoid a tax bill of £100,000 for Hotcourses by paying himself a dividend for his company in the form of half its office building, days before the government accounted a 10% rise in its tax on dividends.

Whether his pecuniary abilities have extended to the National Health Service, has proven to be a different issue.  He has overseen a peculiar cycle since taking over from Andrew Lanslet as Secretary of State for Health: In 2013 the government spent £1.4 billion on NHS redundancies, then £3.9 billion filling the gaps with temporary agency staff run by recruitment agencies. Headhunter firms have had a significant role in vetting key staff within this restructured Health Service. Key amongst these is Odgers Berndston, whose chair and CEO is, again, Jeremy Hunt’s cousin Baroness Virginia Bottomley.

With his mentor Baroness Bottomley acting as a powerful lobbyist in the private health sector, it is no surprise that Jeremy Hunt has made overtures in favour of privatisation.
In his co-authored book Direct Democracy (p78 Jeremy Hunt et al), he stated:

In 2015, Jeremy Hunt signed the largest privatisation deal in history, worth £780 million, to eleven private firms in order to perform diagnostic tests and procedures on NHS patients.

Jeremy Hunt has thus-far managed successfully to avoid media scrutiny for these huge contracts, and this has chiefly been a result of his very close relationship with Rupert Murdoch’s News Corp.  During his time in his previous role as Culture Secretary, his Office provided near-daily updates to Rupert and his son James regarding a proposed takeover of BskyB by News Corp. This relationship has remained strong and has ensured that media coverage of the impending NHS privatisation (which would be immensely unpopular for the British public) has been stifled.

Many who work in the National Health Service have no doubt that the end-goal is to privatise the service, which has been deemed unwieldy by the previous Labour government and the current Conservative government.  As the first group to be targeted, Junior Doctors have rallied to defend the Health Service, voting for industrial action with an overwhelming mandate (99.4% supporting industrial action with 98% supporting a full strike).  Jeremy Hunt
has raised the stakes by proposing a “nuclear option” and remains extraordinarily unpopular with NHS staff, such that he has refused to be interviewed alongside a member of the organisation he oversees. The next steps will be crucial, as the government decide whether it is worth persisting with Jeremy Hunt and alienating the consultants of the future (whether there remains a National Health Service or not) or replace Jeremy Hunt and continue covert privatisation goals by other means.