Is the Conservative government becoming vulnerable over health issues?
Edmund Stubbs, 5 November 2015
Negotiations between Jeremy Hunt and the British Medical Association regarding junior doctors’ pay, which have now lasted for over two years, have failed. Matters turned particularly ugly recently with junior doctors taking to the streets to protest against the imposition of a new contract following the BMA’s refusal to attend meetings with ministers, the reasons for which are presently disputed.
A proposed junior doctors strike could prove a disaster for Hunt who has, to date, enjoyed a relatively easy time as health secretary, as indeed it could for the recently elected Conservative government. Despite a last minute, perhaps desperate, offer of an 11 per cent pay rise for junior doctors, today the BMA will ballot its junior members on the option of striking. Medics dismissed the 11 per cent offer as still leading to an overall 26 per cent pay cut due to the declassification of many formerly antisocial hours for which they receive extra wages.
Mr Hunt, in pursuing a well intentioned attempt to improve poorer quality weekend care, in the process has alienated himself from much of his workforce. However the issue of junior doctors’ contracts is not the only health matter where the conservative government seems out of touch with public and professional opinion.
For example, the implementation of a ‘sugar tax’ appears to enjoy wide support. According to ComRes over half of the general public are in favour such a policy, supported by public health experts, backed by government reports and on a body of scientific literature. David Cameron’s continued opposition to the introduction of such a tax might well cause his image as a personal past user and supporter of the NHS some problems in the future.
The functioning of the NHS’s emergency services over this coming winter is also raising concern. The situation, probably a repeat of what happened last winter, is the result of demographic change exacerbated by decades of underinvestment in community services and perhaps over reliance on acute care facilities. If a crisis occurs, as it probably will, it will be the Conservative government that will be held responsible for it.
Consequently, events this winter could prove extremely damaging for the Conservative party’s overall reputation on health. Striking doctors, crises in A&E departments and attacks by sugar tax activists will not make good headlines. If the government is thought to be reacting to events, perhaps by backing down or making U-turns in policy decisions, it will be especially harmful for them. Angry doctors, ambulances queuing outside hospital gates and controversies over public health issues will have the potential to generate a lasting negative impression of Conservative healthcare management.
Perhaps some of the government’s difficulties might arise from its having too fixed an agenda summed up in slogans such as achieving a ‘seven day NHS’. John McTernan, former advisor to Tony Blair, at a recent Civitas seminar questioned efforts to reduce the extra mortalities at weekends: ‘why focus on these excess mortalities?’ he asked, ‘Why not on the excess mortalities that arise from slow cancer diagnoses rates, or the increased death rate during the winter ?’ Such issues might be addressed without provoking workforce conflict by imposing new contracts on junior doctors. As the NHS already stuggles to maintain its staff’s morale, this policy might lead ever more doctors to abandon their work for the NHS altogether and go abroad.
Dr Sarah Wollaston, Chair of the Health Select Committee, stated in a recent BBC interview that £4 billion of the promised £8 billlion for the NHS during this parliament will be needed this year simply to keep NHS trusts afloat and is consequently not likely to soften the severity of this winter’s health crisis. Flexibility in policy decisions is necessary if the Conservative government wishes to present itself as being serious about safeguarding the NHS’s long term sustainability. Flexibility in the fixed ideas that drive current policy, such as that underlying the junior doctors contracts is particularly necessary. The government needs to adapt to survive.
Edmund Stubbs is Healthcare Researcher at the think tank Civitas, @edmundstubbs1