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10th November 2015 3

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Health Chat

1st December King's Fund 5.30pm

Janet Davis - New CEO and Gen Sec of the RCN

What is the future for nursing?

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News and Comment from Roy Lilley
Do you understand the Junior Docs dispute? I don't. The BBC may? I've watched pictures of angry people marching through the streets but I don't get it?
 
First, I don't get what the Tinkerman is up to? He's never quite got off the back foot after he implied doctors didn't work weekends. A dodgy interpretation of data on deaths in hospital at weekends has not endeared him to a very knowledgeable workforce. Whoever advises him on the management of this dispute might do better working in B&Q.
 
The really stupid idea was to pretend to give the Docs an 11% pay rise. It turned out he was recycling the money they were already earning.
 
The BMA are no better. Since the inception of the NHS, in 1948, their default position has been 'no' to everything. I can't think of one advance, one change or reorganisation they have welcomed or facilitated. Anything to do with the BMA is an uphill struggle. Mostly they make a mess of everything; the Lansley reforms being the zenith of their achievements.
 
What happens next? A strike? Stupid move methinks. There will be a death, or accident or catastrophe. The narrative will shift to ugly.
 
What exactly are the issues? If the objective is to deliver a real seven day NHS then why are we arguing about working a five day week in a six day window?   Why not make it any five days in seven and adjust the pay accordingly?  What is the real agenda?
 
Or, why don't enterprising Trusts use their freedoms and offer local pay and conditions. If enough Trusts did that there would be no raison-d'etre for the BMA.
 
Both sides would do well to remember all wars, disputes strikes and arguments end in talks. The sooner you talk, the sooner it's over. For the BMA to walk away, refuse to talk, plays into the Tinkerman's hands and casts them in the black and white era of Red Robbo.
 
Negotiate. It's the only way out. There are simple rules.
 
Listen. Listen to what the other side is saying. Really listen. Just what is it that they want? If Hunt wants a seven day NHS, arguing the toss over six days makes no sense. I have no idea what he really wants. What exactly do the Docs want? They say it's not about money, it's about safety? About being tired? I thought they were tired now. This whole dispute has disappeared into a fog.
 
Broaden the bandwidth. Is the solution to be found in changing the basis of discussion, should we be talking working any five days in seven, no overtime and a salary uplift to compensate?
 
Timing. The Docs were in no rush but by walking away from talks the BMA finds itself at a point of no-return; they could only escalate to a strike ballot. A cul-de-sac. Bad move. They should have kept talking. The Tinkerman is under pressure from the Treasury, the Cabinet and has to resolve this before the election. That is a while a way but it means the BMA could talk and talk. The DH couldn't impose a settlement whilst genuine talks were ongoing. Now they can. The union reached its walk-away point far too early.
 
What is the win-win? This will not end in outright victory for either side. Both sides will have to win something. The longer it goes on, the bigger the wins have to be and the more difficult the talks.
 
What are the make-weight-issues? A junior doctor's life is not all about hours. It's about study, premium payments, career, childcare, canteens, car parking, travel... there is a list as long as your arm that could be included in the mix. The Tinkerman has to look good, too; in Cabinet, to the Treasury and on the front page of the Daily Mail.  He'll have a list. Everything is negotiable.
 
Ask for help. This dispute is going nowhere. Time for some off the record, quiet discussions with a trusted third party who can help to re-boot talks.
 
Three golden rules:
  • Start again; generally he who initiates the process will win the process
  • Make the talks transparent; talk to the press and be honest about progress.  In the end public sentiment will influence the outcome.
  • Don't walk way; he who walks first, loses.
A workable compromise is the way all disputes end.
 
Stop dancing around yer handbags and get on with it.

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HealthChat
1st December
King's Fund 5.30pm 
Janet Davies
New boss at the RCN
King's Fund 1st December 5.30 pm.
20 Bursary tickets for RCN members - see yellow panel at the top of the page for details.
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19th November
King's Fund 5.30pm
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