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12th January 2016
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HealthChat Two tickets for £49.95 Plus a free glass of wine, or two!
 Fascinating guests; Sir Cyril Chantler and Stephen Dorrell
Details here - be quick!

Bang their heads together
News and Comment from Roy Lilley
I'm hoping that what I am writing now, by the time you read it, will be superfluous and out of date.  I hope you can press delete.  I hope the debacle that is the 'junior doctor's strike' will be called off.  The dispute settled.
 
Fingers crossed.
 
The convolutions of the strike are beyond rocket science to explain.  Save-to-say, the last time the doctors were on strike, in the mid '70's, it was about hours of work and pay... what it boils down to this time.
 
This is no ordinary strike. 
 
The junior doctor's employers are the Trusts.  From conversations I have had with various Trust bosses, all of them have said the same thing; they are sick to the back teeth of the dispute and want to know who's going to pay for it.  

A sentiment confirmed in Shaun Lintern's comprehensive piece in the HSJ.  An exclusive it may be but it is hardly a secret.  Trust boards are very cross.
 
It seems to me, there are two main issues in play.  First, the Tinkerman's frustration that discussions about modernising the 2009 contract started back in 2012, got nowhere.  Thus, he announced if progress wasn't made he would impose a settlement.
 
That was a really stupid thing to do.  I have no idea who advised him to do that but they are to industrial relations what Jeremy Clarkson is to the caravan trade. 
 
Second; the Tory election promise, to extend NHS working to seamless-seven-days, creates an imperative to change Jnr Doctors out-of-hours/premium/overtime payments (call it what you will) to make it affordable within the existing cost envelope.  This generates complexity around just how much they will earn and a working environment the Doc's don't trust.
 
As far as I know the actual employers, the Trusts, have not been consulted about any of this.  The negotiations are instructed by the subsidiary of Tory Central Office, we have come to know as the Department of Health.
 
The actual talks are conducted between the BMA and an outfit called NHS Employers who bill themselves as; "...the authoritative voice of workforce leaders..."
 
Really? Don't they just do what the DH wants; deliver Tory manifesto promises.  They and look to me, about as authoritative as a lollipop lady in a war zone.
 
Let's recap; the row is about a political imperative (fair enough it's a democracy), over which the employers have no say, who have been forced into a dispute with the workforce union they don't want, who are railing against the Department of Health, who are not the employer, but calling the shots and the actual employer has to handle the fall-out.
 
Is that clear?
 
This row is nothing to do with Trusts.
 
What about the Confed?  They claim; "... to speak[s] on behalf of all organisations that plan, commission and provide NHS services... and represent our members with politicians"  Frankly they sound more like Uriah Heep than Henry Kissinger.
 
Will the Confed find its voice and say what everyone in the NHS is saying; 'Tinkerman; this is your mess and don't drag us into it.' 
 
When will their new Chairman, Stephen Dorrell, a former Tory SoS for Health, speak up and speak out?  Who does he represent, the Tories or the Trusts?  Hard to see a ROI for the membership fee...
 
By the way, who said this, in a speech to 12000 junior doctors at the RemedyUK protest in 2007:
 
".. there is a simple truth at the heart of this; you came into the NHS not to get rich or famous but because you have a vocation about curing the ill, about serving your community."
 
Err, David Cameron.  He can't be too pleased with the Tinkerman.
 
Whatever the rights and wrongs of the dispute, it is not an NHS dispute.  It is politics between the Tinkerman and the BMA.
 
The Confed should stand up and say so, NHS Employers should man-up and say so.
 
I hope the strike is off.  If not the message is clear; 

"Tinkerman; take your row with the BMA away from the lives of our patients, the wards, operating theatres and boardrooms of our hospitals.  

It is not our fight.  

BMA, stop bulling the Trusts, they are not your enemy and have no influence over events."
 
And, both of you deserve to have your heads banged together.
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HealthChat
Two tickets, one for each event, £49.95 and a free glass of wine!
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HealthChat
We are taking  
HealthChat and the 
Fabulous Academy 
on the road.
Come and join us , 
we are live in 
Liverpool
11th February at  
Aintree University Hospital.
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Sir Cyril Chantler
I promise you an evening of really 
interesting insights, health policy and outcome stuff.  
I'm really looking forward to this.
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Stephen Dorrell
Former Secretary of
State for Health
Chair of the Confed.
'the reforms were the biggest mistake of the Parliament'
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Gossip
shh
This is what I'm hearing;
if you know different,
tell me here
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>> I'm hearing - Number 10 is getting very nervous about the DH handling of the BMA dispute...
>>  I'm hearing - the Mayor of London's City Hall is imposing its own 10p sugar tax.  On fridge in the cafe; but an important fridge.  Proceeds to Jamies Oliver and Sustain.  
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