6th September 2016

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Ed Smith
Chair of NHSI in conversation with Roy Lilley.
 Ticket sales end this week.  Close to a sell-out, be quick.
The medical establishment 
News and Comment from Roy Lilley
'You don't remember me, do you?'
When a stunning redhead, standing in the queue at Costa, says that to a man of a certain age, a defibrillator may be required, never mind a decaf!
I had a good look; high-rise skinny jeans, Jack Wills shirt, JustFab ballet flats, Land's End scarf, tan leather Hobo tote, cream linen jacket... I'd guess M&S.
As I looked she turned into a ten year old.  Red hair pulled back, leotard, throwing herself down a runway and launching into a Tsukahara.
... yep I remember.  I used to sit with her dad, at gymnastic competitions and hope we would take the kids home in one piece.
Over a Latte we sat and chatted.  She'd seen me on the telly talking about the doctor's strike. 
'I agree with you... what did you say... disproportionate... yes.'
My gymnast has blossomed into a doctor. 
She lowered her bag to the floor, leaned forward in the seat.  Elbows on the table, looking into the coffee.
'I don't want to hear you say any of this on the box...'
I agreed...
The strike; yes she had 'been on strike', of sorts.  Some strategic study days, annual leave, shift swapping and she had avoided the picket line.
'I can't go on strike... but I can't not go on strike.'
Peer pressure and thinly disguised bullying; 'we have to stay together'.  Even pressure from consultants 'to join-in, we'll cover... take the day out, it'll be fun... give Hunt a black-eye...' said one.
There was a lot more.  The moral and ethical conundrum I imagine a lot of doctors are going through.  'Junior' is all wrong.  Training, yes, young, yes.  Junior... no.
This once effervescing, fearless child, now a disheartened, young woman.  
The fact that we still call the backbone of the workforce 'junior' just about sums it up.
I swung the car out of the car-park and headed for the motorway.  

Of course, my encounter happened before we had yesterdays afternoon's news; the first tranche of strikes, in September has been called off.  Now, we all have a lot to think about.
Each time the JDs had been on strike I filmed from the picket lines.  Central London.  Each time I came across JDs who chanted the same; 'not fair' and 'not safe'.  Almost none of them had read what, at that time, was the critical document; St David Dalton's letter setting out the state of play.
None of them had read the proposed contract because it hadn't been published...
Maybe it was a variation of the Stockholm syndrome but I felt sympathetic and had several telecons with the JD leader Johann Malawana.  

Nothing came of it.  We now know why.  The HSJ leaked emails are proof the union wanted to drag out the strike.
The HSJ has provided further proof, a leaked document showing once again the BMA are closer to the British Machiavellian Army than they are to a medical association.
Now what's the state of play?
I said, more than a month ago, the BMA were split.  They denied it. The latest vote 14-16... I'm hearing they had several goes at the vote to get to 14-16.  Now they have backed-down.  Sense prevailed?  Pressure from all sides?
The General Medical Council have woken up and realised strikes can damage patients.  So do cuts in services.  They made dark threats.  They'd never be able to collect evidence to 'strike-off a striking JD' but it added weight to an increasingly nervous medical establishment.
The Academy of Royal Colleges threw in its two-pennyworth.  They agree the NHS is on its knees but not that JDs should be on a picket line.
The clouds in my coffee are telling me the BMA have lost credibility, the GMC are irrelevant and the Academy... who's heard of them.  

Medical leaders and regulators wringing hands, agreeing 
that the NHS is in crisis, but sitting on the JDs, gives The Tinkerman a get out of jail card and begs the question; OK, facing the melt-down of the NHS, what will the medical 
The DH are meddling by-standers the Confed has appeared gutless; NHS Professionals at least managed to sound relevant.  The Patients Association, full of doctors, huffed and puffed.
More strikes in October and November?  There is only one place a junior doctor can go with this moral and ethical dilemma. I told the gymnast...
When you wake up and look in the mirror, ask yourself; if today was your last day doctoring, would you want to spend it on strike.
If there are to be more protests about contracts, money, politics, workforce, workload, resource, re-validation, lack of evidence and waste, it is a protest for all doctors ...  

... not just training doctors, whose careers, emotions and reputations are being shredded by doing the dirty work for all doctors and the medical establishment.
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Beyond Budgeting
One day learning conference that will be worth every penny, from the only consultancy that has fans!
26th Sept Kings Fund  5.30pm.
Ed Smith 
Chair of Not-Monitor 
(I must find out what they are called!)
Great evening in prospect.  He has a huge experience and a raconteur 
Plus the usual wine and networking. 
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Obsession with Activity must end
Report of conference speech from 
Hamish Dibley
Interesting take 
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - apologies to the Radiographers, it was the Radiologists who ducked out of criticising the JDs for striking.
>>  I'm hearing - the CQC (them again) are cutting SpA numbers and slashing fees to 300 per day.  Is it worth it?
>>  I'm hearing - former boss of NHS IT-n-stuff, Tim Kelsey has been appointed CEO of the Australian Digital Health Agency.
>>  I'm hearing - the HSJ plan to halve paper publication and switch to e-offering 
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