Dreaming of an NHS without doctors

This Green and Surprisingly Pleasant Land -doctors and strikers

Is Victoria Atkins, Britain’s health secretary, ignorant or unbelievably cunning? Faced with the longest strike in the National Health Service’s history she claimed to have a new offer to put to junior doctors but will not say what it is until they stop striking.

This approach to negotiating defies experience and, indeed, logic. However it is not unique as was seen during the miner’s strike which began in 1984 and ended with the crushing of the miner’s union, followed in rapid succession with the decimation of the mining industry leaving towns and villages throughout the nations bereft of employment.

Emerging from this carnage was a triumphant Margaret Thatcher who continues to be idolised by members of the Conservative Party, feared by the opposition Labour Party and loathed with a passion by ex-miners and their families who have forgotten nothing.

Such is the shadow cast by the former prime minister that her successors have strained every sinew to follow in her footsteps. Even the Labour leader, Keir Stammer, found it necessary to praise her determination. And then there are the numerous Tory parliamentarians who have erected shrines to her memory by prominently displaying pictures of the deceased Lady Thatcher in their offices.

I do not know whether Ms Atkins has her own shrine but she appears to think that following in the former leader’s footsteps will lead to political success. Whether she is equally concerned about the consequences for the ailing NHS is more open to question.

However it is always a mistake to assume that current problems can be resolved by revisiting past battles without understanding how they were fought and their consequences.

At the time of the miner’s strike I was The Observer’s Labour Editor and followed its twists and turns with an enthusiasm that led some of my bosses to question my judgement. They may have been right but even in the heat of battle (I am speaking literally because many of the confrontations between striking miners and the police were incredibly violent) certain things were clear.

First, the miners’ attempt to save the pits from closure was doomed because the British economy was not nearly as dependent on coal as it had been and even a prolonged strike was not going to bring the country to its knees.

Secondly, the miners were disastrously led by the egomaniac Arthur Scargill. Like Ms Atkins he believed that the battle could be won by looking backwards. In his case to the miner’s victories in 1972 and 1974. Moreover he was captivated by his own rhetoric and convinced that heroic martyrdom was better than any form of compromise.

Mrs Thatcher, no stranger to ego herself, understood Mr Scargill’s fundamental weakness and that of his allies in the labour movement who he seemed bent on alienating. Freed from the constraints of irreversible economic consequences and oblivious to the hardship that would be inflicted on mining communities, she focused on the political battle which she, correctly, assumed would be decisive in securing her leadership.

There was no negotiated settlement with the miners which seems to be the basis of Ms Atkins’ belief  that her hand is as strong as that of the Revered Margaret. It is not.

Most importantly NHS doctors have options which miners never had. If, at the end of the day, the junior doctors fail to secure a decent pay rise it will gradually fuel the outflow from the NHS to private practise and more doctors are likely to emigrate. Britain can survive without coal but not without public service doctors.

She may think it is clever to belittle the junior doctors, describing them as being ‘in training’ and cast doubt on the leadership of their union but she does not appear to realise that the level of public support for this strike has, somewhat surprisingly, remained high.

Given these facts not being prepared to sit down with the strikers makes little sense. Moreover there is the basis of an oven ready settlement to be had. Ms Atkins could start by offering the strikers what the Scottish government successfully offered to their junior doctors.

But she may find it embarrassing to trail in the wake of a Scottish Nationalist administration and is highly unlikely to win plaudits for so doing from her own increasingly frenzied party where the very concept of negotiations with trade unions is viewed as a sign of weakness.

There is also the possibility that the British Medical Association’s negotiators won’t play ball, after all the BMA has historically not covered itself in glory, especially when it opposed the establishment of the NHS.

However there is only way of settling this mess and it will be around a negotiating table. Unless that is, Ms Atkins, is determined to channel her inner Margaret Thatcher and contemplate the total decimation of junior doctors in England and Wales.

Hero of the Week

Belatedly this honour goes to Ireland’s President Michael Higgins who used his Christmas message to laud the contribution of immigrants to his country and to acknowledge their struggles in their new home. Which other European political leader has the courage to speak in these unequivocal terms?

Diary | Christmas Message From President Michael D Higgins23 | President of Ireland