Jeremy Hunt is playing dangerously with escalation in dispute with Doctors over future of NHS as he imposes contracts

Junior doctors and supporters gathered outside the Manchester Royal Infirmary on 10th February, during the latest 24 hour junior doctors strike.

After months of wrangling, Jeremy Hunt has decided to impose contracts on junior doctors (Tran & Campbell, 2016). Hunt's decision came just an hour after the second major strike by Junior doctors, where strikers walked out for 24 hours in protest against extension of hours across the weekend (Triggle, 2016).

Negotiations have been ongoing for months, but had broken down on Tuesday after what Hunt, the Conservative Health Secretary, called his 'final offer' had been rejected (Campbell, 2016). Accusations were also flying that all parties had agreed an alternative deal in principle, only for Hunt to veto it (Stone, 2016).

Imposing the contract could easily further inflame an already controversial situation. Public opinion has been firmly on the side of the junior doctors strikes (Stone, 2016{2}), with Hunt being seen as personally culpable for the ongoing action called by the BMA - the British Medical Association, the doctor's trade union.

What Hunt may be counting on is that, in the initial phase, doctor's will have little choice but to put up and begrudgingly acquiesce. Then, to simply let the matter to blow over with time - gambling on the public having a short memory.

Yet the move could instead lead to escalation. So far the strikes have been 24 hours in duration and left emergency care intact. This move by the Health Secretary could push the opposition to longer strikes, with Healthcare provision reduced to a minimum, other medical professions walking in solidarity and larger public protests.

There have also been reports that the numbers of medical trainees have been dropping and that trained medical professionals have been moving abroad (El Sheika, 2016; Johnson, 2016). The BMA has been using these facts during the negotiations as leverage - and warning of a further exodus if unsafe conditions are extended.

However Hunt's move has called out doctors, expecting them to grumble but ultimately comply. Or may be for them to move into the private sector. There have been doubts about Hunt's commitment to a public, tax-funded NHS - the Health Secretary was a contributor to a book calling for a privatised health market in the UK (Stone, 2016{3}; El Gingihy, 2015).

The general feeling amongst Conservatives seems to be favourable towards a long term future of private sector solutions to social security. Work and Pensions Secretary Iain Duncan Smith won some agreement from Prime Minister David Cameron for the idea of, in essence, privatising sick pay and unemployment benefits by forcing people to pay into savings accounts or to buy social insurance as cover (Mason, 2015).

Health Secretary Jeremy Hunt has risked escalation with his latest move. The BMA says it will consider all options to continue the fight, against changes it believes to be dangerous to public health (Triggle, 2016{2}). Who blinks first matters. Most outcomes could likely be considered a win of some sort for the Conservatives - which shows the cleverness of the game they're playing.

But the game they're playing gambles with social security, the safety net that ensures the common good. In this big moment in the future of the NHS, the Conservatives are showing a ruthless side by pitting the NHS's future against the interests of medical professionals. Its a reckless game in pursuit of prices and profits, but which ignores value - and the fundamental social justice of universal public healthcare.

References

Mark Tran & Denis Campbell's 'Jeremy Hunt to announce that he will force new contract on junior doctors: Health secretary to make Commons statement as thousands of doctors return to work after second 24-hour strike'; in The Guardian; 11 February 2016.

Nick Triggle's 'Operations hit as doctors strike again'; on the BBC; 10 February 2016.

Denis Campbell's 'Jeremy Hunt to impose contract on junior doctors: Doctors’ union threatens to ‘consider all options’ in continuing fight after health secretary says it rejected his final offer'; in The Guardian; 11 February 2016.

Jon Stone's 'Jeremy Hunt dodges question about whether he personally vetoed a deal to end the junior doctors' strike: The deal was supposedly agreed by the Department of Health, NHS Employers, and the British Medical Association'; in The Independent; 9 February 2016.

Jon Stone's 'Public overwhelmingly blame Jeremy Hunt for junior doctors' strike, poll finds: Support for the strike also remains strong'; in The Independent; 10 February 2016{2}.

Sarah El Sheika's 'Remember 11th February 2016. It's the day Jeremy Hunt tried to kill the NHS: We joke about Mr Hunt having shares in Australian emigration, but really this is no laughing matter. Record amounts are leaving the country - or the medical profession altogether'; in The Independent; 11 February 2016.

Sarah Johnson's 'Four in five NHS staff thought about leaving - Exclusive: Healthcare staff in Guardian survey say increasing workloads, unreasonable expectations, cuts and long hours are damaging their lives'; in The Guardian; 12 February 2016.

Jon Stone's 'Jeremy Hunt co-authored book calling for NHS to be replaced with private insurance: 'Direct Democracy: An Agenda For A New Model Party' called for the 'denationalisation' of the NHS'; in The Independent; 10 February 2016{3}.

Youssef El Gingihy's 'How the NHS is being dismantled in 10 easy steps: You might feel like nothing has changed in the national health service - bit actually, the government have legally abolished it and are working to make that abolition a reality'; in The Independent; 27 August 2015.

Rowena Mason's 'David Cameron open to idea of workers saving up to fund own sick pay: PM’s spokeswoman says he is prepared to consider making people pay into savings accounts to cover periods of illness or unemployment'; in The Guardian; 13 July 2015.

Nick Triggle's 'We will fight contract imposition, says BMA'; on the BBC; 11 February 2016{2}.