Nhs

The BMA's decision to cancel the first of its planned five-day strikes yesterday was justified as a response to concerns over patient safety. Yet these warnings were nothing new. The General Medical Council issued frank advice to doctors hours earlier saying the strikes could harm patients. And the former Department of Health director Sir John Oldham - who also wrote Labour’s health policy review two years ago - also said the strikes were unethical. These interventions followed last week’s statement from the Academy of Royal Medical Colleges that, wait for it, made it clear the strikes would cause 'real problems' for the NHS. But amidst those warnings, Labour's silence on patient safety was deafening.

Junior doctors have scrapped plans to strike next week. In a dispute which looks increasingly messy and interminable, this is a small token of welcome news. But whilst the BMA has made the right decision in this instance, they are still sticking with their threat to stage three five-day walkouts in October, November and December. What's more, in justifying why they called off the strike which was due to start on September 12, they're trying to have their cake and eat it. After all, when industrial action was announced last week, patient safety - that all important concept which the BMA had trumpeted in the earlier stages of this row - seemed to have been forgotten. Hospital managers were given just 11 days to work out what to do.

Whenever I try to use the NHS I end up feeling like Bruce Willis’s character in The Sixth Sense. No one can see me. It is as if I don’t exist. And unlike Dr Malcolm Crowe in the movie, I have not, as I wait in hospital and GP surgery queues, found an ally with a special gift which enables him to see me when no one else can. No one has ever come up to me and whispered: ‘I see sick people!’ Instead, I languish like a ghost in every south London minor injury clinic, A&E and doctor’s surgery. Recently, I received a letter informing me that my local GP surgery was closing and I would have to go elsewhere. While I was impressed that they had at least managed to acknowledge my existence by telling me to bugger off, I felt this was a bit of a cheek.

Like Owen Smith, I have an interest to declare when discussing Pfizer.   Somewhere on my bookshelf I have a Pfizer physics prize – a school prize funded by the US pharmaceutical giant which at the time had a research facility nearby. Later, Pfizer helped fund an extension to the school which, appropriately enough given its best-known product, rose to twice the height of the existing science block. I don’t, then, share the view of Jeremy Corbyn who seems to see Pfizer as part of an evil empire trying to undermine the NHS. Rather I see it as a company which, while it gets into the odd scrape with regulators, has some sort of social conscience and which has helped fund and produce drugs which are relied-upon by millions of NHS patients a day.

In Notting Hill Gate, in west London, the division was obvious. On the east side of the street was a row of privately owned Victorian terraced houses painted in pastel colours like different flavoured ice creams. These houses, worth £4 million to £6 million each, were dotted with Remain posters. On the west side was a sad-looking inter-war council block, Nottingwood House, which had dirty bricks and outside staircases and corridors. No posters there. But that is where my fellow campaigners and I headed — down to the basement entrances with their heavy steel gates. We looked up the names on the canvassing sheets and rang the bell of one flat after another until we found someone who would buzz us in. This was the hunting ground for the Leave campaign.

What would you say if a powerful cyclists’ pressure group ganged up on the NHS and lobbied it to provide free cycle helmets to anyone who asked for one, accusing it of having on its hands the blood of every helmet-less cyclist who died while the NHS tried to spurn the demand? I think I can guess the answer in the case of most readers: shove off and buy your own helmets. Why, then, does it become such a different matter when the National Aids Trust demands that the NHS provide a free supply of a drug known as Pre-Exposure Prophylaxis, or PrEP, to people who want to have unprotected sex with multiple partners.

When your mind suddenly goes wonky, you may be the one person who doesn’t realise that there is something wrong with it. That’s what happened a month ago when I was on a country holiday in Tuscany with my wife. It was lovely weather, and lunch had been laid out of doors. I had cooked a sea bass and was feeling rather pleased with myself. We were both happy, and things could hardly have been better. But everything began to go wrong when my wife decided to ask if I could pass her a knife. A knife? I didn’t know what a knife was. I had never heard of such a thing. I was damned if I was going to respond to this strange request, however much she persisted with it.

The junior doctors strike will be remembered not only as the first time in NHS history that a complete walk out took place, but also for its viciousness. Both the British Medical Association and the Government can share their blame in this. Jeremy Hunt's threat to 'impose' contracts on junior doctors was unhelpful in its forcefulness, even if his frustration was understandable. Whilst the rhetoric used by the BMA has also scarcely painted the association in a good light. Junior doctors may have had their concerns about patient safety but this was also a dispute about pay and to suggest otherwise was disingenuous. It seems, at last however, that an agreement has been reached. The BMA's Dr Johann Malawana said the terms offered a 'good deal' for junior doctors.

A deal has been reached between the government and the BMA on the new junior doctors contract. The deal now needs to be approved by a BMA ballot. Details of the deal are still emerging, but I understand that rather than junior doctors working the 11 Saturdays a year that the government wanted them to, they will now work 6 weekends a year. The marginal cost for a hospital of employing a junior doctor will fall by roughly a third if this deal goes through. The government has given some ground elsewhere. Doctors returning from maternity leave will be entitled to catch up on the skills training that they have missed out on while away and once they have done so, they will be entitled to a skills based pay rise as if they hadn’t taken leave.

Jeremy Hunt has not done himself any favours in the past with his comments about junior doctors. But today - the first time junior doctors have ever walked out without providing emergency cover – was the time for sounding conciliatory. The Health Secretary said it was a ‘very, very bleak day for the NHS’. Hunt went on to add that: ‘The reason this has happened is because the Government has been unable to negotiate sensibly and reasonably with the BMA over a manifesto pledge’. His emphasis on the Conservative’s ‘manifesto pledge’ is a clear part of the Health Secretary’s tactics to win over the public and Hunt repeated his focus on this point several times during his interview on the Today programme.