Druin Burch

The BMA makes lots of vague demands for recognition and autonomy, control and civility – Madeline Grant, hearing similar words coming from Angela Rayner recently, called them generic, vibes-based slop. But what the BMA specifically wants is more money – for less work.  Wales is invoked as an exemplar; rarely a good sign in arguments not involving male-voice choirs or leeks. The BMA wants consultants’ top salary point immediately raised by £16,000, to match the Welsh, and to copy the contractual obligation there for doctors to get a fully-paid day and a half a week free of clinical duties. They want higher rates of pay for out of hours work, improvements in pensions, and the working week cut by five hours. Strike action to support these goals was backed by 76 per cent.

Magdalen College, Oxford, is over-represented at The Spectator. Not long ago, Paul Johnson and Matthew d’Ancona were fixtures here. Today, there are Sam Leith, Douglas Murray, and Harry Mount. Unbeknownst to them, there is also me. I was there at the same time as all three, and a while after Matt Ridley. Poor white kids who are clever enough to go to Britain's ancient universities will find it much harder to get a look in Murray, I believe, spent time in a bad state school, but like Leith and Ridley reached Oxford via Eton; for Mount it was Westminster. I came the other way, a route which is now at the heart of a row over whether white kids from disadvantaged backgrounds are being shut out of many Oxbridge diversity schemes.

Across Britain today, people will take prescriptions to pharmacies and be told they can’t be fulfilled. After hearing a lifetime of speeches about the miracle of the NHS, they’ll find the miracle is out of stock. The National Pharmacy Association (NPA) warned earlier this month that we are short of medicines, with the shortages 'some of the most severe the UK has experienced'. Life is a muddle, and the best we can do is battle endlessly against imperfect trade-offs. That’s the lesson to be read in the NPA’s announcement, if it’s one you’re willing to see. Little in the world is an undiluted good, not even the modern decline of premature mortality. There are people who would find the downside to an England victory in the World Cup, although probably only Scots and Welsh.

The Ockenden Maternity Review, published today, finds the NHS is not to be trusted – not for maternity care, possibly not at all. Set up in 2022 in response to concerns over the safety and competence of maternity care at Nottingham University Hospitals NHS Trust (NUH), the report finds failures of leadership, governance, and culture: Poor practice is not investigated; learning is not integrated; and mothers and babies are failed by an organisation they should be able to rely upon. Perfection is not to be found and should not be expected. My son’s arrival into the world was delayed by a junior doctor’s dishonest laziness. Spotting problems, she prevaricated, arranging unnecessary tests that delayed decision-making until her shift finished.

TThe junior doctors were due to strike again, and everyone was sick of the whole business. At the last minute, after a new government offer, the walkout has been called off. This is a relief, even if it isn’t yet a resolution. The vast majority of junior doctors I work with have become as fed up with the dispute as the rest of us. As the strikes have progressed, an ever-increasing number have turned up to work despite being members of the BMA. But even if this dispute now ends, new legislation means similar ones may soon return with dreary frequency in other trades and professions.  Junior doctors feel underpaid, and we ought to manage some sympathy for that, if only on the grounds that few of us feel we’re overpaid.

The quiet kid from my friend’s school has become a trillionaire, and many people are unhappy that this should be so. Musk’s success narrows our lives only when we let it make us prisoners of our own resentment Being a boy in a white South African classroom isn’t easy if you’re not outgoing and sporty. The culture that grew in the shadow of the Boers is not forgiving of eccentricity or admiring of unvarnished intellect. Elon Musk appears to have suffered childhood misery that a trillion-dollar fortune can’t buy back. What money buys, for him as for the rest of us, is freedom - and he has more of it than anyone alive. “I call people rich,” Henry James had one of his characters say, “when they're able to meet the requirements of their imagination.

This April, we agreed another deal with France to stop migrants coming across the Channel. The Home Office has explained it is ‘bearing down’ on small boat crossings, and that this latest £662 million deal would ensure ‘enforcement action on beaches and put people smugglers behind bars.’ Over the last Bank Holiday weekend, almost a thousand migrants were recorded as coming across the English Channel. This is regrettable, but there is no alternative. Small boat crossings began at scale in 2018. Since then, the total number of recorded arrivals comes to about 200,000. We have to accept that they are now a fact of life.

“Leaders take responsibility,” Wes Streeting wrote, in what has already been called his Wesignation letter. The charge against Keir Starmer was that he hadn't; the boast, gift-wrapped in NHS statistics, was that the outgoing Health Secretary had. “The only question that matters in government is whether we leave our successors a better situation than we inherited.” As he angles for the top job after almost two years running the NHS, what does his record amount to? Streeting’s no wild success, but no abject failure Streeting’s letter is heavy with figures. Ambulance response times for heart attacks and strokes have improved, A&E waiting times too, and GP recruitment is up.

Florence Nightingale, born in Florence on this day in 1820, made her world measurably better. She counted the dead until the living had to listen. Her contemporary in Crimea, Mary Seacole, is now zealously celebrated alongside her – and for the wrong reasons. Nightingale acted from duty, Seacole from entrepreneurial ambition Seacole, Jamaican and mixed-race, improved her world because she was a successful small-scale capitalist: brave, exuberant, and possessed of a chutzpah that tended toward creative fiction. Nightingale was part of the Whig advance of history. Her work in data science and sanitation underlies the health improvements we enjoy today.

‘The King and Queen got me to do something that nobody else was able to do, without hardly even asking!’ Donald Trump announced on Thursday. In their honour, after their White House visit, he is removing tariffs on Scotch whiskey and bourbon, ‘two very important industries within Scotland and Kentucky’. A few more visits from His Majesty, and who knows what might follow. The obvious next gifts would be Virginia and the Carolinas. In the meantime the US is open for business, and our whiskey no longer faces tariff headwinds. Trump’s announcement pleased me more than my own drinking tastes justify. Like many another Englishman, I did not take naturally to whiskey. Despite the best efforts of a wine-loving stepfather, I went the traditional route.

Kemi Badenoch has said she will ban doctors from striking. Yesterday, asked if he would do the same, Health Secretary Wes Streeting refused to rule it out. The police aren’t allowed to strike and nor is the military. Why should doctors be different?  The junior doctors are now on day four of their six-day strike; I have lost track of which number strike this is. Since I’m doing 13-hour days covering for them and have worked through Easter, I’ve also lost track of what day it is and fervently wish the legislation to ban the strikes was already in place. I’m being paid well above my normal rates, and my part of the hospital is running smoothly. I deal only with emergencies, so am one step removed from the costs of cancelled clinics and operations.