There are an array of numbers relating to the NHS that, it’s safe to assume, make Wes Streeting wince.
Take, for example, the number of hospital tests and treatments people in England are waiting for – 7.42 million – and the number of people who need them – 6.24 million. Both have come down since Labour took power 17 months ago but still remain near worst-ever highs.
There is also the proportion of A&E patients across the UK who are routinely cared for in corridors, waiting rooms or backs of ambulances because hospitals are so overcrowded: 18%. There is also the estimated number of very unwell people in England who die every year because it takes too long to find them a bed: 16,600, according to the Royal College of Emergency Medicine. All very worrying statistics.
Wednesday brings another set of sobering statistics for the health secretary. It will be day one of the 14th strike that resident doctors in England have staged over the last 33 months in an effort to win what is now a 26% pay rise. The five days involved will be the 55th, 56th, 57th, 58th and 59th days of what NHS bosses privately fear could, without a dramatic change, become a “never-ending” dispute.
In September last year Streeting recalled to the New Statesman how he had managed to end the strikes by those who were then called junior doctors, courtesy of a 22.3% pay rise over two years. “I managed to do within three weeks what they [the Conservatives] had failed to do over more than a year, which was to agree a deal with the junior doctors.”
So he thought. However, the peace – and the pause in the doctors’ campaign of industrial action – proved short-lived.
A year on from that false dawn, the medics now known as resident doctors went on strike again, in July this year, for the first time under Labour. That was in pursuit of their new goal – a further 26% pay rise, albeit staged over several years. Thousands of doctors below the level of consultant struck for five days then and another five days last month and are now withdrawing their labour for another five days. Streeting says the British Medical Association is being unreasonable; the BMA, the doctors union, blames him for not rewarding medics properly for their vital work.
After eight strikes under the Tories and now three under Labour, the prospects of a settlement look as distant as at any point in the last 33 months. “At this rate, this is going to drag on and on and on all next year unless something changes. It’s never-ending,” said one NHS official. His comments reflect the beleaguered mood in a service that yet again has had to cancel tens of thousands of appointments and operations, ask senior doctors to cover more junior colleagues’ shifts and plead with the public to come to A&E over the next five days only if absolutely necessary.
Streeting, a politician with a talent for pithy phrase-making, has deployed a lexicon of outrage when describing the strikes. This latest stoppage could prove to be “the Jenga piece” that leads to the NHS collapsing, given the intense pressure that winter diseases are putting on it, he said. The parlous state of the public finances mean he cannot give the residents the 26% they are seeking, he has explained repeatedly. He has made three offers to expand the number of training places for resident doctors to pursue their chosen medical specialty and avoid them being left jobless. They have rejected all three, the latest by 83% to 17% in a survey this week. Progress towards a settlement seems elusive.
Streeting is winning the PR battle. During the Tories’ time in office a clear majority of voters backed the pay demands. But after their 22.3% rise, the worm of public opinion has turned: YouGov reported last week that 33% support the strikes and 58% oppose them. However, he is not winning the hearts and minds of those who matter most – the doctors.
BMA sources say Streeting’s increasingly dramatic comments, as residents voted on his latest offer, hardened attitudes and made it more likely to produce a no vote.
One BMA source said: “There’s a determination that they don’t want to be pushed around by the government or told what to do. For some time the [government’s] thinking appears to have been that the BMA is out of step with doctors. This [83% v 17%] result means they will have to reassess that and in the new year open the door to a discussion on a multi-year pay deal.”
Their 13 strikes so far have pushed two governments to give them pay rises well above inflation. They have also led Streeting to double, then double again – from 1,000 to 2,000, then 4,000 – the number of specialist training places for doctors to apply for. But the resident doctors remain immoveable, especially on the 26%.
The BMA’s legal mandate to strike runs out on 6 January. Streeting and NHS chiefs hope that when they then seek members’ approval for a further six-month campaign of strikes, that enough doctors – strike-weary and tired of losing money when they refuse to work – say no. The history of this long, increasingly fractious dispute suggests they should hope but not expect that to happen.
