After the love has gone

16 Mar 07
VICTORIA MACDONALD | Poor Patricia Hewitt. In a recent survey of just under 100 NHS chief executives, she came out as the least popular health secretary of the past decade, just pipping Frank Dobson to this (dis)honour.

Poor Patricia Hewitt. In a recent survey of just under 100 NHS chief executives, she came out as the least popular health secretary of the past decade, just pipping Frank Dobson to this (dis)honour.

The most popular (though let’s be clear we are not talking Mr Conviviality 2007 here) was Alan Milburn, in the post for four years from 1999.

So how did it all go so wrong in such a relatively short space of time? It is quite obviously not just a case of personalities, though Hewitt has been accused of coming across as a wee bit patronising in interviews. Nor is it as simple as health secretaries following the same downward trajectory in the popularity stakes as the Labour Party itself.

But the plain fact is there was so much goodwill around when Milburn published his NHS Plan in 2000 it was hard to believe that the health service would ever make angry headlines again. Who, after all, was going to be doing the criticising? Everyone, from the British Medical Association to the nurses, to the chiropodists, was signed up to his vision of the future.

Now ministers appear to have squandered it. They have gone to a dinner party and thrown the champagne back in the faces of those who loved them the most. And if anything serves to illustrate this, it is the latest row with the junior doctors. The government has enraged thousands of them and alienated hospital consultants and some of the medical colleges.

It is a complex saga but it boils down to the introduction of a new, fast-track method of training and a computer system set up for job applications: the Medical Training Application Service (MTAS).

This system crashed while juniors were trying to fill in their applications. Some jobs did not appear as expected and some wrong posts were advertised.

Nor did the space available on the forms allow the juniors to expand on why they were suitable for the post.

Nor were the consultants who were expected to conduct the interviews given enough training in how to choose between candidates.

In the end, thousands of

junior doctors have not been

short-listed for jobs they could have been expected to at least be interviewed for.

The reaction out of Richmond House was first to deny that there was a problem, in the face of compelling evidence, then secondly, to appoint a committee to look into the problem without including the BMA, which had been highlighting the issue since last summer.

The health minister, Lord Hunt, was put into the television studios, where he rather disingenuously focused on the new training

scheme, insinuating that the juniors just did not like change, and failed to address the legitimate concerns about MTAS.

Yet the team from the royal colleges, finally asked by the Department of Health to review the situation, took just three days to recommend that there should be a rerun of the first round of interviews to make sure all worthy candidates were shortlisted.

Not that this assuaged the BMA’s junior doctors committee, who have voted for the entire system to be scrapped.

It is true that one isolated row does not serve to make a minister less popular. And it could be that Hewitt was always in a no-win situation by taking over the reins from a succession of health secretaries who could not stop making changes even when the medical profession begged for respite.

It could also be that Hewitt is under far more pressure than her predecessors simply because time is running out and the big spending on the NHS comes to an end next year.

Nevertheless, she has presided over the 2.5% staged pay deal to nurses and 0% to doctors; redundancies; job freezes; furious dentists; and a mental health Bill that had to go back to the drawing board.

Now we are just two weeks away from the end of a difficult financial year, in which balanced books will be achieved only by some deft movement of money from achieving trusts to those that are failing.

Indeed, 132 trusts are expected to overspend by £1.3bn, according to estimates.

Remember Jennifer’s ear? It is the little stories that can make an unexpectedly big noise. Access to GPs in the last election for instance, or Tony Blair being confronted by the partner of a cancer patient.

Junior doctors? It is a story that is not going away.

And then there was this in the Guardian last week, a poignant letter from a junior doctor writing to say that their trust management has taken away the on-call room and the ‘knobbly plank they call our bed’.

Instead, they face power naps in the corridor during their 12-and-a-half-hour night shifts, all to save £300 a month. That seemed to sum it all up.

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