As I type these words ballot papers are being printed and sent out across the country to junior doctors in preparation for a proposed strike that now seems all but inevitable. This strike, the first of its kind for 40 years, represents a catastrophic breakdown in the relationship between the Department of Health and the medical profession.
The strike has become necessary as the Department of Health has tried to bully the British Medical Association into accepting a contract for its members in which pay is likely to fall, working hours are likely to increase, and patients are likely to be put at risk. It has been repeatedly claimed that this contract is 'cost neutral' and not a money saving exercise which begs the question, if the people who are being 'offered' the contract thinks it's a terrible deal, and anyone who knows what they are talking about thinks it's unfair and unsafe, and it's not even going to save any money, why on earth are they pushing ahead with it?
We must hope that the strike will break the deadlock in contract negotiations and both sides will be able to re-enter discussions on a more equal footing. But this presents its own problem, after the strike the government's negotiator-in-chief will still be Jeremy Hunt.
It will be almost impossible for the BMA to re-enter negotiations with Hunt because he has become a figure so reviled and mistrusted by the medical profession that for the BMA to even engage with him will feel like a betrayal to many doctors.
There are numerous reasons for this. Firstly, Hunt's stated aim is to privatise the NHS as he outlined in his 2005 book Direct Democracy. Every step he takes looks like a step in this direction. The current plan seems to be; step 1, ask an underfunded NHS to provide an impossible level of service; step 2, systematically demoralise the staff so they will no longer go the extra mile to make the service work; step 3, generously fund private sector providers to save the day; step 4, point out how wonderful the private sector have been and muse that the whole health service might be better provided for privately.
Secondly, Hunt lies endlessly. These lies are beginning to stray well beyond the norm of political doublespeak. He insists that 11,000 patients die needlessly each year because of poor staffing of hospitals at the weekend based on a paper that specifically states that it would be 'rash and misleading' to assume that these deaths are avoidable. The editor of the British Medical Journal, in which the paper appeared, has written to him demanding an explanation, and another group are petitioning parliament to investigate Hunt for breaching parliamentary standards for misleading the House of Commons with his rogue statistics.
Time and again he has also claimed that no junior doctor will get paid less on the new contract but has recently let slip that the doctors who work the longest hours will indeed get paid less. Furthermore he has invented the fact that supplemental pay is termed 'danger money' in the NHS which is a term that neither I nor any doctor I know has ever heard used within the health service. This can only be another cheap attempt to portray the current NHS, consistently proven to be one of the finest healthcare services in the world, as dangerous and inadequate.
Thirdly, he may have blood on his hands. So convincing has he been at denigrating the service offered by the NHS at weekends that he has created the entirely new phenomenon of patients not going to hospital when they need to in the belief that it will be shut. The extent to which 'The Hunt Effect' has harmed patients, and possibly even resulted in deaths, is currently being investigated.
Lastly, he is Jeremy Hunt. When he talks you feel that his mother probably didn't hug him much. I find I can't blame her though because he exudes the warmth and huggability of a komodo dragon. This may seem like mindless Hunt-bashing but the serious point is that any negotiation is a product of the personalities involved. His apparent lack of empathy for patients and NHS staff, and his evident lack of understanding of all matters health, make him an entirely inappropriate man to lead the government's part in these negotiations.
Clearly all these policies are not all of Hunt's design. If he is removed then the government will no doubt persist in trying to implement all these policies none-the-less. And yet it must surely be the politically shrewd, if not obvious, move to sack the first Secretary of State for Health to induce a junior doctors' strike in four decades. If nothing else it would be a gesture signalling that the government is willing to negotiate. Whilst Hunt remains in post the negotiations are likely to remain in deadlock.