Comment

Shut out of the dispute

Shirley Cramer CBE, chief executive of the Institute of Healthcare Management (IHM), looks at how NHS managers have not been involved in the recent junior doctors’ contract dispute.

However, and whenever, the junior doctors’ row over their new contract is finally resolved, it will be without consulting those who may well be left with a toxic legacy to deal with – NHS managers. 

Hopes are high that the junior doctors’ dispute over their new contract may be close to resolution after five months of strikes and disruption to services which, even parts of the ever-critical media acknowledge, have been mitigated by the professionalism of NHS leaders and managers. The final outcome does, of course, depend on whether the deal will be accepted by the BMA membership in a referendum to be held in June. Meanwhile, the press unhelpfully, but predictably, focus on who are the “winners” and “losers” in the dispute. 

The waiting is not yet over and this has been a long-running and bitter fight. So was there anything else that could have been done to speed along a settlement? According to a recent snapshot survey by the IHM, the answer is “yes”: the politicians and the BMA could have asked the opinion of NHS managers. 

Involvement overlooked 

In the survey, IHM’s members were asked if their views on the junior doctors’ dispute had been sought and whether, if it had, their input into the discussions could have been useful. An overwhelming 87% of the 101 respondents had not been asked for an opinion, while 76% felt that their involvement in discussions could have paid dividends. 

A survey earlier this year (January 2016) revealed that six in 10 (58%) of the healthcare managers who responded backed the strike action being taken by NHS junior doctors, with more than four in 10 (43%) saying they ‘strongly’ supported it. A third (33%) said they opposed the action. 

These figures may well have changed, but the most recent survey highlighted some interesting findings. Over a quarter of respondents (26%) felt that “speaking out” on the issue would have a negative impact on their relationship with their senior management, 29% thought it would impact unhelpfully on their careers, and while over a third (34%) predicted input would not change their relationship with those they were managing, nearly 16% thought it would have a positive result. 

We will now never know. However, in disputes that potentially threaten the safety of patients and the quality of care they receive, there cannot be too much communication. Surely it would make sense to canvass the views of those who work close to the coal face, are tasked with managing the consequences of strike action, and have the smooth running and best interests of both staff and patients at heart?

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