The NHS, a lesson in politics: part II

The BMA is being out maneuvered.

The next salvo in the NHS saga continues. Mr Hunt has decreed that actually doctors don’t work weekends, and provides some “stats” to prove it.

The premiership has started again, and there is the wonderfully emotive spectre of Immigrants knocking at the front gate. (A fine time to break out National Socialist language from the 1930s) So the current episode of Hunt vs NHS is not getting much press. This is what the SPADs were counting on.

The current position which the BMA is taking is untenable:

“The reason there are less staff, including nurses and other specialists, in hospitals on Saturdays and Sundays is because the Government does not provide the workforce, resources or infrastructure to maintain the level of service that exists during the week.”

I know this, you know this, and deep down the public recognises this, if they bothered to think past the wonderfully loaded headlines.

Before we carry on….

I’m not a doctor, and I don’t work in health. However I have a keen interest in science. I’ve also been working in media (darling) long enough to spot the fat podgy hand of westminister. Whilst it might seem hopeless, Mr Hunt is actually in a weak position, and ([he knows it]. Unlike Gove and the Teachers, the public recognise that doctors work hard. This is why through all of this He’s fixated on the opt-out clause.

Stating the obvious isn’t going to work

“Team Hunt” are brazening it out. They know perfectly well that there isn’t enough staff to run the NHS as it is. Let alone enough time, cash and skill to run an extra two days in the week. They also know that you doctors won’t strike. Because as referenced in the previous article doctors are shire horses.

Therefore it requires a change in tact. At the moment the BMA language is rather passive/defensive:

“Doctors have always been open to more seven-day services in hospitals”

Fail. C- for conviction, U for understanding the current media landscape. If we evaluate the whole quote we get a turgid fart that’s almost audible. Instead of pointing out what is obviously deficient, welcome the changes that you need. This is basically the standard Government tactic. (See ISPs(ISPs), BBC, restaurant Tipping)

Unilaterally say that you’ve reached agreement and lay out your demands. This then allows you to talk to the newspapers with the same condescending tone that the DoH does.


“Doctors have always been open to more seven-day services in hospitals”

Must be changed to:

“We are pleased that the DoH has finally recognised the importance of a fully resourced 7 day NHS. We are reassured by the health secretary pledging to increase staff numbers by 30%. This will go some way to combat the higher mortality rate caused by a national shortage of doctors, nurses and skilled technicians

The Staff increase will go some way to tackle the unsafe practices of 90 hour weeks and under staffing wards to save money.”

Why is this better?

Instead of being defensive, it clearly states the lack of resources. Abandoning the “opt-out”, which is a lost cause, moves the debate on to what is actually causing mortality in the NHS, understaffed wards full of overworked doctors.

More importantly its far harder to pick apart. It states that the BMA has always been for the “7 day NHS”. (in todays media landscape, only a hand full of reporters will actually question this. Only the members of the public who are already galvanised will actually bother to read it. Insert Eastasia Orwell quote here ) Even better, for Mr Hunt to refute this he’ll have to either say that there is no such thing as high weekend mortality, or that staff numbers are not the problem.

If they choose to refute higher weekend mortality, they’ll then have to explain why they want to negotiate more weekend work for doctors.

If they choose to refute the link between low staff numbers and higher death rates, then they’ll have justify why they want extra staff at the weekends.

Either way they’ll have to nobble one of their main negotiating strategies. Something they’ll be loathed to do.

Most importantly

It fits neatly inside the space alloted for “canned comments”. Its short enough to be included without editing, and long enough to make the point your after: “We’d love to have a 7-day NHS, give us the money to do it safely or fuck the hell off”.

If the BMA were to be really bold, they’d simply state:

“We are itching to build a 7-day NHS. Give us the cash to do it safely, or take your spin and fuck off.”

Followed by this:

“Ask the public this: do they want weekend chiropody with a 400% increase risk of death, or waiting two days with no increase”


Once again we find that the BMA’s media skills are lacking. They need to hire themselves an ex SPAD or spin doctor. There are two weeks left, without a change in tact, we’ll see unsafe & illegal working practices baked into the new contracts.


I’ve watched/read a few interviews with doctors on the ground about the proposed changes. Whilst one cannot fault the depth of feeling, the presentation is lacking. This is understandable. To counter this I provide you with this quick and handy guide:

  1. Be very brief in your answers, you’ll only have ~15 seconds to get your point across

There is a very short opening in which you can capture your audience. If you don’t connect at the very first instance, you’ve pretty much lost it. Think speed dating, but much less fun.

  1. Make your point at the start of the sentence/paragraph/article

You’re not writing an academic paper, you are not being marked by your peers. You are communicating a feeling to the mass of unwashed idiots that are staring unblinking at a glowing white screen. They don’t reason, they react. They have no understanding of what its like to be a doctor, you need to break down the argument into tiny morsels that will trigger a reaction: X change will cause n deaths & this change will kill many children or Z will mean that you’ll need to pay money to avoid pain

Its crude, yes. But deep down so are we, sadly.

  1. Don’t be clever

Your public are stupid. The only people that will get your cleverness have already formed an opinion.

  1. Don’t fight stats with more stats

Fight them with feelings.

Once again the public are stupid. ([They don’t understand stats] They are less likely to actually understand stats and more likely to look at you as a doctor and blindly trust that you are telling the truth.

Yes, it is important to have a base of truth to back you up, so that if you are questioned deeply on a subject you can flop out the ace of truth and silence your questioner (who also is probably lacking intellect, unless you are on newsnight or something similar.)

Sample Q&A

How do you feel about the proposed changes? The government appears to be enforcing dangerous working practices like those found in mid-staffs in an attempt to save face.

Boom, the government want to save money even if it kills you

The government says that you don’t work weekends We don’t have enough cash to keep A&E open at the weekend, do you recommend we cut back on Emergency Surgery for children who are involved in car crashes so that we can run chiropody sessions on a Saturday?

*Emote the shit out of it. You are using absurdist logic, but it doesn’t matter because it allows you to call the government heartless child murderers. This means that in the follow up question which will be something like “the Government has promised an extra 8 billion to do blah” you can reply: what would you rather, emergency surgery for your child, or chiropody for that nagging bunion? *

2 replies on “The NHS, a lesson in politics: part II”

“[The BMA] need to hire themselves an ex SPAD or spin doctor.”

I feel they would be better equipped if they hired you. Refreshing and insightful blogging.

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