So our Health Secretary intends to impose new contracts on Junior Doctors in the National Health Service. A democratically elected Government is seriously planning to impose contracts having failed to get its way at the negotiating table. The imposition of changed working conditions, pay, and contracted hours on the nation's front line medical care staff is stated in Parliament with attempted ministerial gravitas as if it were a decision to uphold the law against those who are wilfully and destructively breaking it. Junior doctors are demonised; the British Medical Association, one of the most highly respected professional unions in the country is labelled "totally irresponsible"; patients lives are being put at risk by unjustified and selfish resistance to necessary change to improve Health Service provision, or so it is claimed; and of course the Government has no responsibility whatsoever for the impasse, the misinformation, and the hardening of ideological positions.
Jeremy Hunt has presided over the most confrontational episode involving front line medical staff in my lifetime. He is simply blaming others, asseting both his rightness and his authority, and yet is so uninformed of the actual experience of Junior Docotors' working conditions he resorts to misinformation and insinuation. Indeed he has been described by several eloquent and passionate doctors as a man who is lying to the public and pursuing a privatisation agenda that will endanger the fundamental principle of universal care at the point of need.
There are many political points to be made here; how imposition of state contracts fits with our democratic institutions; ideological pursuit of privatisation; non-availability of additional funding to enable the proposed expanded cover to weekends; electoral promises which are selectively implemented and were selectively explained in the manifesto. But as a Christian I come at all this with additional questions, about ministerial integrity and honesty in speech; about Government responsibility for sustaining the capacity of our society to provide medical care for all, from the poorest to the richest; about vocation and calling and the protection of those whose passion is to serve and care, from exploitation of that life-transforming motivation to drive through policies that undermine those same ideals; about trust, the trust of patient to doctor and of doctor to the Government institutions which resource our nations medical provision. That's a long list, and each issue has profoundly ethical implications that overlap into theological considerations.
The NHS is an institutional safeguard of our nation's humanity. The dignity, worth and place of each person is recognised and affirmed by the way our society treats each person in need of medical care. A theological anthropology underlies, or at least underwrites that view of each human being.
The role of a Government minister is to govern, and in a democracy that means seeking consensus, negotiating around differences, building and sustaining trust within the structures and between the persons, and ensuring the interests of the Department are upheld within the wider concerns of Government such as budget, development and future human resourcing. The Christian ideal of conciliation and compassion seem to me to be primary absences in the current situation.
Junior doctors claim they are vocation driven and that their commitment to the NHS is the real source of their opposition to the proposed changes to their role and conditions. Yet some have said their concern for the NHS might lead them to emigrate or go into private medicine. It is a hard ask to align such statements with the publicly declared commitment to the NHS as the underlying driver for BMA opposition to these changes. Thus on both sides a need for honesty about motive, and guarding against a fatal sclerosis of the conduits of dialogue to avoid our NHS provision and structures breaking down completely. An imposition of will by one side in a dialogue, is an act of unilateral deafness, and individual hubris.
As to what can be done? Well I guess the Christian cop out is to say, we can only pray for a resolution to this quite dangerous precedent. And I agree. So long as praying is neither seen as cop out, or reduced in significance as mere last resort. The work of the Holy Spirit is to be looked for outside the church, abroad in our society, haunting the corridors of power, moving in closed minds and across emotional barriers. Peace-making, conciliation, understanding, changes of mind, new perspectives, forgiveness, confession of failures, mistakes and wrong turnings, resources of patience and goodwill – these are the fruit of the Spirit invading the market mentality, unhinging the closed door ideologies, rebuilding the fractured relationships where trust lies in pieces on the floor, recalling and re-calling people to the work for which God made them, and turning heads away from the intensity of confrontation to possible new horizons to which it is possible walk together. Yes. That kind of praying to that kind of Holy Spirit, set loose in our kind of world.
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