No health secretary in the history of the NHS has ever walked away from the job feeling an increased fondness for the British Medical Association (BMA).
The professional body representing doctors likes to pretend it is rather more than just a trade union. But it tends to fight harder and for longer than the traditional ones.
Many ministers who’ve held a number of briefs across government have said the BMA was far harder to deal with than the more notorious RMT or Unite unions. The stand-offs can last for years, the strikes are visceral and the war of words even more so. They mostly end in tears for both sides.
And yet Wes Streeting’s current fight with the BMA could leave the Health Secretary strengthened rather than bruised. He has made an improved offer to avert strikes by resident – formerly junior – doctors in the middle of a particularly bad flu outbreak, promising to give UK-trained medics priority for NHS jobs, and to address other frustrations including the cost of exam fees and a shortage of specialty training places.
The union is consulting its members on whether to go ahead with its planned strike from 17-22 December, but some of its senior figures have suggested it is unlikely members will accept given the offer “does nothing on pay”.
As is so often the case in a government fight with the BMA, doctors are also annoyed with the language adopted by the minister. In previous disputes, the BMA has had to twist the words of a politician slightly to rile up its members: back in 2015 when Jeremy Hunt was having his own fight with juniors, he was accused of claiming that the doctors lacked “professionalism and a sense of vocation” when he had in fact been talking about the wording of their contract.
This time around, Streeting’s own words can be taken verbatim and entirely in context, for he has chosen to describe the union as behaving like “moaning Minnies” over plans to make all GP practices offer online bookings for non-urgent appointments.
He has also said that “we’ve seen an outbreak in the British Medical Association of juvenile delinquency”. No one likes having their professionalism called into question, least of all doctors, who are used to commanding a degree of respect within society.
Normally Labour politicians would reserve this kind of fruity language for strike-breakers, not striking workers, but the reason Streeting feels able to be so blunt is that the dispute can actually benefit him politically.
The BMA is not an affiliated Labour trade union. Its comparatively well-paid members do not have the same emotional hold over Labour MPs and members as other trade unionists. This is therefore the one fight that Streeting can have with a union that benefits him across the Labour Party, rather than calls into question his Labour credentials. He is fortunate not to be in dispute with nurses.
Public support for striking doctors has also been falling after their very good pay offer last year: they don’t see medics as the priority for more money when people on much lower incomes are feeling the pinch more acutely. The proportion of voters blaming both parties, rather than just the Government, for the stand-off is rising too.
Mind you, the BMA argues that Streeting’s latest offer shows that striking does work as a threat, as he’s only produced it at the last minute before doctors walk out. Similarly, the pay offer last year was something many across the political spectrum feared would only encourage the BMA that if they pushed again and for long enough, they’d get more in future.
Streeting needs now to be clear that he really has offered doctors everything that is reasonable, and that there will be no more caving.
Once again, that stand also benefits the Health Secretary politically: in contrast to Starmer, who has performed more about-turns on policies than Odile in Swan Lake – though with far less grace.
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A feature of this government now is that it will inevitably change position on even key issues, and that instability is a key factor in Labour MPs’ dissatisfaction with their “caretaker” leader.
Streeting visibly wants to take over from Starmer, and needs to show that he’s not prone to being buffeted about so much. He has the perfect row to demonstrate that – though like every health secretary who has come before him, he will have to sustain a few more bruises from the BMA before it’s over.
Isabel Hardman is assistant editor of The Spectator magazine
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