That reflected his view that patients aren’t interested in sweeping promises of “NHS reform”; they support the principles of the NHS, they value the commitment and professionalism of those who work in it – and they expect the politicians to find ways to work with the NHS to deliver the principles on which the service was founded.
When the NHS is in the headlines, it is usually because the politicians have forgotten these cardinal principles.
It has been clear for months that every part of the NHS would be working under unsustainable pressure during the current winter season as it grapples with the combined effects of lengthening waiting lists, staff shortages and collapsing social care. These trends were, sadly, well established before the pandemic but have all been exacerbated both by the pandemic and this year’s flu epidemic.
It has also been clear that Pay Review Body recommendations which were based on evidence submitted by the government on 23 February 2022 would not be regarded by NHS staff as providing a fair basis for a pay settlement for this winter – with inflation running at virtually double the rate of 12 months ago.
Against this background the government made several crucial mistakes:
1. It allowed itself to be challenged by staff across the traditional public sector; it should have recognised that NHS staff are seen differently by most people – particularly in view of the pressures and risks which they accepted during the pandemic;
2. It should have prioritised a settlement with NHS staff in order to maintain services during an unprecedented winter crisis;
3. It could easily have done so by asking the review body, in the exceptional circumstances of 2022 to make an interim recommendation for the current year – reflecting the practice of many employers across the private sector;
4. The health secretary should never have refused to discuss pay – the very issue which lies at the heart of the dispute;
5. It is simply extraordinary to waste parliamentary time by introducing legislation which removes the right of NHS staff to withdraw their labour in a future dispute at a time when ministers and MPs should be focusing on resolving the current dispute.
These mistakes have led to a protracted dispute with staff who enjoy widespread public support and whose primary ask is that their employers recognise that their living standards had already fallen when they gave unstinting service during the pandemic – and now face further decline as a result of inflation.
The worst insult to these staff was the endless repetition by ministers of the assertion that “the taxpayer can’t afford a 19 per cent increase for the nurses” when the Royal College of Nursing (RCN) leadership was making it crystal clear that it was simply seeking a negotiation.
While ministers chanted from the grandstand, NHS staff were dealing with unprecedented pressures and seeking recognition of the pressures on their families.
It is good news that the prime minister finally had the sense to tell his ministers to engage with the issues; his mistake was not to do so on the day he appointed them.
Stephen Dorrell is a Liberal Democrat politician who served as health secretary under John Major from 1995 to 1997. He was also chairman of the House of Commons Health select committee from 2010 to 2014