Leading article

Any deal with the junior doctors should cut both ways

The way we fund medical training is out of date and does not take into account that there is a global marketplace for doctors

13 February 2016

9:00 AM

13 February 2016

9:00 AM

A few months ago, paramedics were on the brink of industrial action. They had legitimate grievances. Ambulance services were being run down, their staffing levels were dangerously thin — and the mismanagement (much of it exposed by Mary Wakefield in The Spectator) was horrendous. But in the end they stepped back from the brink — for good reason. It went against their nature to endanger lives, and in addition it would have been a tactical mistake. If a single patient died as a result of the strike, paramedics would have lost public sympathy. Should a nationalised health service really use the unwell as a bargaining chip?

English doctors have not shown the same strategic foresight. They cancelled 3,000 operations on Wednesday because of a dispute over pay, saying they would give only emergency care. At least some of those cancelled operations will have serious consequences, as the doctors well know. In the long term, everyone who depends on the NHS will feel a little less safe and doctors look as if they are holding a nation to ransom.

The doctors have good reason to be upset. Their new contract has been handled badly by a government that has at times looked almost as if it was inviting confrontation. Jeremy Hunt, the Health Secretary, has made his case badly, placing too much weight on a controversial study suggesting that patients receive worse care at weekends. But the British Medical Association’s argument has sometimes bordered on outright deceit. It published a fake pay calculator on its website, wrongly suggesting that doctors’ pay would go down. It claims it is worried about patient safety: the blunt truth is that it is worried about money. The BMA is organising an NHS-wide strike because it can, taking advantage of the fact that the NHS is a massive, monolithic bureaucracy to impose a nationwide stoppage. The NHS is one of the largest organisations in the world behind the Chinese army and the Indian railway system. If it were liberalised, and hospitals were free to hire doctors on their own terms and conditions, the country could not be held to ransom. The strike is a reminder that keeping the NHS in its present form is a liability.


There does need to be a discussion about money. At present, those who train to be doctors in Britain are given generous subsidies by the government — more than trainee doctors in Australia or Canada. For decades, there has been an unspoken deal: in return for such generous taxpayer support during their training, junior doctors will work for lower pay than they might other-wise be offered. Certainly they earn less than in countries like Australia and the US, where the deal is that doctors take on far more student debt, which they can then repay with their higher wages.

In recent years, a new trend has been emerging: British doctors take the training subsidy offered here, then leg it to Australia for better pay. On an episode of BBC Question Time, a young doctor in the audience made precisely that point: if the UK wasn’t going to pay her properly, she said, she’d go to a country that would. She expected applause, but the audience turned on her. This response carried a warning for the BMA: yes, Britain values its doctors, but if they threaten to undermine the NHS, public sympathy falls away.

Doctors are as entitled as anyone else to pursue careers abroad. Global mobility of labour is a trademark of the 21st century, especially in healthcare. Just look at the NHS: one in four NHS doctors are foreign nationals. One in five Australian medical specialists are British, as are some 2,000 doctors in Canada. A global medical marketplace is up and running. One reason the junior doctors are striking is that they are more acutely aware of how much more money they could be making abroad. But they’d be hard pushed to name another country where doctors are given so much taxpayer support while they train.

The way we fund medical training was established in a previous era. It should be reassessed in that light. We must face the fact that we’re setting up several thousand young medics for careers in other countries. So we should offer young doctors a choice: if they take the full subsidy, then they ought to sign a contract agreeing to a certain number of years of service. If they wish to reserve the right to emigrate upon graduation, they must take their debt with them.

This is one of several changes that need to be made. The unions at present have too much control over the number of nurses and doctors who train. This should end; there should be no artificial limit on the number of training places for aspiring doctors and nurses. Once trained, it would be up to them to find work, here or abroad, just as it is up to every graduate of law, engineering or computer science. The NHS is a mass importer of medical talent; our universities are a mass exporter of talent. It is time for a funding -system that properly acknowledges that fact.

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Show comments
  • rtj1211

    Let me tell you something mate: I couldn’t imagine a worse nightmare than a ‘free market in healthcare’ having some awful management abusing doctors who took out their wrath on patients, treating them less well due to ongoing feelings of hatred to being abused.

    You simply can’t afford to abuse life-critical workers. No, you shouldn’t appease and pander to them either, but creating a ‘rush to the bottom’ in medicine is pure evil.

    I hope you personally take responsibility for the deaths that would result from it.

    You are a right wing dogmatist unable to think through the consequences of your dogma.

    Now take responsibility for your political ignorance rather than claim that it is just Hunt and the Doctors who are responsible.

    • Matthew O’Malley

      Except that the situation you envisage doesn’t take place anywhere in the world. My experience of private healthcare in other ‘free market’ countries has been much better than my experience of the NHS. The NHS is lionised far too much in our society to the point where a sizeable portion of the community can’t see it’s faults.

      I won’t argue that the NHS has some merits, but it shouldn’t be a special case resistant to the effects of the market and the real world.

      • Fraser Magee

        Does the market and the real world not include the right for doctors to leave to find better working conditions in the global marketplace? Why should they be any different from any other skilled profession?

        • Matthew O’Malley

          Yes it does and so it should. What about my comment made you think I was arguing the opposite?

  • Webwrights

    Health professionals have been treated appallingly for too long. Health policy has, for years, simply layered Band-Aid over Elastoplast over dirty old gauze and presented each successive bodge as a brilliant initiative. We have too few medical school places, many of which are filled with overseas students so British students are unable to get in; I know three of them. Consequently, we import doctors (and indeed nurses) to prop up the NHS. Governments treat doctors and hurses with the same casual disdain – despite their years of dedication and training – as shelf-stackers and till-jockeys. We don’t deserve their dedication, and something must change.

    Bluntly, I rather hope that ‘industrial relations’ deteriorate to the point that the doctors simply down stethoscopes and stage an all-out strike. Let’s see just how long Jeremy Hunt and his army of bean-counters and spinners would be able to withstand that. Perhaps, out of the wreckage, we could have a sensible, integrated, 21st century health policy. It took the Strangeways riot (and others) of 1990 to wake the government and people up to the disgusting, barbaric state of our prisons, leading to the Woolf Report and eventual reform. It would appear that workers in the NHS will need to do something equally radical to be taken seriously.

    • Chris

      The day you show me anyone in the NHS excluding cleaners that actually does a days work is the day they get my support.

      • Andy

        Please work on your English and basic grammar, then get back to us.

        • Chris

          Boring little fart.

          • Andy

            Better, thank you.

  • All the lies in the junior doctors’ dispute have come from Jeremy Hunt; he has consistently misled the public, and his promises to doctors just don’t stand up. His belief that that you can buy five pints of milk, share them among seven pint bottles and see them all full is risible and pathetic, even for a tory set on privatising the NHS.
    Doctors – unlike nurses and paramedics – do have a way out; there’s a ready market for them all over the world. And Hunt’s plan to use that market to steal cheap doctors from the developing world to fill the gaps will not work. First, many of them will need to learn English, which will take time, and second, most will have families – the dreaded immigrant nightmare that UKIPper back-bench tories fear so much.
    You cannot get any NHS on the cheap, let alone a 7/7 NHS that Hunt is so obsessed with.

  • thomasaikenhead

    At long last the role of the BMA and the greed of doctors, junior or otherwise, is being made obvious in public!

    Patient-centric medical care in the NHS remains a fantasy, for so many doctors it is all about the money!

    • Fraser Magee

      Only if you choose to believe the fact free nonsense served up on a weekly basis by the Spectator. Next you’ll be defending Delingpole’s latest demented ramblings. Or is that a step too far even for Spectator readers?

      • thomasaikenhead

        The facts are very clear, junior doctors know that evening and weekend cover in NHS hospitals is poor, they are willing to provide it, they just want to get paid a lot of money for doing so!

        Nothing wrong with that, any more than the Tube drivers who strike to be paid more to work during the night.

        The difference is that the Tube drivers are honest, and do not provide a lot of hypocritical cant about wanting more money.

  • peter williams

    “Trainee doctors get generous subsidies from taxpayers”. What planet does the author of this leader live on?

    Our son is at medical school and hasn’t taken the option to go into debt with a student loan. OK our choice, but the consequence is £9,000 annual fees, £8,000 annual occomodation and living expenses totalling £17k p.a. For four years (£68k) and his final year’s fees are paid for by the NHS. So after 5 long years it will have cost £68k + £8k = £76,000. Where’s the subsidy?

    On a political point; I view Jermey Hunt’s megaphone misinformation diplomacy as an attempt to follow in his role model’s footsteps. By this I mean Mr Michael Gove. There is so much more Mr Hunt could be doing to improve our NHS, but I fear he is a disciple of privatisation!

    • Kelso128

      This is no different to any other student at university. Medical and practical science based courses are far more heavily subsidised than say a law course. A university charges the same but it should be obvious that such cost more to run, equipment, insurance, assistance costs etc. The NHS is government funded and pay for the final year course cost, no one stepped in a paid my final year tuition fee costs at university. The truth is the government do subsidise all degrees as there value is not set by the market but by government regulation. Medical courses are the only courses with a cap on numbers left again capping the market inflating their value.

      You’re right it is your choice not to take one of the most generous loan systems available. No market or bank based loan would set a rate so low and only ask you pay it back when you earn over a certain amount.

      The truth is doctors used to work a lot harder for a lot less. This is simply about greed. Doctors had unbelievably generous contracts handed out under Labour. Doctors today look at how much doctors earn in the US and Australia and say I deserve that too. Thousands of people have suffered because of this self centred protest. It is holding a country’s medical system to ransom. You can’t have a market rate of pay in a socialised system. If junior doctors want to leave they know where the airports are.

      • Fraser Magee

        40 years ago even a junior doctor could afford to buy a house in the UK. I would actually be earning more now if I had stayed in McDonald’s and entered management training than I have from my medical career. It’s actually cost me several hundred thousand pounds to pursue a career as a specialist in Intensive Care compared to what I would have earned if I had gone into General Practice at the age of 27. My choice, but don’t call us greedy when you have absolutely no idea of the demands and sacrifices required to reach the top in medicine.

        • Kelso128

          Don’t call doctors greedy yet every point you make is about money? I see from your other posts you claim to currently live in Sydney and are off to start a £300K job soon… McDonald’s managers don’t make that much. I am fully aware of the demands that are placed on doctors my own partner is a junior doctor. As I pointed out and as you have clearly done doctors have the option to leave if they no longer accept the terms of the contract offered by the government. How does this concern you now? You don’t live in the UK any more and by the sounds of it don’t want to come back. Doctors operate in a marketplace like everyone else. You went chasing the big bucks because you could. Good for you.

          I had every sympathy with junior doctors to begin with then they opted to refuse to negotiate after the government gave more ground. It’s worth pointing out paramedics went through something similar yet never went on strike because they knew the human cost if they did. Then junior doctors played on the fears of people and said they’d leave on mass. You eventually get to a point were you say ok just go if you are going.

          • Fraser Magee

            I was referring to my salary as a junior doctor before I left the UK- just over £30,000.

            Since when did the definition of greed incorporate someone who talks about money in a debate about money?

          • Kelso128

            Many people work for a lot longer and can only dream of earning £30K a year. You’re complaining about a starting salary that’s higher than the average salary. My partner was one of the few to vote against strike action. She is probably one of the few doctors not resorting to fear tactics. “We’ll leave the UK and take our skills with us, you’ll suffer under foreign trained doctors” the list goes on. I’ve been to enough medical conferences and gatherings to witness the God Complex a lot of doctors seem to suffer from. It is simply utter bull for you to claim you’d be better off financially working in McDonalds.

            I recently had to have an operation. After years of being told there was nothing wrong by British GP’s I saw a Polish trained GP who spotted that there was an issue and it had been made worse by being ignored. I was operated on by a Lithuanian surgeon and had an Australian anaesthetist. Bigoted comments about foreign doctors I’ve seen in your other posts just further proves my point.

            You’ve pointed out how fabulous you are and that you are starting a £300K job and how employable you are so why does this matter to you? My message to any UK medic who feels so hard done by in the UK is to follow in your footsteps and leave. Plenty of well equipped doctors willing to take your place. Your average doctor in France earns between £50-60K a year without complaint. As a junior you were already well under way to that.

          • Fraser Magee

            The £30,000 salary was after I had been qualified for ten years, not my starting salary.

            The proposed changes don’t affect me at all- I’m no longer a junior doctor and I work in Australia. It doesn’t mean that I can’t object to an inaccurate article written about the medical profession though.

            And yet still no one has addressed the completely false claims in this article- that medical education is subsidised to a greater degree in the UK than it is in Australia.

            Are you sure doctors in France work without complaint? How many do you know? It seems unlikely that there is universal contentment amongst public sector workers in France of all places.

            I agree with your other point that doctors should leave. I’ve been advising plenty of other to do the same.

  • Bonkim

    Emigrating doctors should be asked to refund the cost of their education and training.

    • Webwrights

      If asked, they should flourish a metaphorical brace of digits rampant, and leave their student loans behind them for a graceless and ungrateful country to pay.

      • KingEric

        By upping sticks and pissing off as soon as their generously funded training is over, it is the newly qualified doctors who are showing a lack of gratitude and not the other way round.

        • Webwrights

          To be fair, they have not gone yet. There are two ways in which they fund all those years in which they learn: i) they pay, or take out loans; ii) they are paid for by their mums and dads. That is the brave new world in which we and they live. The state does not pay for my child to learn, so what you claim is quite wrong. If they want to “piss off”, it is for them to choose. I think that they should, though, and, to show the way they feel, they should not pay off their loans.

          There you are; in words of one syllable.

          • KingEric

            Are you seriously telling me, accommodation excepted as you pay that, studying or not, that it only costs £9,000 pa to train a doctor? I think you’ll find it is an awful lot more than that which is not covered by either of your options. By pissing off, they are showing ingratitude to the amount that the taxpayers have contributed to their education. Not paying back the loan only increases the ingratitude.

          • Webwrights

            But the point is that they have NOT pissed off. It remains as an option, however; and it’s an option that can only look increasingly attractive, they more they are pushed about by this mean-spirited, short-term, ‘management consultancy’ approach to medicine.

          • Fraser Magee

            Much more of our taxes were spent on bailing out the banks than on training junior doctors. I don’t recall doctors trashing the global economy through greed and mismanagement. You’re all choosing the wrong targets.

        • Fraser Magee

          What about the junior docs who have already worked in the NHS for ten years?

    • Andy

      Fair enough asking for them to pay back the cost of their training if they leave, but not if you impose a contract on them they fundamentally disagree with! This is not what they signed up to. I don’t blame them for leaving and its comments like this that are simply flippant and unhelpful.

      • Bonkim

        Nothing stays the same. The Doctors can leave the NHS and claim constructive dismissal. Will be interesting to see what happens. This is a free country and the NHS is a closed shop where doctors find security and good wages not enjoyed by people who work in other industries. The State/NHS also spends huge amounts training them to world standards – so it is ungrateful of these doctors to behave like British Leyland labour used to in the 1960s and 70’s.

        They are not badly paid and in the old days doctors had to set up their own practices and income was not their main consideration – they made a good living and had respect in the communities – now if doctors want to be just mercenaries they will not have the respect of the public.

        • Andy

          It’s so ungrateful of these doctors who work hours past their contracted hours to look after your loved ones. It’s so ungrateful of them to have bugger all social life as they have to work long hours at unsociable times. It’s so ungrateful of them to not want to accept a contract which will result in them working ridiculous hours, causing them to be over tired and unsafe. It’s so ungrateful of them to make a stand for the NHS against a man who has co-authored a book on why the NHS should be scrapped for a private system.

          You talk about respect from the public. The whole situation has been engineered by the government. You are obviously the sort of person that has never respected doctors anyway. Or anyone who you perceive to be in a more comfortable position than yourself. You seem convinced that being a doctor is easy, well paid and that they have no sense of vocation. I hope that when you are in hospital one day, you are treated by the doctors I know, not the ones you seem to think exist.

          • Bonkim

            Doctors were respected particularly family doctors that one went to regularly and was seen as not greedy but a part of the society one live in. They were approachable 24/7.

            The NHS is a structured business with faceless entities processing you – that is the difference. More so in the large cities. Medicine on demand rather than medicine according to need. The NHS also does more than essential medicine and poorly managed as a business, caters to health tourists and those strictly not entitled to free health services.

            Junior Doctors are also not all well mannered – many recruits fro overseas don’t speak the language, etc, etc, – it is a health service – but the community knows little about it and the people that work particularly Junior doctors.

            To pick on your point – they are not badly paid compared with many other professional workers and Saturday working is a non-issue – 24 hour shifts are not unknown in many walks of life.

          • Fraser Magee

            Be prepared for many more recruits from overseas who don’t speak the language. The good British docs will all be earning £200,000 in Australia. You get what you pay for.

          • Bonkim

            £200K or Aus$200K? Please check. Even if wages are higher their taxes are also higher.

            Australia also recruits from other Asian countries. If wage was the main consideration there are other locations on earth with still higher wages – but you have to be at the top end of skills and ability to command that – the average run of the mill British doctor will not be able to compete in that market. Also in most countries it is private enterprise and high pressure/high legal liability for bad performance compared with the British NHS which is much more egalitarian, comfortable and safe.

            So the doctors’ choice – yes if they are any good, adaptable, and venturesome, will find it better elsewhere.

    • Chris

      Even better if we could make it a condition that they could never work for the NHS again. Even these greedy sods are aware of which side their bread is buttered and would probably think twice.

      • Bonkim

        Eastern European countries during the Soviet era demanded a payment to part-cover the cost of education and bringing you up before they gave an exit-visa to prospective emigrants. Not such a bad thing.

        • Chris

          I have recently been treated by an excellent Lithuanian Doctor who did exactly that. He came here because he thinks the NHS is fantastic and for the opportunities it affords him. But unless I have got him completely wrong he seems like a decent human being with a calling and not one of the grubby self serving excuses that the NHS is riddled with at the moment.

      • Fraser Magee

        I’ve left for Sydney and would be more than happy to never work for the NHS again. The conditions are appalling. Visit a south London Emergency Department on a Saturday night to gain some idea of what it’s like. The next stop for me is a £300,000 salary in the Middle East. There’s a huge global marketplace for well trained doctors- I’m not sure why any would want to stay in England.

        • Chris

          I’ve spent many years in the middle east and you are in for one almighty shock is all I’ve got to say. Enjoy your salary.

        • Mary Hansen

          Where did you do your training?

    • Fraser Magee

      What about the ones who have already worked in the NHS for ten years? If multinational corporations paid even a fraction of their tax obligations, it would pay for medical training for the next 100 years.

  • The Sceptic

    A side note: the NHS, in fact, now employs over 1.7m staff, up from 1.4m in 2010 – overtaking the Indian Railways (1.4m), Chinese State Grid (1.5m) and Chinese National Petroleum Corporation (1.6m).

    • Bonkim

      Don’t publicise that – the NHS bigwigs and managers will demand international salaries and share options there will be less to share amongst medical staff.

      • John Lindsay

        That’s easy, pay them the same as the Chinese and Indians, 🙂 (the Bigwigs and Managers that is)

  • Jacobi

    Recent demonstrations by junior doctors, some of them not very junior looking, has been distasteful. The usual lining up with well prepared slogans before anxious to co-operate cameras. Endless coverage on the news.

    These doctors are well paid by any standards. They have a particular objection to working at weekends. Well hard luck. Bus drivers, train drivers, policemen, taxi drivers, the services all work at the weekend. Before I retiring, it never occurred to me not to catch up on some work at the weekend.

    These strikes have proved one thing. Doctors are now just another set of workers and probably a rather unpleasant set, determined to screw the most they can out of their employers, the tax-payer.

    The British Medical Association, a once respected body is now seen to be no better.

    From now on, I for one will look at any doctor as just that, another, and rather unpleasantly greedy, worker!

    • Bonkim

      Not mentioning you plumber and his call out charge. Doctors are cheap in comparison.

      • Jacobi

        So doctors are not yet as on the ball as plumbers. Well don’t worry they soon will be!

      • Mary Hansen

        Have you checked the call out fee for an out of hours doctor?

        • Bonkim

          Blue murder!

    • John Lindsay

      Apparently the term “Junior Doctor” can be applied to people who have been in the NHS for 10 years or more. It does not mean “Apprentice” or “Newly Qualified”. I only found this out myself a few days ago.

  • Andy

    Agree with some of the points the article makes; the taxpayer does invest about £250,000 in training people in medical school and it would make sense to have some form of tie in. Definitely.

    However, as I read this, I couldn’t help but feel that someone with somewhat of an agenda wrote it. Firstly, this isn’t really the issue at hand. I think if doctors were offered a reasonable contract, which didn’t mean them working more hours in a manner unsafe for patients for less pay, then they’d be happy to accept some form of tie in. I honestly do.

    This new contract involves all doctors up to the level of consultant; so doctors who’ve already worked in the NHS for years. I was in a room full of 3-6 year qualified doctors yesterday, all of whom were on the internet looking at jobs elsewhere. Not just abroad, but management consultancy, pharmaceuticals, etc. You could only tie people into the NHS for so long. If you either don’t provide half-sensible working conditions or reflect that in their pay, it’s only natural to look elsewhere. Especially if the working conditions don’t allow them to do their job in a safe way.

    Secondly, all of the polls suggest at least 2/3 of the public support the strikes. 3000 operations were cancelled, but over 90% went ahead. All cancer-related clinics and procedures went ahead. So saying strikes “lacked strategic foresight” is not really entirely true is it? They have gained the attention of the media and the wider public in an issue.

    Thirdly, stating doctors are holding the nation to ransom is grossly unfair. Both NHS England and the BMA agreed a cost neutral contract, which Mr Hunt chose to veto. Doctors are not particularly well paid equivalent to other professions and much of the dispute does not come down to money.

    It all comes down to trying to provide full services seven days a week, with the same amount of money and staff as there are five days a week. Which is all the result of Mr Hunt misquoting a paper which the author stated that the increased death rates (within 30 days of admission) associated with people ADMITTED at the weekend “may be preventable, to assume that they are avoidable would be rash and misleading. You’ll be surprised to hear that Wednesday is the most popular day to die in hospital”.

    Finally, saying that the unions have far too much say on how many doctors are trained is complete and utter rubbish. Initially, he says how much it costs the taxpayer to train doctors…. He doesn’t take into account that there are currently more doctors qualifying than jobs available. There are about 300 students who will qualify this year and won’t initially have jobs. So training unlimited numbers of doctors at great cost to the state, who then cannot get jobs, is one of the most illogical arguments I’ve heard.

    So overall, to summarize my rant: an article that makes a valid point, albeit irrelevant to the issue at hand, written by someone with an right-wing agenda intended to try to smear doctors on an issue that isn’t even an a current issue (although I agree with their point, but I don’t think many doctors would argue with it).

    • Andy

      Also, you say doctors are taking advantage of the fact that the NHS is a massive, monolithic bureaucracy… do you not accept the fact that the government banks on the NHS being a monopoly employer?! Trust me, doctors would earn A LOT MORE money should the NHS be replaced by a privatised system.

      • Fraser Magee

        A couple of terrific posts Andy. The claim in this article that medical training in Australia is unsubsidised is also untrue. The author misses the point that safeguarding working hours and not lower pay is the main reason for the strikes. Spectator leading articles are usually pretty good but they’ve let themselves down on this one.

      • Bonkim

        Unlikely – a few will but people will not visit them in emergencies if the charges are prohibitive. Much like dentists.

  • Jacobi

    We are all forgetting the real heroes of the NHS, in my humble opinion and experience. And that is the nurses. Yes even the tubby ones of which there seem to be quite a few?

  • Barney

    Everybody who goes to university should do career specific national service? Really?

    • Bonkim

      and pay reparations to Britain if they choose to emigrate.

  • Damian Bragg

    The cost of training is absolutely nonsensical. Yes £250000 might be what is quoted, but seriously, nobody – not the medical schools or the NHS, has any idea where that money goes. Yes there are a few lectures to attend, and some dissection in the first 2 years, but years 3,4 and 5 are primarily spent on the wards observing – seriously how much money do you think it costs the NHS to have a medical student watch a procedure or stand at the back of a ward round? Pennies. The NHS needs to start accounting for the money that is invested in it for medical students – but to demonise the students – who I’m sure don’t feel that they have received a £250000 course – is wrong.

  • ROUCynic

    Well – we now know that Hunt was lying about being able to impose a contract – he can’t and now admits that:-

    “The health secretary has retreated from his claim that he has the
    right to exercise what he called the “nuclear option” of imposition. His
    U-turn is revealed in a letter from the government’s lawyers that was
    seen by the Guardian and confirmed by his own Department of Health.

    Hunt’s insistence now that he is merely “introducing” the contract
    has prompted questions about his negotiating tactics during the
    seven-month dispute and whether he has been in breach of his powers by
    using the threat. He regularly outlined in Commons debates, speeches and
    interviews the government’s intention to compel junior doctors to
    accept changes that have provoked anxiety across the medical profession
    and NHS.”

    He must now be sacked and a competent Minister brought in to clear up the mess he has made.

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