Tackling the strikes

As the old year moves to a close I am urging Ministers to set out how they intend to create a new year less troubled by strikes. So far the government has worked hard on ways to limit the damage strikes cause whilst declining to enter talks with Unions over pay.

The government needs to differentiate between the strikes and tailor its response to their differences. The railway disputes are taking place in an industry that has lost a lot of its passengers and fare revenue. It has become very reliant on state subsidy, and runs too many near empty trains at taxpayer expense. Now its main revenue earner, five day a week commuting, has been changed by more homeworking it has lost bargaining power as well as fare income. The government should expect management and Unions to settle with something for something deals to improve working practises and manning arrangements. It should continue to make clear there is no increased subsidy on offer.

The NHS strikes take place in a service that has many unfilled  vacancies, has problems with retaining  staff and has a big waiting list of work. The senior managers should be required to deliver the much delayed manpower plan which should set out how grading, rostering, pay scales and conditions of employment will be improved to ensure full numbers and a motivated workforce. The immediate talks need to be between Health Secretary, Chancellor and PM with the top management of the NHS to agree a plan and to create a common response to the strikes. The strikes are said to be about more than money. Managers have flex over grading, bands, increments and promotions. There needs to be a recruitment and retention solution. Some of the top management seem to be on the side of the Unions. There needs to be a common agreement between Ministers and senior executives which managers then need to implement. There needs to be an agreed way of getting more value for all the extra cash channelled into the NHS.

83 Comments

  1. mancunius
    December 26, 2022

    The pretty well continuous chaos since mid-November makes it appear that there is a lot of unofficial and undeclared strike action that is organised on private social media. On several non-strike days, large numbers ‘coincidentally’ declare they are too unwell to work, or deliberately neglect a particular task. lax management throughout the public sector, NHS, transport industry and Royal Mail has neither the oversight nor the will to manage this indiscipline. The advantages for the unionised workforce are that it is taking industrial action but still getting paid.
    For example, although the local Royal Mail DO declares it has no problems at all, everyone in this has experienced entire weeks without any delivery for several months, with tracking info showing that letters and parcels have remained stuck in local delivery offices for weeks at a time. This cannot continue: it is not industrial action, it is deliberate sabotage.

    1. mancunius
      December 26, 2022

      everyone in this *area*…

    2. Peter
      December 26, 2022

      Maybe the government should also look beyond the strikes and consider the way in which both the railways and the NHS are currently set up.

      The fragmented nature of the railways is a huge weakness, though strikes will still be an issue whether you have split companies or one huge structure.

      The NHS has been allowed to balloon in size with many hugely rewarded posts and a top heavy management structure that seem to add little to patient care. Private companies also continue to cream off profitable elements with considerable cost but not necessarily beneficial outcomes.

    3. Donna
      December 26, 2022

      It’s been continual chaos since Johnson locked down the country over a Low Consequence Infectious Disease with a mortality rate of 0.2% back in March 2020.

      The present incumbents of No.10 and 11 are both significantly responsible for it (Sunak – along with Bailey – for wrecking the economy and Hunt for failing, over 6 years, to ensure that the NHS could cope with a bad ‘flu year and for failing to improve the Care Home situation).

      1. Timaction
        December 26, 2022

        ………………and the whole Tory Government are responsible for the mass immigration imposed on us without mandate. 6.9 million have now registered to live in the UK from the EU. They are still allowing applications 18 months AFTER the cut off date and at 45,000 a month (BREXIT FACTS4U). These are vast numbers and can probably be doubled for people who come from outside the EU. That is why we can’t see our Doctors, get seen in A&E, get a dentist appointment, have a housing crisis, can’t get school places etc. The link is obvious to EVERY ONE outside your bubble Sir John. We are all paying the price of your Government’s rank stupidity.
        In further news the Government still refuses to take emergency action to stop and deport the boat people at ÂŁ7 million a day and rising. Mr Rees Mogg says on GB News there is no will in Parliament to withdraw from the ECHR and allowed it’s membership to be within the Trade and Cooperation agreement with the EU. So we can’t kick them out as we are not a sovereign Nation, despite all the lies spun. Madness. Just like allowing energy to be linked to fish. Please let me know where our negotiators are as I have a bridge I want to sell them. Fools one and all. We desperately need new Government and a Party to represent the English people.

        1. X-Tory
          December 26, 2022

          The new sections 80b and 80c of the Nationality, Immigration and Asylum Act 2002, already allow the government to declare that all asylum applications by those who came through France (or any other safe country) are INADMISSIBLE. So why the hell isn’t Suella Braverman doing this and IMMEDIATELY deporting the applicants back to their home countries? She is utterly useless and a complete FRAUD. This government deserves to be totally destroyed.

          1. glen cullen
            December 26, 2022

            +1

          2. anon
            December 29, 2022

            ECHR is the ultimate arbiter , court of law for the UK. Unlike for the EU. Source facts4eu.org/news/2022_dec_echr_nonsense.

      2. Pauline Baxter
        December 26, 2022

        Donna. Quite. I 100% agree with you.

    4. agricola
      December 26, 2022

      Mancunius a suggestion. Where strike action is deemed to be political I would suggest much stronger action. To the RMT I would say don’t bother returning until the end of February. We have learnt to do without you over recent weeks, being inured to your games we don’t need you.

      1. a-tracy
        December 27, 2022

        Agricola, there is a pattern to some of these strikes. Do them at holiday time. Our buses went on strike for six weeks over summer.

        I wonder if they lost their subsidy for six weeks or the money was just made up for the operating company and they still made a profit?! It saved them a fortune not having to run around double deckers all day long for one or two customers, those without vehicles were left with no alternatives, no dlr, just expensive taxis no uber, most booked up.

        The council didn’t even try to get six seater taxi shares, why not? They might have found the service could be completely replaced with that and save a lot of money. They didn’t even try it just at the two rush hours!

        The strikers got their back pay and a massive bonus! And they want us all reliant on public transport, this is the future people, held to ransom every day by a minority of workers who think they deserve more than anyone else in similar jobs.

      2. Mickey Taking
        December 27, 2022

        a great opportunity for coach and minibus businesses to trim their fleet to provide fixed routes into cities from ‘park and rides’.?
        A shining example is’ OXFORD TUBE’ run from a bus station, but the principle works anywhere. Fix a season ticket price with reserved seats, fixed departure time, identify maybe 2 or 3 stops and find out what times to pickup in reverse works!

  2. SM
    December 26, 2022

    Re the alleged insufficiency of NHS funding: a lot of comment has been generated, understandably, by the issue of highly-paid Diversity Managers and their teams.

    There are far bigger drains on the NHS budget than that, and I would urge both MPs and the public to look at – for a start – the NHS Confederation. I would suggest, however, that taking anti-high blood-pressure medication before reading about it is advisable.

    1. Stred
      December 26, 2022

      The process of diversity management could be the cause of unfilled posts. How to decide how to appoint one protected applicant over another. Maybe a points system is operating and there are ties for the winner. Or perhaps an applicant has a brilliant record but the other one is lousy but has top marks for skin colour and thinks it’s a different gender from its biological chromasones. It must be so difficult sometimes, especially when some staff just want to cure patients quickly.

      1. X-Tory
        December 26, 2022

        We are now informed that in some Trusts if you recruit a white candidate you have to justify why you did not select a minority one. And this government, of course, takes no action to ban this racially discriminatory procedure. Labour will not be any worse at all.

    2. Jim Whitehead
      December 26, 2022

      ‘Management’ is so often cited when criticising the NHS structure. This almost invariably overlooks or is wholly ignorant of the extra component of friction, namely the CQC.
      The CQC has teeth and is greatly feared and much detested by those who are trying to provide clinical care through a Sargasso Sea of protocols, regulations, directives, mandates, guidelines, all of which, if worked to rule, would utterly choke and cripple the effort to provide the services that the employees and professionals are trained to do.
      CQC is an effective screen behind which Ministers can hide.
      Many GPs choose to bail out early into early retirement from what they had once declared was a ‘vocation’ when they were young and idealistic.
      Think about that.

      1. a-tracy
        December 27, 2022

        You should be just as worried at all the business creators bailing out.

  3. Mark B
    December 26, 2022

    Good morning.

    Are the Matchgirls on strike ? What about the blacksmiths, the coopers, the door-to-door salesman, the charcoal burners, the windmillers who grind the corn, and last of all, the coal miners ? Any of those on strike ?

    No ! And there is a reason for all that ? Times change.

    The railways are destroying there own market and the NHS is losing sympathy increasing the need for major structural reform.

    Pay the lower paid nurses more and tell the ytrain drivers they are lucky to have a job.

    1. a-tracy
      December 27, 2022

      Why wasn’t the Elizabethan line dlr?

  4. Margaretbj.
    December 26, 2022

    As far as the NHS is concerned might it not be the case that manager’s deliberately keep posts open ,go through the motions of interviewing but never take new staff on?

    1. James Freeman
      December 26, 2022

      When I recently worked on an NHS project, it took nine weeks to complete checks after appointing new staff. This delay goes a long way towards explaining the staff shortages. As well as large numbers waiting to start, many get better offers while waiting, meaning the recruitment process begins again.

  5. Shirley M
    December 26, 2022

    “The NHS Pension Scheme employer contribution rate increased on 1 April 2019 from 14.3% to 20.6%, plus the employer levy of 0.08%.”

    20.6% paid by the employer (the taxpayer) is an overlooked benefit. A very good benefit too. Drop the pension contributions by 10% and add that money to basic salary. The lower pension may also encourage medics NOT to retire at 50, but will still give them a better pension than most people in the private sector receive.

    1. Nigel
      December 26, 2022

      Can you supply details of this increase. I can find no reference to it.
      Thanks.
      Nigel

  6. Peter Wood
    December 26, 2022

    Good Morning,
    Strikes are one feature of a number that indicate our nation is on a slippery slope to civil unrest. A weak government, a dysfunctional civil service, an unreliable police force; an economy so mal-administered that despite the highest taxes since a world war we still run a budget deficit. There are more. We are like the frog in a slowly boiling pot.
    The problem lies first with our political leaders, as many here have said, there is nary one who merits the epithet ‘Statesman’, and there hasn’t been for many years.
    When the present technocratic incumbents of Downing Street shuffle away in failure, again, there could easily be violence on the streets and a country ripe for take-over by foreign powers.
    We need a new broom with experience and common sense, and we need it now.

    1. IanT
      December 26, 2022

      Our politicians don’t have the courage to grip these issues but I have to say that I have very little faith in the senior management of our Civil Service and Public Services.
      Poor performance in the private sector either results in the share price collapsing or the company going bust. Either way, failing management gets pushed or simply finds themselves out of work. They rarely get someone come along and say “Here’s a few more Billion, spend your way out of incompetence”

    2. turboterrier
      December 26, 2022

      Peter Wood
      100%+ with you on this one Peter
      The running and selection processes of all the parties are the reasons for such lamentable government and opposition

      1. Lynn Atkinson
        December 26, 2022

        Quite right! The country produces top quality individuals with monotonous regularity. Because we now have a Parliament instead of a rubber stamp, they will propose themselves and members will select them. We want individual thinkers who will challenge ideas and find the weaknesses in discussion – cheaply – rather than after implementation and massive sunk cost – see HS2 for example.

  7. Anselm
    December 26, 2022

    Boxing Day: I love it! Sir John, I trust you had a lovely Christmas dinner too.

    Anyway, it is ” the top management of the NHS ” who ought to hang their heads in shame. They are on vast salaries and could not organise a booze up in a brewery. Something is going incredibly wrong. I read the Mail myself (once the Telegraph) and the facts are all there. They have swallowed whole all the money given out for nurses’ pay after covid when the front line staff risked their lives. The local hospital is falling down (literally). Doctors have sort of disappeared round here too.
    Illegal migrants get hotels: bedblockers just stay there in hospital.
    Apropos of this, I noted at the time that when it was decided (by whom exactly?) to bring down Boris Johnson, the partygate scandal picture was redacted so the faces of the other miscreants were blurred out. I do not like all this anonymity.
    In the Spectator, the Prime Minister says he is going to do something about the burgeoning office staff, but only after careful thought. I respect him enough to think that he means it.

  8. Clough
    December 26, 2022

    Limiting the damage caused by strikes over pay comes down to getting a grip on inflation, without creating a recession. Is this government up to it? Let us see if there is a plan for growth, as you suggest, Sir John, or whether they’ll just muddle along till the next election and hope for the best.

  9. Stred
    December 26, 2022

    Good to see the Border Farce on strike. That should give the unofficial Channel taxi service some problems and the civil service UN Migration Pact office more time to assist with hotel bookings.

    1. beresford
      December 26, 2022

      I read that some senior Tories are saying that the fake ‘asylum-seekers’ should be able to get jobs while waiting for their ‘claim’ to be processed. This of course would make them impossible to deport regardless of the success of said claim, as they have ‘established a life in the UK’. As well as increasing the pull factor it would also provide more ammunition for the smugglers. “…..and once you’re over there my brother can give you a job in his sweatshop’.

      1. Donna
        December 26, 2022

        Sunak’s going to “clear the backlog” by effectively declaring an amnesty and fast-tracking approval of their claims for asylum. Not that he’ll admit it, of course.

        There’ll be some high profile deportations of Albanians so he can pretend otherwise, of course.

    2. Mickey Taking
      December 26, 2022

      Ninety people crossed the English Channel in two small boats on Christmas Day, the Ministry of Defence said.
      More than 45,000 migrants have made the perilous crossing from France to England so far this year. In 2021, the figure was far less, at almost 28,500.
      On 14 December, four people died and 39 others were rescued after a migrant boat ran into difficulties.
      Prime Minister Rishi Sunak has labelled the small boats crisis a priority for his premiership.
      The 90 people who arrived on Sunday were taken to Western Jet Foil processing centre in Dover, the ministry confirmed.
      Ministry of Defence statement – do they view it as invasion?

  10. Barrie Emmett
    December 26, 2022

    Managers need to manage. I believe the pandemic has created a false illusion whereby the public expect the government to solve all issues.

    1. Hat man
      December 26, 2022

      I think the government created that illusion themselves, Barrie, or were pushed into creating it by the likes of Cummings, the media, and the public health covidocracy.

    2. formula57
      December 26, 2022

      @ Barrie Emmett – surely your “false illusion” has been prevalent for many years now, although I would think it has become modified of late where the public no longer expects the government to provide solutions, rather just pretend to do so.

  11. Mickey Taking
    December 26, 2022

    Government should insist on job cuts during the under used daytime train schedules.
    Many lines have almost empty trains at 20 minute or 30 minutes intervals. Cut them to hourly and sack some drivers. The TAXpayer should not bail out strikers whose industry is in constant massive debt.
    The lesson needs to be learnt by the unions and drivers who strike.

    Nurses were held in awe up to perhaps a decade ago, like the teachers. Once you break that devotion there is only disillusion left. Nationally stated pay and benefits has made millions look and think ‘we don’t get those hours, that pay, that sickness benefit nor pension. They are mostly mere mortals after all, and should be treated like any other worker.
    Time for reality in this gun held to the head nonsense.

  12. beresford
    December 26, 2022

    Yeah let’s differentiate. The railway workers are asking for more than 4% at a time of Government-created double digit inflation. Are MPs and senior civil servants (overmanned, unproductive, etc.) going to settle for 4%? Is there really no future for railways at a time when our WEF politicians are trying to get rid of private cars (for the plebs at least). Meanwhile the nurses are asking for an inflation-busting 19%.

  13. Donna
    December 26, 2022

    The Government’s problem starts and ends in No.10 and No.11.

    Sunak’s strategy, if you can call it that, resembles the one adopted by Louis 16th: sit grandly on his golden throne pretending all is wonderful with the world, whilst the seething masses riot below. Occasionally he ventures forth and comes into contact with “a real person” where he invariably demonstrates that he has no understanding of their lives, or any connection with them whatsoever, unlike his predecessor but one.

    He’s now had a brainwave and hired James Forsyth (fellow Wykehamist and old school chum) to improve his Media/PR, demonstrating yet again that he is completely divorced from anything remotely approaching normal life in the UK. He doesn’t need the likes of Forsyth who represents the same highly privileged, metropolitan “liberal” class as himself, he needs someone like Andrew Pierce if he’s going to stand any chance of limiting the culling of Pretendy-CON MPs which is currently nailed on.

    1. formula57
      December 26, 2022

      @ Donna – overlooking (as of course we cannot) the demands of his job, I could not condemn Mr. Sunak for being ” completely divorced from anything remotely approaching normal life in the UK” for that is my own hope and aim.

  14. The Prangwizard
    December 26, 2022

    In my view all the strikes have a political objective based in hard Left Socialism, the desire of the unions is to bring down the government and install new controls. I am sure they intend to continue campaigns even if they do get big pay rises. They know the Tories are unpopular and Labour benefitting.

    The government must not show weakness which will be exploited; compromise and compassion are easily taken advantage of. We need a strong leadership which we can believe in.

    The subversive political issue must be addressed and dangerous motives publicly exposed. So far it seems to me the unions are getting away with their actions as just innocent pay claims, much helped in tbe broadcast media.

    1. Geoffrey Berg
      December 26, 2022

      While I accept many of the Union leaders fronting the strikes want to bring the government down (though I suspect they are less enthusiastic about Starmer than they were about Corbyn) they do need the support of the majority of their workers to win a strike ballot and most of those workers aren’t willing to strike for political reasons but are only interested in striking to selfishly increase their own pay irrespective of the consequences for the rest of society. So I blame these ‘ordinary’ workers far more than I blame the admittedly provocative union leaders for these strikes.

  15. Tony Hart
    December 26, 2022

    Totally agree. How about stopping HS2?

    1. MFD
      December 26, 2022

      I think the Railways should be scrapped totally as they are not fit for this century.

      Build more fast roads and scrap the speed limits

      1. Mickey Taking
        December 27, 2022

        so you are happy with a 17 year old driving mummy’s present of a clapped out Fiesta doing 100 mph with boasting abandon on our motorways?

  16. Nigl
    December 26, 2022

    The NHS is too big. Politically there cannot be a better time to invoke reform, the problem as I see it from my armchair, is that you neither have the courage or the ideas to achieve it. Surely demand needs to be reduced and that has to involve the private sector and outsourcing.

    Is there there analysis to show how much a particular intervention costs, simplistically operation plus post care and could similar be done cheaper by ‘bulk buying’ in the private sector. So all knees, hips, cataracts etc are sent to a ‘conveyor belt’ leaving the NHS to do the ‘life saving’ stuff.

    Use/build if necessary, nightingale’ type wards to take bed blockers.

    Maybe all nonsense but there must be solutions from both here and other countries. We need a ‘skunk works’ set up where no idea is too crazy until proved so, without the dead hand inertia of NHS groupthink and the stultifying accusation of ‘privatisation’

    1. SM
      December 26, 2022

      Yes, Nigl, there have been analyses done over the past 20 years to my knowledge, and just as you say, it is indeed cheaper and quicker to commission many straightforward procedures, both testing and surgical, from private contractors.

      There will be geographic areas where this is not possible, plus there will be patients who may require intensive care services, and bearing in mind the need for students to train in real-life situations, and accidents and emergencies, mean the NHS is still needed.

  17. Nigl
    December 26, 2022

    And on a related theme, we see the appalling state of NHS dentistry. As usual we get an utter rubbish denial from a government spokesperson.

    Total lack of provision with interventions underfunded so nothing ‘cosmetic’ even if you need it to eat so NHS dentists reduced to extractions rather than more costly teeth saving procedures.

    It has been a scandal for decades.

    1. rose
      December 26, 2022

      Teeth, eyes, and feet have been private since the Blair regime. Dentists who went private at the time said they couldn’t deliver the standards they wanted to under the Blair arrangements.

    2. forthurst
      December 26, 2022

      Why are NHS dentists allowed to use mercury, a deadly poison to fill teeth?

  18. Lynn Atkinson
    December 26, 2022

    The NHS strike is especially worrying for the public. As well as proper management as you suggest, is there not also a solution in your latest tweet about the need for the many to own capital and be invested in the country and economy for Capitalism to even exist?
    Self employed Doctors and medical facilities are not a new thing, indeed they are the tried and tested method of delivering healthcare. It’s the experimental NHS that has failed. Bevan would be shocked to see the perversion of his vision, hopes and dreams.
    I am battling to keep a small number of small shopkeepers in business. The demands of the energy companies with 20% VAT added mean that I’m granting rent free periods, the deep fryer is turned off and therefore no-chips-with-anything and it looks as though the all-day-breakfast will die a death in the New Year. My shops attract no business rates, my rents are less than the electricity bill by a margin.
    Please draw Ministers attention to the fact that these are the people in County Durham, who voted Conservative for the first time. Having trashed Truss’ sensible economics, they will not be doing it again, but to keep them in business, employing others, please demand that the VAT be removed form their energy bills.
    Also the Government need to face the fact that Russian energy will never again be available without the eye-watering margin demanded by Turkey and India. So they need to stop mucking about and FRACK! They may not like that but it is they who join in on the attack on Russia and created this situation. They made their bed and now they have to lie in it.

    1. R.Grange
      December 26, 2022

      The government (and the ones before it) did a lot to create the energy crisis in this country, giving us the most expensive prices in Europe according to what I read. It seems wrong that they then profit from it by hugely increased VAT payments on top.

      Sanctions on Russian oil and gas were more the EU’s stupid idea than they were ours. So the sanctions have made us suffer high energy prices only indirectly, thanks to the higher world market prices they caused.

      I seem to remember at the beginning the Biden administration advised against oil sanctions, but the EU thought they knew better. Well, now they’re in deep doo-doo but they can’t admit the US was right.

      1. Lynn Atkinson
        December 26, 2022

        It is humiliating to have the Russian President point out the old truth that every capitalist surely knows: ‘to create a shortage of tomatoes put a price cap on them’. (Noble Economics Prizewinner Milton Friedman – one of our own)
        When I read the readouts of his speeches it is also the Russian President pressing for negotiations, limiting military action and stating repeatedly that Russian will NEVER use the nuclear option first, but will defend itself by all means. I don’t think this is unreasonable.
        It is these warmongering Neo-Cons goading Russia and China – what they think they will fight with when we will shortly have no internal combustion engines not to mention fuel, I know not. I am horrified when China lays just and reasoned accusations at the door of the west. How on earth have we managed to put China on the high ground?
        The Christian Russian President refers to us as ‘The Empire of Sodom’. With all my heart I wish I could deny his accusation and claim the high moral ground. But I am forced to concede that he is right. He is the Statesman and we are flailing about wondering how to select those who ‘govern us by consent’!

  19. Brian Tomkinson
    December 26, 2022

    The NHS top management need clearing out. This must be among the worst run organisations in the country despite being given ÂŁ200bn of taxpayers’ cash per annum.

  20. rose
    December 26, 2022

    Congratulations to Lord Botham for unmasking JP Morgan’s woman in the Treasury. She used that chillingly undemocratic phrase, “the Bank of England and policy makers…”

    Actually, one wouldn’t mind if they got it all right.

    1. Wanderer
      December 26, 2022

      @Rose, I missed that story but googling Lord Botham and JP Morgan simply turns up anodyne feelgood stories about cricket or banking, so I am none the wiser. Without going into any details of the underlying matter, what media outlet might illuminate it for me?

      1. rose
        December 26, 2022

        BBC’s Today Programme on Radio 4 have a custom at this time of year of inviting a few guest editors to shape the programme. Today it was Lord Botham. He chose the subjects for this morning’s discussion and interviews. Now it may be that he did not choose that particular interview, the one with Karen Ward, because they don’t make it clear how much they are sub editing the guest editor, but with no interruptions it gave one a clear idea of what she is like, and I like to think he was canny enough to ask for it even if he didn’t.

  21. J M
    December 26, 2022

    A real problem that the NHS needs to address is the payment to locum staff. The reason that there is a recruitment and retention crisis is that staff can earn far, far more by work as part-time locums than they can on the payroll. Until part-time staff are paid a simple divisible of the full-time salary, this will not change.

  22. Bert Young
    December 26, 2022

    Agree with the post . Much change is required for the way forward to be economically and socially acceptable . A firm hand at the top is essential to control Union intervention .

  23. agricola
    December 26, 2022

    The railways are set up to provide a service , at great expense to users, but that market place has changed. It cannot compete with air travel were the airlines allowed to operate a domestic bus type service. If railways are to work for passenger they must be cheap, clean, and on time in a plus or minus 30 second bracket. Japanese railways do better than that. Ticketing should be fully automated. Drivers should be monitors of a fully automated service, much like airline pilots, only hands on in strong crosswinds or other emergencies.
    Railways should develope a long distance logistics service. At present a lost opportunity.

    I suspect that the NHS is grossly over administered with 47% of total employment being none medical or approaching 600,000. It is not easy to get accurate figures from the 1.2 million total. Talk is of it being 130,000 medical personel short. Cut down the admin bodies and have the money to pay better and recruit the requisit medics. Remove training costs from students for ten years of bound service to the NHS. Encourage trusts to run kaizen schemes to maximise production from large capital invested hospitals. Invest heavily in post hospital care to remove bed blockages. Aim to expand A&E so that patients only use ambulances for life saving transport, not as expensIve beds in A&E.
    Professionalise central purchasing and cut out the waste that the medical staff are all too well aware of.

  24. Bryan Harris
    December 26, 2022

    First of all t he government need to be able to take the political elements out of strikes – Trade Union Bosses have a long history of fighting against the crown and all it stands for, desiring to break our society into some form of dark socialism. The only difference between now and the unrest of the 70’s is that so far there has been no politically inspired violence.

    Ministers need to become smarter at side tracking anti-society ambitions, and concentrate on real dialogue. We’ve all heard the side of the unions, but have HMG explained in real language just how we got into this mess – will they admit that it was down to mis-government, and that pay rises were deliberately kept low for decades.

    The elephant in the room, which union bosses must surely understand and will use to their advantage, is that with inflation soaring, and set to soar higher, any huge pay rises they get will be worthless in a very short time, and this will trigger more strikes, more disruption, and certainly more inflation!

    Surely if this is understood by all concerned, we can see some rational conclusions

  25. Bryan Harris
    December 26, 2022

    It is looking ever more likely that the NHS cannot be saved in its present form – It is too big to simply change some vague concepts of how it is run – It needs to be totally remodeled.

    0. Define what actually makes a good health service, what we want and what we can afford;
    1. review all options for a new model – choose the top five which give us potential to create a health service fit for today;
    2. put these models into effect in small areas that have enough facilities to make it a good trial – include everything from GPs to hospital boards and hospital design, as well as training;
    3. Extend trials of so far successful models, then choose the best – Get it implemented country-wide.

  26. glen cullen
    December 26, 2022

    It isn’t the tackling of strikes, it why are they striking 
and why is it in the main, the public sector or the former public sector workers striking
    Maybe its because they see our government with so much money and they want a slice of it 
after all they see government paying themselves, paying for hotels for immigrants, paying the French, paying the EU, paying Rwanda, paying for HS2, paying foreign aid etc etc
    There’s a line of public sector workers ready to go on strike, maybe our government needs to show some leadership, by cutting its pay and cancelling its vanity projects

    1. Bill B.
      December 26, 2022

      That makes sense to me, Glen. Unfortunately. The state played Lady Bountiful for two years, so it can carry on doing the same. Why should Johnson and Hancock’s chums, with their dodgy Covid deals, be the ones to benefit and not us – could well be the attitude.

  27. Norman
    December 26, 2022

    Agree with both eminently sensible posts, with thanks to you Sir John for persevering in such daunting circumstances.
    I’m afraid the underlying culture in the three organizations currently subject to strikes is deeply affected with ‘the old disease’, which never really went away, and it’s going to take a full-on battle to significantly change them. I get the impression some senior medics are quite cynical, too, probably out of sheer frustration. The opportunism of malign forces, is being facilitated by government stupidity in major policy areas, so sadly, we are in for difficult days ahead. Such a pity, and all so unnecessary. But thankyou again for your positive analysis.

  28. Geoffrey Berg
    December 26, 2022

    I cannot agree with this post because strikes are strikes and the underlying technique of striking is the same and fundamentally illegitimate.
    Obviously the overall circumstances in the rail industry are different to the NHS and in day to day terms may be managed differently.
    However the very point of strikes in all cases is to get management to capitulate to strikers’ demands by making the activity unmanageable except by capitulation, harming the public and often other workers in their industry in the process. If strikers succeed strikes will become commonplace in many industries, not only their own in future but in other industries as well. If they fail , as the miners did in 1984, that does deter others from striking. In the end those who lose out most from strikes are the self employed and those many who cannot strike effectively.
    I want so far as practicable for strikes to be made illegal but if they are legal the government is under a public/moral duty to protect the public at large by rendering striking ineffective in all cases.

  29. Pauline Baxter
    December 26, 2022

    Broadly speaking Sir John, you are correct about trains and NHS. Do you seriously believe though, that your Party will follow your good advice?
    Meanwhile, we have vast numbers of illegal ‘immigrants’ being welcomed in and given hotel accommodation!
    Unfortunately the other Party would undoubtedly be even worse.
    I for one, will vote elsewhere when I get the chance.
    I have had more than enough of the ‘Don’t do that, you will let the other side in’ con.

    1. MFD
      December 26, 2022

      +1 Pauline. my sentiments entirely

  30. Ray Veysey
    December 26, 2022

    The NHS unions are almost totally controlled by communists, or far left activists. Which is essentially the same thing. Their power must be removed, indeed the far left should be rumored from positions of power completely. Individual rights are wonderful until they threaten the majority.

  31. Original Richard
    December 26, 2022

    Many institutions, the NHS and Civil Service included, have succumbed to employing large numbers of highly paid “Diversity Managers” and associated staff.

    Diversity is a communist device designed to destroy meritocracy one of the West’s most powerful tools, together with freedom of speech, for bringing equality and prosperity.

    Diversity is like a cancer or myiasis of the institution devouring the institution from within by deliberately filling posts with incompetent staff and at the same time causing resentment and loss of camaraderie.

    To quote Robert Conquest’s second and third laws of politics :

    – “Any organization not explicitly right-wing sooner or later becomes left-wing.”

    – “The simplest way to explain the behaviour of any bureaucratic organization is to assume that it is controlled by a cabal of its enemies.”

  32. formula57
    December 26, 2022

    So I take it the Government will now give in to the nurses? Just so, no point in prolonging matters.

    Of probable real assistance to the Health Secretary, Chancellor and PM in their forthcoming “immediate talks” is the advice Sir Arnold gave to Sir Humphrey on pay although even he had not considered wholesale re-grading. rostering etc.. You may recall Sir Arnold proposed larger and more “allowances” that being expenses are not reported as pay – so nurses could have some or all of allowances for being at teaching hospitals, those with A&E facilities, those in inner cities, those with patients, merit awards for turning up to work and/or having qualifications etc.. A willing mind could easily get to 19 per cent..

    1. Dave Andrews
      December 26, 2022

      Why should they give in? They are toast anyway at the next election. The striking healthcare workers aren’t inconveniencing them whilst they can afford private healthcare arrangements.
      I find it so bizarre. They are striking to influence politicians who have given their pay arrangements to a quango, and the people being inconvenienced are the ones who can do nothing about it.

  33. Roy Grainger
    December 26, 2022

    NHS pay is set by an independent pay review board whose recommendations the government accepts. This seems a reasonable approach. However last year the government ignored it and gave the nurses an extra 3% on top. This has set the precedent whereby the pay review board’s recommendations can be overruled but only in one direction (up). For that reason I suggest we abolish it and ministers can negotiate pay rises directly (not that they’d be any good at it of course).

  34. X-Tory
    December 26, 2022

    Sir John, I hate to be negative so soon after the Christmas goodwill, but I’m afraid that your post today is very weak. Of course managerial improvements are required but these are quite separate to the issue of how to respond to strikes. Managerial changes are a long-term project but strikes need an immediate response.

    As I have said many times, the government should publish a list of ‘essential jobs’ where strikes are simply not permitted. Nurses would obviously be on this list, as should those working for any form of public transport. Just ban the strikes and stop allowing the trades unions to make life an absolute misery for everyone.

    This pathetically weak and pusillanimous government is contemptible and deserves to be wiped out at the next election.

    1. anon
      December 29, 2022

      Not just essential jobs , but those where there is a monopoly or limited competition then strike action needs to curtailed. I tend to agree but beware..

      Its all part of the plan to bring a solution inline with the Agenda.

  35. Richard II
    December 26, 2022

    I don’t believe the government will come out well from a confrontation with NHS nurses, and I think SJR’s point that NHS management leaves a lot to be desired is also key to a solution. ‘Getting more value for all the extra cash channelled into the NHS’ is surely the way out of the current stand-off. A deal with the nurses and the senior executives can at the same time drive through the sort of efficiency improvements and avoidance of waste that need to happen anyway.

    The situation is certainly different with the striking rail workers, although it is rather hypocritical of government supporters to say too many empty trains are being run. It was the government that destroyed the rail industries’ business model based on commuting, with its lockdowns and by encouraging WFH. Have we forgotten Boris Johnson (23rd March ’20): ‘You must stay home’?

    1. glen cullen
      December 26, 2022

      Stopping all bank/agency temp recruitment would be a start

      1. Mickey Taking
        December 27, 2022

        No doubt more operations etc would be cancelled – a perfect excuse to make an anti-Government point. BUT if guns were stuck to, the out of work agency people might just have to apply for NHS employed jobs once again. Problem solved and external agency work billed removed.

  36. glen cullen
    December 26, 2022

    90 more people for a free dinner yesterday 
that we know about

    1. Mickey Taking
      December 27, 2022

      nice day for a boat trip? Then a hotel for extended holiday… whats not to like?

  37. turboterrier
    December 26, 2022

    Peter Wood
    100%+ with you on this one Peter
    The running and selection processes of all the parties are the reasons for such lamentable government and opposition

  38. turboterrier
    December 26, 2022

    This government desperately needs a win win in just one area will suffice just to try and stop this fast decline to near oblivion.
    Dingy Invaders as it ticks a lot of public concern would be the easiest. Take full control with your big majority instead of giving money to all and sundry and be seen to be actually doing something positive.
    Whether they like it or not its become Showtime and the cast have got to step up to the mark and start delivering.
    The party is divided and very disjointed even within the various elements.
    If they don’t there will be another leadership crisis on the cards before the new year approaching is too old.

  39. Lindsay McDougall
    December 27, 2022

    I would go a lot further than you. Why should the railway industry not be forced to make a profit? The Government would make decisions in favour of taxpayers. The necessary levers are available: (1) Network Rail should be ordered to raise track access charges to cover – perhaps more than cover – their costs (2) Unprofitable rail services would be withdrawn (3) Railway lines incapable of sustaining any profitable services would be shut and possibly sold off (4) The guarantee of no redundancies could and should be withdrawn. Within that envelope, RMT and the other rail unions could negotiate wages and manning practices. They would probably be more realistic.

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