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A negotiator’s crystal ball?

David Bannister
Negotiation Nhs [Converted]

As I write, it is Sunday 7th July.  Last week, the UK saw a widely predicted change of government.  I am going to look at a negotiation that is yet to happen as a result of the election, consider the important factors in play and try to predict what might result.

A couple of weeks ago, while listening to the news on the car radio, I said to my wife that within a few days of the new government taking office, the new health secretary, who I correctly predicted would be Wes Streeting, would have a meeting to attempt to negotiate an end to the long period of industrial action taken by the English junior doctors called by their representatives in the British Medical Association (BMA).  To refresh your memory the English junior doctors have been in dispute with the government for almost two years over their pay resulting in strikes and an acrimonious stand-off.

The new health secretary wasted no time in pronouncing the NHS to be “broken” – an interesting choice of words as I always thought that when something was broken it would no longer work.  I suspect that this is a tactical choice of expression allowing Streeting to eventually claim he has mended the service (even if that proves to be debatable).  Nevertheless, my prediction was correct and the secretary of state has arranged to meet the junior doctors in this week.  This gives me the opportunity to speculate about what might happen and to look at the variables and tactics here.

First of all. The fact of the government calling a meeting may be a tactical victory for the doctors because the previous secretary of  state refused to meet them when they were staging strikes.  Arranging the meeting is, in itself, then, a signal of intent – Streeting wants a deal perhaps because a negotiated return to normal working by the junior doctors can be heralded as a start to the “mending” process.  I am confident that the junior doctors have an expectation that this new government will be more willing to deal than the last one.  But, there remain interesting issues.  Significant amongst these is the matter of precedent – important in negotiations – precedent can, of course, be both followed and created.  There is precedent here as the Scottish and Welsh junior doctors have settled their pay claims by agreeing a 12.6% increase with the relevant devolved governments. Allowing the secretary of state to ask, if he dare: “Explain to me please, why a doctor’s work is more valuable in England than it is in Wales or Scotland”.   Also, hospital consultants have made a deal of between 12.6% and 19.6% with a restructuring of their pay arrangements meaning that they earn more faster than they did previously and thus introducing the infinitely flexible variable of time – more of this in a moment.

What signals do we read here?  The junior doctors cited 15 years of not keeping up with inflation and claim that a pay increase of 35% is necessary to restore their relative position.  There are a number  of things about this – first, you can calculate their “loss” using different and equally valid, measures of inflation and arrive at different outcomes.  Second, nobody, even the most delusional optimists on the Junior Doctors’ Committee of the BMA believes that they will end up with close to 35% now with settlements of 12.6% elsewhere - the precedent that would create would be a hole through which nurses, consultants, auxiliary staff and all  of the other NHS employees from radiologists to physiotherapists would leap without needing invitation not to mention the junior doctors in Scotland and Wales and, probably the rest of the UK public sector.  However, the English junior doctors’ representatives have said that any offer has to be “credible” but, unhelpfully, have failed to define what that means so that if they arrive at a settlement they will be free to recommend it to their members as being “credible”, risking, perhaps, the possibility that their claims have raised members’  expectations to an unachievable level.   However, the first thing which Streeting should do at his meeting this week is get them to define “credible” if he can.  If he can’t then testing the water with an offer might be the way in which he flushes out that elusive definition.  The current, rejected offer is 11.8% made by the previous government leaving precious little room for movement before the 12.6% accepted and implemented elsewhere is exceeded and we get into precedent creating territory.  So here, Streeting may be able to use the variable of time.  He is quoted as saying, in a very significant negotiating signal, that this will be a “journey not an event”.  In a very important reciprocal signal, the junior doctors’ reps have indicated the possible acceptability of “phasing in” a deal allowing for a possible staged agreement.


Looming over all of this, of course is the credibility of a newly appointed secretary of state who has spent much time suggesting that he can fix the problem but not with a 35% offer (although he has never suggested a figure which might be possible) thus bringing into play that emotional negotiating issue of loss of face - it is my opinion that he must get a deal but has to tread a very fine line between the success of getting an agreement to end  a lengthy dispute and the failure of being accused of simply throwing money at the problem.

This fascinating game will be played in a relatively public forum this week.  So I shall stick my neck out:  no final deal this week – it would look too much like caving in after such a long and cantankerous stand-off. But there will, I think, be a clear indication of “significant progress”, with lots of more conciliatory and cooperative noises. The outcome which will emerge soon after, will involve more than one stage in the resolution and a deal not too far removed from the Welsh and Scottish ones with more reserved for the future.  Some of Streeting’s recent public announcements have been about his intention to do what some people call “sweat the assets” of the NHS – get more from what is there and this may be the opportunity for him to announce the practical beginnings of such a strategy.  So I would expect some element of productivity in its broadest sense to be attached, like a good negotiator, as a condition to the phasing in of additional pay. We shall see!

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