Tag: United Kingdom

The growing resistance of bacteria to antibiotics threatens, according to the World Health Organisation, sending modern medicine back decades to an era “when even routine surgeries were hazardous”.

But a recent inquiry by the Science, Innovation and Technology Committee, which I chair, has heard compelling evidence of a medical treatment that can evade anti-microbial resistance.

Bacteriophages, or phages for short, are viruses that invade specific bacteria and destroy them. They have shown success in treating deadly infections that are resistant to antibiotics. But, even after years of research and growing evidence of their efficacy, phages have never been licensed for therapeutic use in the UK. They have only been used here as “compassionate” treatments of last resort in a small number of cases, using phages imported from overseas.

Medical interest in phages increased in 2019, after the recovery in Britain of a teenager with an untreatable lung infection. After a nine-month stay at Great Ormond Street hospital she returned to her home in Kent for palliative care but recovered after her consultant teamed up with a US laboratory to develop a specific phage therapy. Afterwards, the lab received requests from doctors around the world seeking hope for their patients.

Phages are not a panacea. They are specific to an individual infection and may require months of laboratory development. The UK is developing a ‘library’ of phages, with advanced genomic sequencing and understanding of the viruses’ therapeutic interactions. But to begin to realise the benefits of phage treatment at scale, we need clinical trials. And that is where the UK is at an impasse.

Current UK regulations require the phages used for clinical trials to be manufactured to an exacting set of standards known as Good Manufacturing Practices or GMP. Here there is a Catch-22 problem. We cannot conduct clinical trials until we can manufacture phages to GMP standards, but we cannot manufacture phages to GMP standards without significant investment in qualifying design, equipment, installation and processes which will not be forthcoming without successful clinical trials.

Our Select Committee’s report recommends establishing a small collective manufacturing facility in which researchers and companies can produce phages to GMP standards without incurring the full set up costs of a manufacturing facility themselves. This has precedents in the Catapult network, which provides collective test facilities for advanced manufacturing companies and for new satellites being developed.

One such facility, which has already received over £1 billion of public funding, could be the Rosalind Franklin Laboratory in the West Midlands. This state-of-the-art testing and diagnostic lab was established by the Government to bring an end the inadequacy of testing capacity that so hampered the national response to Covid. It consists of modern, secure laboratory facilities and was meant to be an important source of national resilience against future pandemics. But the Rosalind Franklin Laboratory has suddenly appeared for sale on the property website Rightmove, to the astonishment of the science and health communities. Our Committee’s report on phages asks for the Rosalind Franklin Laboratory to be considered for this purpose, rather than be lost to the nation and to science in a firesale.

In the meantime, we recommend that the UK medicines regulator, the Medicines and Healthcare Products Regulatory Agency, should consider allowing the compassionate, last resort use of non-GMP phages produced in the UK.

Phages are an example of personalised medicine, in which therapeutic medicines are bespoke to the patient. How we approach the licensing of bacteriophages may supply useful lessons and experience as our respected medical regulators, world-renowned researchers and innovative life sciences sector work together on treatments that may offer solutions to the some of the world’s biggest problems, like antimicrobial resistance.

Source

Thank you Claire, you will be a great candidate for Filton and Bradley Stoke, and in time I hope, an even better MP.

And it’s great to be here again looking at the next generation of aircraft wings. You can see some of the instruments behind me. This is the third time and I love it, and it features quite heavily in a number of my speeches.

On behalf of the Labour Party – thank you for being here this morning and Happy New Year.

Now – as a politician, you’ve got to be a bit careful with these new year messages.

We all remember Boris Johnson’s prediction of a “fantastic year ahead”. That was in 2020.

Then, last year, I stuck my neck out and occasionally predicted glory for Arsenal, so I’ll pass on that one today.

But look, there is one thing that we can be sure is coming this year and I’m ready for it. The thought of millions of people, right across our country, putting a cross on that ballot paper.

It’s what we’ve been waiting for, preparing for, fighting for. A year of choice.

A chance to change Britain. A clock that is ticking on this government, because whether it’s in the spring or later in the year, the moment when power is taken out of Tory hands and given, not to me, but to you. That moment is getting closer by the second.

So, if you’ve spent the last 14 years volunteering to keep your park clean, your library open, for children to have opportunities. If you’ve been breaking your back to keep trading, steering your business through the pandemic, the cost-of-living crisis, the challenge of Brexit and the chaos of Westminster. If you’ve been serving our country, whether in scrubs or the uniform of your regiment, and what you want now is a politics that serves you – then make no mistake, this is your year. The opportunity to shape our country’s future rests in your hands.

And that is a new year message of hope. The hope of democracy. The power of the vote. The potential for national renewal. The chance, finally, to turn the page, lift the weight off our shoulders, unite as a country, and get our future back.

Four years, I’ve been working for this. Four years, working for the chance to tilt this country, firmly and decisively, back towards the interests of working people.

It’s been a long, hard slog, and I won’t lie, I’ve hated the futility of opposition.

The powerlessness and yes, the pain, that comes from watching the Tories drive the country I love into the rocks of decline.

I didn’t come into politics for that. I didn’t expect a front row seat on this Tory performance art, a song and dance for your political attention, because they find performing so much easier than the hard graft of practical achievement.

No. I came into politics to serve, to get things done, to strive, each and every day, to make a difference to the lives of working people, that’s what gets me up in the morning.

And if you can put aside the reality of Westminster just for a moment, it’s why I still believe in politics.

I had a long career before this: at the Crown Prosecution Service, as a human rights lawyer, in my work with the Police Service of Northern Ireland. I’ve looked into the eyes of people I’ve served and represented, and I have seen reflected back the knowledge that government can make or break a life.

Literally, when it comes to work I’ve done with people on death row. Life and death decisions, in your hands.

Now there’s pressure that comes with that, of course there is. But that’s the responsibility of justice and public service, and it’s the responsibility of serious government.

This isn’t a game. Politics shouldn’t be a hobby – a pastime for people who enjoy the feeling of power. And nor should it be a sermon from on high, a self-regarding lecture, vanity dressed up as virtue.

No, it should be a higher calling. The power of the vote. The hope of change and renewal, married to the responsibility of service, that’s what I believe in.

And yes, I believe it’s still the best way to change our country for the better.

Its success or failure, written into the walls of every community in this country.

The hospital your children were born in, the home you live in, the wage in your pocket, the opportunities in your town, the sense of pride – or unease – when you walk down your street. That’s all politics.

So, this year, at the General Election, against the tide of cynicism in Westminster, the gauntlet of fear the Tories will unleash, and most of all – the understandable despair of a downtrodden country, I will ask the British people to believe in it again.

I will say, you’re right to be anti-Westminster, right to be angry about what politics has become. But hold on to the flickering hope in your heart that things can be better, because they can.

You can choose it. You can choose the hope of national renewal, the responsibility of service, what politics can and should be, and you can reject the pointless populist gestures, and the low-road cynicism that the Tories believe is all you deserve.

That’s all they’ve got left now, after 14 years, with nothing good to show, no practical achievements to point towards, no purpose beyond the fight to save their own skins, this is their only project.

They can’t change Britain, so they will try to undermine the possibility of change itself. Take Britain down to their level, kick the hope out of us all.

But I believe in this country, I believe in its spirit, I believe in its people, in its businesses, in its communities, and most of all, I believe that if the British people see respect and service in their politics – if they see a plan which matches the ambition and pride they have for their community, a path, finally, to an economy that rewards and respects their efforts – then yes, they will commit to the mission of national renewal, and will believe that Britain can get its future back.

But I am under no illusions. This is a huge test. We’re trying not just to defeat the Tories, but to defeat their entire way of doing politics, a mindset that seeks out any differences between the people of this country, and, like weeds between the paving stones, will pull apart the cracks, so ultimately, they can divide and rule.

I have to warn you all, they will leave no stone unturned this year. Every opportunity for division will be exploited for political potential. That’s a given. But do not doubt for a second that we’re ready for it, do not doubt that we will show the British people that the real risk is five more years of a Tory Government that would be even more entitled, even more self-serving, even more complacent that your vote can be taken for granted.

And yet, at the same time, we have to bring the country together, have to earn trust as well as votes, nurture a spirit of national unity. This is what’s distinctive about our job this year. To truly defeat this miserabilist Tory project, we must crush their politics of divide and decline with a new Project Hope.

Not a grandiose utopian hope. Not the hope of the easy answer, the quick fix, or the miracle cure. People have had their fill of that from politicians over the past 14 years.

No – they need credible hope, a frank hope, a hope that levels with you about the hard road ahead, but which shows you a way through, a light at the end of the tunnel. The hope of a certain destination.

That’s why the national missions we’ve set, the measurable goals. Whether it’s the highest growth in the G7, halving violence against women and girls, clean power by 2030 – they are unapologetically ambitious.

I know they will take hard-work, determination, patience – a true national effort. And for many people that invites a sharp intake of breath, a raised eyebrow, a question – can this really be done?

But look, what really keeps me up at night is a different reaction altogether, the biggest challenge we face – bar none. The shrug of the shoulder.

Because this is the paradox of British politics right now. Everyone agrees we are in a huge mess. Services on their knees, an economy that doesn’t work for working people even when it grows, let alone now when it stagnates like right now.

Everyone agrees as well – that it’s been like this for a while. That Britain needs change, wants change, is crying out for change. And yet, trust in politics is now so low, so degraded, that nobody believes you can make a difference anymore.

Also, that after the sex scandals, the expenses scandals, the waste scandals, the contracts for friends, even in a crisis like the pandemic, some people have looked at us and concluded we’re all just in it for ourselves.

A nation that is so exhausted, tired, despairing even, that they’ve given up on hope. A national mood which, if we aren’t successful with our Project Hope, the Tories will subtly seek to exploit.

Seriously, after failing to deliver change, after ludicrously pretending that they could represent change, they now sense the opportunity of a new strategy, an attempt to take the change option off the table altogether.

And not just at the next election. No – their strategy also has one eye on salting the earth of Britain’s future, a plan to make sure that if Labour does earn the right to serve, we will find it harder to bring our country together for the common good.

So I say to every voter in this country: know that all this is coming your way. Know that if we are to heal the wounds of the past 14 years and move forward, Britain must come together.

And that means we will need you. But also know that whether you’re thinking of voting Labour for the first time, whether you always vote Labour, or whether you have no intention of voting Labour whatsoever, my party will serve you.

That’s who we are now. A changed party. No longer in thrall to gesture politics, no longer a party of protest, a party of service.

Rebuilt, renewed, reconnected to an old partnership, a Labour partnership, that we serve working people as they drive Britain forward.

So this is what I promise – my side of the deal, the answer to the question why Labour?

I promise a new purpose. To drag politics in this country back to service, tilt our economy back towards the interests of working people. Reward their efforts fairly, once again.

I promise a new plan with new priorities, five national missions that will sweep away the era of Tory division, a plan for the long-term.

With higher growth, a reformed planning system no longer blocking the homes, infrastructure and investment we need.

Safer streets, more police in your town, cracking down on anti-social behaviour.

Cheaper bills, with GB Energy, a new public company, using clean British power not foreign oil and gas.

More opportunities for your children, new technical excellence colleges training our kids in the skills they need and businesses want.

Better mental health support in schools, expert teachers in every classroom, paid for – by removing tax breaks on private schools.

And our NHS back on its feet, with a plan to cut the waiting lists, paid for by removing the non-dom tax status. Two million more appointments every year in an NHS clearing the backlog, seven days a week.

And written through this new plan, I also promise this: a total overhaul in how we approach the economy and government.

On government, it means a new level of ambition and focus. I ran a public service for years and the clue is in that word – service.

What the Tories have done to our public realm over the last 14 years, not just the cuts, also the denigration of the people who serve this country, the total lack of respect, honestly there are no words.

But I also have to say this, I don’t see our job as going back to some kind of golden age, I don’t think that’s how working people look at things at all. Government in this country is too centralised and controlling, and because of that, too disconnected from the communities it needs to serve.

And yet despite hoarding all that power, it also lacks ambition. A view of the potential of government that is content just to mop up problems, after the fact, armed only with a big state cheque-book.

We have got to change this. It is vital for taking on the profound challenges of our era: the rising geopolitical temperature, climate change, terrorism, securing our borders, the revolutions in science, energy, technology that are reshaping everything we know about our world.

So I promise this: a new mindset – Mission Government. An understanding at the core of everything we do, that it is our job to tackle tomorrow’s challenges – today.

On the economy it means a deeper argument about who growth should serve, where it comes from, who it comes from, where is the great untapped potential?

And the answer to every one of those questions, the Labour answer, working people. Communities casually ignored and disregarded, passed over as sources of economic dynamism, subjected to the Tory argument that thinks growth comes from driving down their wages and security, while they, in turn, should be grateful for anything handed down from those at the top.

I’ve read that the Tories want to fight the election on this terrain, that they think their economic comfort zone still has some purchase.

But let me tell you, what used to be their strength is now their weakness. The so-called party of business which now hates business, that boasts about tax cuts, while raising taxes higher than any time since the war, that claim, even now, to be the party of sound finance, but that crashed the economy and made you pay.

They have nothing left on this anymore. Their credit rating is zero, and we have turned the tables with a plan for the growth Britain needs.

Only Labour will deliver a proper industrial policy and higher investment.

Only Labour will bulldoze through planning red tape and get Britain building.

Only Labour will transform our labour market with stronger workers’ rights.

We don’t just expect an election on the economy, we want an election on the economy, we’re ready for that fight, ready to close the book on their trickle-down nonsense, once and for all.

And finally, I promise this. A determination to bring our country together, not exploit its divisions. An understanding that Britain’s standing in the world can never be taken for granted, and a politics of respect and service that shows zero tolerance towards the darker side of Westminster.

Don’t get me wrong, there are good people in Westminster. People who love their country and want to change it for the better. And yet a basic principle of any organisation I’ve worked in outside of politics, that you should follow the rules you set for others, uphold the values you advocate, this just doesn’t seem to be followed or understood in Westminster.

Honestly, what does anybody think it looks like to the people of this country, to see people rewarded, honoured, for crashing the economy under Liz Truss?

If your mortgage is going up this year and you see those people swanning around the House of Lords, what do you think?

No. I say to all my fellow politicians – Labour and Tory – to change Britain, we must change ourselves.

We need to clean up politics. No more VIP fast lanes. No more kickbacks for colleagues. No more revolving doors between Government and the companies they regulate. I will restore standards in public life with a total crackdown on cronyism.

I’ve put expense cheat politicians in jail before and I didn’t care if they were Labour or Tory.

And I grew up working class, so spare me the self-serving excuses, they just won’t wash. This ends now. Nobody will be above the law in a Britain I lead.

But with respect and service I also promise this: a politics that treads a little lighter on all of our lives.

Because that’s the thing about populism, or nationalism, any politics fuelled by division.

It needs your full attention. It needs you constantly focusing on this week’s common enemy. And that’s exhausting, isn’t it?

On the other hand, a politics that aspires to national unity, bringing people together, the common good, that’s harder to express, less colourful, fewer clicks on social media. And, in some ways, it’s more demanding of you.

It asks you to moderate your political wishes out of respect for the different wishes of others. 45 million voters can’t get everything that they want, that’s democracy.

So no matter the road the Tories take this year, I believe that if people see the commitment to service is always there in politics. If they can see that people in power respect their concerns, then I think a lot of people across this country, after everything we’ve been through in the past 14 years, will find some hope in that.

It will feel different, frankly. The character of politics will change, and with it the national mood. A collective breathing out. A burden lifted. And then, the space for a more hopeful look forward.

Because the truth is, it’s this kind of politics and only this kind of politics that can offer real change. The energy needed for divisive politics is a distraction. You can see that with the SNP in Scotland or the Tories here in England.

I learnt this first-hand in Northern Ireland. Before the Police Service of Northern Ireland was set-up, the idea that the nationalist community would buy into it in any way was utterly unthinkable.

Now, there’s always more work to do on that, peace in Northern Ireland has to be won every day. And yet, with patient listening, with determination, with the people of Northern Ireland coming together, not only with those different to them.

Not only with those who disagreed with them, but who even took up arms against the, the unthinkable happened. Catholic men and women did step-up to serve.

So don’t listen to the siren voices that say we can’t change Britain. We can, and we will. Don’t listen when they say we’re all the same. We’re not, and we never will be. And don’t listen when they say politics makes no difference – because it does.

If you can’t get an affordable home in your town, but with Labour you can, that’s a difference worth fighting for.

If you can’t get a job with regular hours that will let you look after your family but with Labour you can, that’s a difference worth fighting for.

If you’re a care worker who saved lives during the pandemic and has been rewarded with poverty wages, but with Labour you can get a fair pay agreement, that’s a difference worth fighting for.

The same is true for our NHS. For our schools, climate change and energy security, securing our borders, restoring Britain’s standing, crime and justice.

Only Labour will make a difference.

Only Labour will drag our politics back to service.

Only Labour can lead Britain towards national renewal.

And you have the power to vote for it.

A party of service with a plan, versus a party with nothing to offer because it only cares about itself?

Hope or cynicism?

A new politics or the same old Westminster? Continued decline with the Tories, or national renewal with Labour?

Nobody in Britain thinks the years ahead will be easy. But this year is the chance, the only chance, to change our course.

The future of Britain in your hands, the power of the vote in your control, and we will fight every day to earn it.

Why Labour? Because we serve your interests.

Why Labour? Because we will grow every corner of our country.

Why Labour? Because we have a plan to take back our streets, switch on Great British Energy, get the NHS back on its feet, tear down the barriers to opportunity, and get Britain building again.

A partnership with you in pursuit of a new Britain with foundations built to last.

The value of hard work – restored.

Sticking plasters – rejected.

The Tory era of division – over.

A Britain standing tall again, looking forward again, believing again, that tomorrow will be better for your children.

That is our future. And this year, we get it back.

Thank you.

Source

Rishi Sunak has appeared to rule out holding a general election in the first half of the year.

It comes amid speculation that the prime minister could call an election as early as May.

Speaking in the East Midlands, he was asked if he knew when Britons will head to the polls for an election.

“My working assumption is we’ll have a general election in the second half of this year and in the meantime I’ve got lots that I want to get on with”, Sunak told ITV.

Pressed if he could rule out a May election, he repeated it is his “working assumption” that the vote will be held later in the year.

He added: “I want to keep going, managing the economy well and cutting people’s taxes. But I also want to keep tackling illegal migration”.

“So, I’ve got lots to get on with and I’m determined to keep delivering for the British people.”

Under the Dissolution and Calling of Parliament Act 2022, January 2025 is the latest the prime minister could hold an election according to law. 

According to the Act, if an election was not called by 17 December 2024, parliament would automatically dissolve and the election would take place 25 working days later.

17 December 2024 is exactly five years since parliament first met after the last general election, held in 2019.

Sunak’s comments today come after he confirmed to lobby journalists at a press gallery drinks reception in No 10 Downing Street before Christmas that an election “will” be held this year in 2024. 

Rishi Sunak confirms election will be next year, despite legal right to wait until January 2025

Source

Keir Starmer will today say that Britain is “exhausted” as he launches Labour’s election campaign promising to change the “character of politics”

The Labour leader will say he no longer leads a party that pursues “gestures politics”, while accusing the prime minister of “pointless populist gestures”.

Claiming he helped send both Labour and Conservative politicians to jail in the wake of the 2009 expenses scandal, while serving as the director of public prosecutions, Starmer will describe the UK as “exhausted” by “the sex scandals, the expenses scandals, the waste scandals, the contracts for friends”.

He will add: “Whether you’re thinking of voting Labour for the first time, whether you always vote Labour, or whether you have no intention of voting Labour whatsoever: my party will serve you.

“That’s who we are now, a changed Labour Party. No longer in thrall to gesture politics, no longer a party of protest, but a party of service.”

He will argue that the only chance of “national renewal” is to “defeat this miserablist Tory project”.

He will promise to “clean up politics” of sleaze, adding: “No more VIP fast lanes, no more kickbacks for colleagues, no more revolving doors between government and the companies they regulate.

“I will restore standards in public life with a total crackdown on cronyism: this ends now.”

“They can’t change Britain, so they try to undermine the possibility of change itself”, he will say, adding: “pointless populist gestures and the low-road cynicism that the Tories believe is all you deserve”.

As Starmer sets out his stall, prime minister Rishi Sunak will give a rival new year stump speech in the East Midlands. 

The Labour leader will also attack former Conservative prime ministers Boris Johnson and David Cameron, insisting politics is not a “hobby” for people who “enjoy the feeling of power”.

Ahead of Starmer’s speech today, Conservative Party chair Richard Holden said: “Nothing is more cynical and populist than a weathervane Labour leader who has a consistent track record of telling people whatever he thinks they want to hear on any given day.

“He was for a second Brexit referendum, then he wasn’t. He told Labour members when he was running to be leader he would nationalise industry and scrap tuition fees, but then dropped these policies as soon as the contest was over.

“And he says he opposes Jeremy Corbyn now despite campaigning twice to make him prime minister and calling him his ‘friend’.

“The only thing we know for certain about Keir Starmer is that he has a £28 billion black hole in his spending promises which will mean thousands of pounds of tax rises every year for families.”

Meanwhile, shadow chancellor of the Duchy of Lancaster Pat McFadden has rejected the suggestion that Labour has failed to show policy detail under Keir Starmer’s leadership.

McFadden told the BBC Radio 4 Today programme: “I go back a long way in politics and if I compare the list that I have just read out to you that will be in Keir Starmer’s speech today with the pledge card that we produced in the run up to the 1997 election, I would say we have set out more policy in advance of this election than we did in the past.

“I think we need to take head on the idea that we are not setting out policy.”

Source

English local government is on the brink of a major financial crisis, one with the potential to drastically shift the course of events in the election year of 2024. If these dominoes fall, there will be major implications for our public services.

The chair of the Office for Local Government points to mismanagement and governance issues in the affected local authorities, and of course these have been a factor.

But this crisis also has a basis in a deeper problem. It is perhaps not surprising if some parts of the local government sector – after facing years of fiscal retrenchment, unfunded mandates, local democratic deficits, growing and ever-more-complex levels of demand on its services – should start to buckle under the pressure.

Our local authorities are tasked with some of the most challenging aspects of service delivery. But they do not have the autonomy to play to local strengths, or change how they raise funds, or arrange their own approaches. This makes England an international outlier. In almost any other comparable context, local and regional government is better resourced, more capable, and able to pursue its objectives in line with the priorities of local people.

It is not only local government that feels the strain of the hyper-centralised English system. It also has the effect of burdening Whitehall with unsustainable micromanagement. Too often, central government sees its bandwidth consumed by decisions and policies which, almost anywhere else, would be managed closer to the people they affect most. Civil servants with no proximity or practical connection dictate the minutiae of local governance, developing policies which are expected  – somehow – to work as well in Hartlepool as in Harlow.

Our new report, Devolve by default: Decentralisation and a redefined Whitehall offers a stark diagnosis and a bold prescription: a radical program of devolution would not merely be beneficial for our creaking system of government, but necessary.

The current system demands that central government micromanage local affairs, consuming vast amounts of capacity and detracting from its ability to address strategic, long-term concerns. The inefficiencies are evident: resources misallocated, opportunities missed, and services that are out of touch with local needs. We spoke to senior civil servants who reported teams of officials organising and evaluating submissions to funding pots which should never have been ‘owned’ by central government in the first place, or wasting time designing strategies for the layout of local parks, taskforces for promoting chess-playing, and programmes for the reduction of littered chewing gum.

Local authorities can’t change local road rules, or change local meeting patterns, or change their own workforces’ working hours without a ticking-off from Whitehall. This isn’t only ridiculous – it means that central government’s precious time and capacity is being wasted.

Devolution offers a pathway out of the current impasse. By shifting powers to more localised structures, we can reduce the administrative burden on Whitehall, allowing it to focus on national and strategic concerns. Local governments can become more responsive, efficient, and aligned with the needs of their communities.

Devolve by default sets out a new framework for evaluating the readiness of local systems to take on more of the workload that currently hamstrings the centre. To make this possible, new structures will be needed.

Government policymakers will have to start asking themselves – and each other – what aspects of their work would be much better handled at smaller and more local scales, and we recommend that this become a systematic component in the work of government departments.

Meanwhile, it is crucial to continue – and accelerate – the work of introducing the ‘missing tier’ in England’s governance. Most countries of comparable size and complexity have a regional tier to manage larger-scale planning and strategic decisions which are not a comfortable fit for central or local government. England doesn’t have this – in some ways, it never has – and the lass concerted effort to introduce functional regions was shelved in the Blair years (after a victory scored by none other than Dominic Cummings).

Now, combined authorities are rolling out – but they will need a firmer footing, and a better approach than the current glacial and badly-incentivised dealmaking, to one day cover all of England.

The current financial crisis engulfing local authorities is a symptom of a deeper malaise in our system of governance. The cure is a radical redistribution of power through England: devolution by default that empowers local governments and redefines Whitehall. This should be a central part of the policy debate in the next general election – and then, perhaps, the political appetite will finally be in place to get Whitehall focused on the things that only it can do well.

Source

I was working a long shift which required me to be on the ward by 8am.

After doing the ward round with the consultant, listening to the needs of patients and families, the noises of random alarms, the bleep I am carrying and people retching, it reaches 1 pm by the time I have to carry out my morning tasks. 

The screen in front of me says that a patient has an acute kidney injury and, simultaneously, I realise I have not had a sip of water all day. My kidneys cannot have been far off similar function. 

I am exhausted and it is not even near the end of the day. It is a feeling that most junior doctors have multiple times throughout a normal week. I cannot help but feel the strikes are something we look forward to.

Over 28 days of strikes, the British Medical Association (BMA) has adopted a deeply draconian stance. Most of its argument is based around pay restoration, with only some scant whispers of working conditions. 

The net outcome of this? Virtually nil. And whilst yes, a substantial pay increase is warranted for doctors across the country — the same can and should be said about the rest of the public sector across the country over the last decade. It has been disheartening to read time and time again that, in an attempt to try and substantiate their own salary increase, I have seen doctors patronise the pay of others.

The strikes have been unsuccessful for different reasons. Partly because of the incompetence and ignorance of the Department of Health and Social Care. Undoubtedly, its inability to negotiate whilst regurgitating the same rhetoric about how they do appreciate doctors and other healthcare staff has done irreparable damage. 

After the trauma of Covid-19 and what staff put themselves through in the name of public service, there was a sense, maybe naively, that the NHS would not be taken for granted again, and that reward would be given. This has not been the case.

Likewise, the stalemate has also been caused by the strikes, somewhat ironically, has created a vacuum of temporary staff shortages which are filled by locum staff for extortionate rates. The staff who are filling these positions are the very junior doctors who are striking. It means the continuity of care is largely unaffected and that the strikes — conducted in the best interest of patient care — are causing less disruption than needed to force the government into making the offer doctors need.

However, even if by some miracle the strikes were successful, and the deserved pay was given, I believe the mass exodus of doctors leaving the country or changing profession would not stop. Many doctors I have spoken to, including myself, cherish the time off we (rarely) have and want better working conditions. 

After speaking to my colleagues, I have five suggestions I believe would tangibly improve the lives of doctors in this country and make the NHS an attractive place to work once more.

1. Fixing the rota system

As a junior doctor, most trusts across the country say you can only take annual leave on a normal working day (NWD). This sounds fine in practice, but on an average rotation, half of your shifts across the four months will not be NWDs. It means for those shifts you are not entitled to annual leave, unless you can find your own cover. And, as professionals who often work over 60-hour weeks, one simply cannot find the time to cover for your colleagues. An alternative system needs to be implemented which allows you to take annual leave on any type of shift — and it should not be the doctors who have to find the alternative cover.

2. Changing the volume of mandatory out of hour shifts (OOH)

Working out of hours is something which is inevitable as a doctor, you have to shelve whatever else is going on in your life and spend a week or so being nocturnal. Now, while these shifts can be enjoyable for a lot of staff, they are not adequately paid. The rate of pay for these shifts should be moved closer to that of a locum cover, which would make it more attractive for staff to work these shifts. This would mean the government would not have to focus so heavily on increasing base salary, and have a different way of increasing the salary of doctors. It should also be more flexible on whether a doctor should or shouldn’t work these shifts. 

The strikes have proven if the right pay is available, those gaps will be filled. Flexibility is the one thing which keeps a lot of doctors in the profession in the long run, and this should be increased, not reduced as it currently is.

3. Remove the bottleneck for training opportunities and training programmes

Despite what is being said by the government, with the increased numbers of doctors both graduating in and migrating to the UK, there are actually fewer training opportunities available than ever. The competition ratios are increasing year on year, and if we want to have a health service with highly qualified doctors specialised as GPs or consultants, then we need to increase the number of training places. It is counterintuitive to have increased numbers of junior doctors and not let them train.

4. Allow doctors to work privately earlier in their career

Another way of increasing the pay of doctors in the UK is to increase the scope of what private work they can do. This would require fundamental policy change in the UK, but if doctors really want the pay they deserve, this needs to be considered. It is currently the unspoken truth that a lot more doctors than it may seem are willing to work privately on the basis that the NHS is overworked and heftily underpaid.

5. Create a vision for the NHS which is hopeful and innovative – not toxic and depleted

The NHS was, at one point, the marvel of the world — and it still remains one of the things this country is proudest of. After all, it is no wonder it was used as the showcase in the 2012 Olympics opening ceremony. 

But that moment feels like a lifetime ago now. The Department of Health and Social Care needs to wake up to the fact that staff are leaving in droves, and a career which was once prestigious and rewarded is now a laughingstock. 

Opportunity, reward and respect should be the key messages in shaping the NHS for the future. Despite the negativity in working in the NHS currently, there is no reason why it cannot change and become the envy of the world again. It just requires the right minds and belief to get it there.

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