This Week’s Doctors’ Strike Is Another Test Of Wes Streeting’s Mettle. He Is Right Not To Buckle | Polly Toynbee

The bizarre, self-defeating assault connected Wes Streeting suggests a pre-budget panic. This feels for illustration a authorities losing touch and escaping from dismal circumstances successful nan existent world. The ricochets damaged nan PM and Morgan McSweeney, whoever organised these orchestrated briefings. If nan briefers are not “found” and fired, No 10 looks either anemic aliases guilty.

The wellness caput shrugged it disconnected pinch wit and agility successful a big of interviews and near for Manchester to speak to nan NHS Providers conference. There, he addressed grim-faced managers confronting nan hardest of times. Resident (formerly junior) doctors spell retired connected a five-day onslaught from 7am connected Friday. Their timing intends astatine maximum disruption successful what will beryllium “one of nan toughest winters our unit person ever faced” according to NHS England’s CEO, Jim Mackey. An exceptionally virulent flu strain has arrived early, pinch cases already respective times higher than normal. Last month, flu hospitalisations were up 74% week-on-week.

The latest NHS figures retired this week show that successful October 54,000 patients waited much than 12 hours for a furniture successful emergency departments, astir 10% much than nan aforesaid period past year. With nan elective waiting database now astatine 7.39 million, Health Foundation analysis has suggested that connected existent trends, nan authorities will autumn conscionable short of its header promise to reconstruct nan 18-week elective attraction modular by nan extremity of this parliament. In nan 49 days of strikes complete nan past 2 years, 1.5m appointments were rescheduled crossed England.

In their ballot, covering some their July action and this week’s, 90% of doctors voted successful favour of striking, connected a 55% turnout. No one, including nan wellness secretary, doubts they person heavy grievances astir their moving lives successful a strategy that damages nan NHS and detaches young doctors from nan hospitals wherever they concisely work. After difficult student years, starring to debts of up to £100,000, they person to rotate betwixt different master training posts astir nan country, ne'er a portion of nan squad wherever they work, ever anxious astir their adjacent accelerated placement, treated roughly, often going without basking meals, chairs, beds aliases holidays.

But Streeting has group astir improvements. He has pledged to ease nan bottleneck by giving UK-trained doctors first prime of training places. The BMA resident doctors committee says immoderate 30,000 doctors use for 10,000 places. But Streeting’s agency says that now only 8% of UK-trained doctors who use for a station neglect to get one. That’s 8 percent points excessively many, but they’ve been promised that further reforms are connected nan way.

Their salary declare is greeted pinch a batch little sympathy. As soon arsenic he was appointed, Streeting settled generously pinch a 22.3% rise complete 2 years and an above-inflation mean of 5.4% this year, making an mean summation of 28.9% crossed 3 years. The doctors sewage by acold nan most; nurses, midwives and physiotherapists are offered 3.6%. The doctors yet want another 29%, to reconstruct their salary to wherever it erstwhile was earlier nan bankers’ crash. There is conflict complete which measurement of ostentation should beryllium utilized successful nan calculations, RPI aliases CPI, but either measurement nan full nationalist assemblage has has had its salary ruinously diminished since 2008. Paul Nowak of nan TUC says that real wages would beryllium £217 a week more had they kept rising astatine pre-2008 rates.

The doctors person done amended than others, which is why Streeting can’t and won’t springiness in. He’s nary headbanger wanting to beryllium his worthy fighting pinch unions; connected nan contrary, he has been eager to settee pinch them but has been snubbed by nan BMA’s ungracious haste to strike. The committee has refused his request to meet them.

Under nan Tory government, nan nationalist backed nan striking doctors. Polls person now swung nan different way, pinch 51% against and 40% successful support. Even so, 40% is still rather high, considering nan wide worry astir waiting lists. But 51% presently opportunity doctors should never beryllium allowed to strike, a opposition pinch attitudes to nurses, where 53% say they should beryllium permitted. But location is nary wide turning against waste and acquisition unionism: attitudes towards waste and acquisition unions remain positive, by 33% to 28% negative.

Slipping support for resident doctors whitethorn travel from hearing much astir their pay, astatine £38,000 for beginners, rising to £109,000 arsenic a first-year afloat trained consultant, which reaches £145,000, pinch bonuses for immoderate and backstage believe for others. Given these difficult times, nan costs of surviving and stagnant salary for most, these are not nan astir evident candidates for nationalist sympathy.

I couldn’t find anyone to talk connected nan record, but I said to resident expert “Martin” connected Thursday betwixt engaged clinics. He will not beryllium striking. He says he knows others who won’t either, because they’re worried astir diligent safety. He does deliberation those starting retired successful training posts are severely treated, but that hospitals are now hurrying to amended conditions. Pay, he says, is little of an issue.

We hold to spot really galore doctors travel out. A solution to nan training-post shortages is urgently needed. A study this week from nan Higher Education Policy Institute suggested different route, training up less super-specialist consultants but galore more training places for doctors and GPs successful nan community, preventing infirmary admissions. Generalists would lick much problems of aged group pinch aggregate conditions. But bully reforms will beryllium harder to work together successful nan bitter ambiance of strikes.

• Polly Toynbee is simply a Guardian columnist