Intended for healthcare professionals


Wider political context underlying the NHS junior doctors’ dispute

BMJ 2015; 351 doi: (Published 24 November 2015) Cite this as: BMJ 2015;351:h6317
  1. David J Hunter, professor of health policy and management
  1. 1Centre for Public Policy and Health, School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees TS17 6BH, UK
  1. d.j.hunter{at}

Unhappy doctors are back centre stage with a vengeance

Whatever the rights and wrongs of the dispute over the junior doctor contract, the ramifications will be felt throughout the NHS for some time to come. These have their roots in a wider political context that may prove decisive in settling the longer term fate of the NHS.

This dispute has striking echoes of the deep malaise among doctors in the late 1990s and early 2000s, also a time when the NHS was under severe financial pressure and undergoing reorganisation. The then prime minister, Tony Blair, spoke of bearing “the scars on my back” from attempts to reshape public services. An editorial in The BMJ in 2001 asked why doctors were unhappy.1 It suggested the causes were multiple but highlighted one in particular: the mismatch between what doctors were trained for and what they are required to do. Trained in a particular medical specialty, doctors found …

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