Junior doctors, Trump, and the Overton Window

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Overton himself, looking good

These junior doctors, eh? Their ridiculous contract ‘negotiated’ by the canny BMA, who steamrollered the Labour government of the day, creating an unworkable melange of the European Working Time Directive and the New Deal, that has badly damaged training, introduced perverse financial incentives (possibly more later) and made hospital rotas (and therefore safety) very difficult to organise. Ever wondered why you can hardly find a doctor at night in a hospital ward? Even the BMJ acknowledges there’s a problem. This is a detailed and very prescient piece on the mess, from NHS ophthalmologists in 2006.

However, that’s not my main point, it’s just one of the most familiar, and egregious, examples of the EWTD, which in theory might affect any of us. A perfect example of how being in the EU has all sorts of unanticipated effects.

The point is this: 10 years ago, if you raised concerns re the EWTD, you were told that it was ‘non-negotiable’, because our membership of the EU was set in stone. The overt implication was that would never, ever change, and very few people questioned it. UKIP were barely on the horizon.

Look at it now. A pro-Europe Prime Minister with a majority is pressing on with a referendum to potentially leave the EU. This is the Overton Window in action. In 2007 the official government view (via a question in the Lords) was reluctantly expressed, by Lord Triesman as: Parliament may amend or repeal any existing Act of Parliament, including the European Communities Act 1972. There is no formal procedure for withdrawal in the EU treaties, nor are there any provisions in the treaties or any other international obligations which affect the ultimate ability of the UK to withdraw from the EU. However, given that the UK has been a member of the EU for more than 25 years, and its laws and economy are intricately bound up with those of the EU, the Government would in practice have to negotiate the terms of any departure over a lengthy period. Otherwise known as: ‘forget it, it won’t happen’. Yet here we are.

The Overton Window is best described as the range of policies acceptable to the public, or more specifically, to quote Wikipedia: a range of policies considered politically acceptable in the current climate of public opinion, which a politician can recommend without being considered too extreme to gain or keep public office.

This week’s main example is of course thanks to Donald Trump, and despite the reflexive Trump hating in the media (and I’m not a Trump supporter), I think he rather cynically made his comment about Muslims and immigration to shift the window. What he actually said was slightly more nuanced than has been widely reported. Specifically: Donald J. Trump is calling for a total and complete shutdown of Muslims entering the United States until our country’s representatives can figure out what is going on. That was Trump moving the window, and already the discourse is changing. A lot of US media types think it will allow the more moderate Ted Cruz to hoover up votes from this part of the political spectrum. They may be right. This beautifully presented discussion by David French is worth reading.

Another current example lies in the reporting of the futile Paris climate change love in. It’s not just the BBC, Sky and ITV are reporting it without any sense that there is a very real and growing debate over the validity of the assumptions that lie behind it. In TV terms at least the Overton Window has shifted to the climate-change-is-real-any-action-however-expensive-or-impractical-is-good axis. Dissent is simply not mentioned. That is probably an example of the TV media’s OW being in a somewhat different position to that of the average punter, on reflection.

No-one at all, back in 2005 when NHS medics were wrestling with producing EWTD compliant rotas, would have predicted that we would now be discussing the possibility/probability that we could dump the reason for the EWTD, yet here we are, and a good thing too.

Control the window, you control the debate.

 

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Those junior doctors: another viewpoint

I’ve taken the original post down for a while. I can’t be bothered with the possibility of lots of online whingeing/abuse.

The essence was: the current Junior Doctors’ Contract is  a rubbish contract for reasons of complexity,  training/experience, continuity of care, harmony, financial transparency and vocational medicine (as opposed to highly paid serfdom).

It needs reforming. The devil is in the detail, of course

I’ve left one pic, to give people a taste of how it currently works

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