How has this come to pass?
Obviously not being part of the inner-circle I can only offer my own perceptions on what could, or might, have happened here. And that's the point. It's down to perceptions. Perceptions of their own and each other's values, perceptions of position, power and status, perceptions of what's right, or not. Perceptions of truth and reality, perceptions of what was on offer and what was not, perceptions of how far the other side would bend or remain firm. Perceptions of trust.
This is where I think it has all fallen down. Trust is critical to any negotiation, whether it's public or private sector, it's critical to any productive relationship and trust is now all too lacking in this sad, sad stand-off. Was it ever there?
6 Levels of Trust
The first is the trust that the general public has about the NHS, our most major of institutions and, for anyone who has lived outside of the UK, one of its most precious.
The second is the level of trust in one particular section of the NHS - it's doctors. Trust from the general public, the individual patient, between colleagues and between the medical hierarchy.
The third is trust between the doctors and their representatives, in this case the BMA. The fourth is between the Minister and his advisors, his parliamentary colleagues and his own boss.
The fifth level of trust is between the press and its readers, whether it reports fairly and impartially and how it's used, or abused by interested parties.
And finally the sixth between the BMA and the Department of Health and, importantly the public face of the DoH, the Minister.
It's a complex beast isn't it, Trust? It takes careful nurturing to build and the slightest whiff to bring it down. A word, a phrase, a look can smash trust when emotions are raised or confidence is lacking in oneself. The individual then perceives the other in a negative frame, not willing or able to see that there might be a different interpretation. The language becomes gladiatorial: winning the battle, retreating, stepping back, stepping down, taking a stand.
Will trust be regained? It appears, and again I emphasis that this is my perception based on what the press have allowed me to read and hear, that the first four levels of trust will hold. The fifth is still shaky but the sixth, ah the sixth.
Which strategy to follow next?
How will the government respond? Once they've stood by the Minister to get the contract imposed what will happen in the succeeding months? Will they quietly move him on to allow a new face to re-build trust? Sometimes that is the only thing that can be done, regardless of the abilities of the individual. Or will the BMA re-think their approach, accept that this time they misjudged the situation and quietly settle on a new understanding, re-think their strategy of how to proceed the next time negotiations need to be undertaken?
Whatever the outcome, damage has occurred and both sides need to think long and hard about how they operate in the future. What's true for these protagonists is also true with any business negotiation.