Why the No vote means nothing and everything

Rejected sign Image copyright Aquir

There is a precedent for the No vote by junior doctors and medical students over their new contract.

Back in 2002, consultants in England rejected the terms on offer and British Medical Association negotiators went back into talks with the government. A year later, a deal was agreed second time round and the contract was brought in.

But history is not going to repeat itself this time. Government sources have already indicated they are "minded" to impose the contract that they agreed with union leaders in May. We can expect confirmation of this in a couple of days I'm told.

The truth is the dispute has lasted too long and caused too much damage and bad will to see the two sides return to the table. And even if it hadn't, ministers feel hospitals have gone too far down the road implementing it to row back now.

New rotas are due to be introduced next month for 6,000 newly qualified junior doctors, with changes to pay to follow later in the year. Much of the rest of the profession is expected to follow over the course of the next 12 months. It is why on Monday I suggested the result of the vote may well end up being academic.

And regardless of all this the BMA is hardly in a position to fight its corner. It's in disarray.

The union's junior doctor leader Dr Johann Malawana has resigned (after spending the past two months arguing it was a good deal) and its senior leadership have no stomach to carry on fighting given the current situation facing the country over Brexit.

Ahead of the vote result being announced, they, in effect, ruled out sanctioning further industrial action in the short term.

In theory, that could all change when a new junior doctor leader is appointed, but the vote is not binding on the BMA and momentum has been lost anyway.

But that does not mean this is the end of this sorry saga. Far from it.

It's stating the obvious to say the profession is angry. It is furious. Throughout the dispute, the government had tried to paint BMA leaders as militant firebrands - unwilling to listen and politically motivated.

But when it came to it, the wider membership has ended up even more militant.

That, as the influential junior doctor blogger Rachel Clarke points out, has as much to do with the wider pressures in the system as it does with the details of the contract.

The risk now is that a whole generation of junior doctors feels disenfranchised, upset and undervalued. That is a disaster.

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