Published: 20/06/2002, Volume II2, No.5810 Page 23
Ifyou want an example of 'spin wars' in a field less arcane than who said what to whom over the Queen Mother's cortege you could do much worse than flick through the broadsheet newspaper coverage of the hospital consultants' pay deal.
Differences of interpretation reflect underlying differences yet to be resolved over the long-term implications of the agreement between Andrew Foster, the Department of Health's director of personnel, and the British Medical Assocation. In other words, what does it mean?
When I caught Dr Liam Fox, the Tory spokesman, on the M25 on Sunday night, he was naturally unimpressed. Consultant friends were unclear about what the details were or would mean in practice. It all looks very expensive. If they are as generous to the GPs in their negotiations, it will cost 1 billion of Gordon Brown's extra pounds, he said.
'The demeanour of Alan Milburn was interesting. When he's got something to crow about he usually bounces around like a kangaroo.He didn't, 'Dr Fox noted.
We'll get back to that excellent mixed metaphor after the broadsheets.
The Guardian and Indy ran modest reports, calling the deal a U-turn because Mr Milburn has backed away from the NHS plan's proposal that new consultants do no private work for their first seven years.
Actually, the plan talked, not of a ban, but of working 'exclusively' for the NHS.
Ministers believe they have got a formula as close to that as a free society will allow. Spin or what? We shall see. As the FT explained in its calm way, new consultants have agreed to 10 four-hour sessions a week, plus an optional two extra, a belated tidying up of Nye Bevan's 1948 compromise.
Only if they turn the extra time down, explicitly to do private practice (golf is OK), will they lose their increments. Basic salaries (does anyone actually get them? ) rise from£52,640-£68,505 to£63,000-£85,250 and increments will be performance related.
The Times and Telegraph were more interesting. The Daily Telegraph led last Thursday's edition with 'You must lose sight in one eye before NHS will treat You' - its take on NICE's restrictions on photo-dynamic therapy as a cure for age-related macular degeneration.
On a sidebar it highlighted the two surgeons being prosecuted in Cardiff for manslaughter after ignoring a med student's warning that they were removing the wrong kidney. I call that an antiNHS front page, implicitly underpinning Dr Fox's basic point that extra money for the NHS is going straight into a black hole. The NHS plan is merely a wish-list, he says.
The tone contrasts with The Times, which helpfully blended the consultants' '20% pay rise' (It is not really that good, I am told, and the FT says 15 per cent) with its own survey of consultants' conduct in the face of Sir Magdi Yacoub's campaign to recruit foreign surgeons.
The Times survey, which (nothing inherently wrong with this) had the flavour of guidance from unnamed 'Whitehall officials', suggested that resistance from some 'consultants cartels' - especially cardiac - to seeing their own power diluted by newcomers is undermining Sir Magdi's efforts.
The BMA deal was headlined 'Doctors' big pay rise won at cost of local freedom', the fear that managers will now acquire a tighter grip on consultants' time. During the negotiation I heard rumours - I could not confirm them - that a DoH medic had drawn up a list of consultants' rackets (including payment for driving time), which caused gross offence.
So, what does it all mean? My equivalent of The Times's 'Whitehall officials' calls it a Blairish third-way outcome which Mr Milburn stood back and allowed the BMA team to announce with their own gloss (spin? ) because they have to sell it in their members ballot - he doesn't.
The core working week has been (at last) defined and expanded from 9am to 5pm to 8am to 10pm, plus Saturday.
Clearly this is a supply-side reform to get more ops, provided Mr Milburn can find the support staff, flexible working and money to do them.
Dr Fox, incidentally, says that orthopaedic surgeons in London - where most private practice is - would have quit the NHS if forced to choose. 'They're getting a whacking pay rise and are not more restricted at all, ' he chuckles.
Yet others say the BMA team may have conceded too much. Who's right? I do not yet know.Call it spin.