Can the King fix the Trump Starmer special relationship?

[0:00] Hello, it's Adam in the Newscast Studio, and shortly we will get a double dose of updates [0:04] on doctors' strikes in England, because there might be another one in addition to the resident [0:10] doctors, formerly known as junior doctors, who already have a strike scheduled for after [0:14] Easter. [0:15] But first of all, we're going to talk about the Royals, because the state visit by the [0:19] King and Queen to the United States of America is on. [0:23] It was confirmed today on Tuesday by Buckingham Palace that the King and Queen will go to [0:28] Washington at the end of April. [0:31] Obviously, this has become a big political hot potato, with several British political [0:34] parties saying that the visit should be cancelled in the wake of Donald Trump's disobliging [0:39] comments about the UK. [0:41] Comments which have continued today as well. [0:44] And we've got two people who can tie this all together for us. [0:47] Joining me here in the Newscast Studio is my podcasting sister from the Global Story, [0:52] Asma Khalid. [0:52] Hello, Asma. [0:53] Good to be with you. [0:54] What brings you across the Atlantic? [0:56] Yes. [0:56] Well, you know, my co-host... [0:58] My co-host is normally based in London, and after a while of talking to people across [1:01] Zoom screens, you're just like, no, no, I need to actually work in real life with them. [1:04] But we've also got CastFest coming up at the end of the month. [1:07] Yes, 25th of April. [1:08] Very exciting. [1:09] People will be able to come and see us making our podcasts in front of their very eyes. [1:13] But good to do a little preview now. [1:16] And also joining us is Sean Coughlin, who is the BBC's Royal Correspondent. [1:19] Hello, Sean. [1:20] Hello. [1:21] Right. [1:21] Let's do a little bit of a timeline. [1:23] So I suppose the first thing that happened, Asma, was a Trump post on TruthSoul. [1:28] Which, even by his standards, was kind of quite divisive and bombastic. [1:33] You know, it's funny you say that, Adam. [1:34] I used to cover the White House, and so I feel like my threshold of what you might consider [1:38] to be bombastic, it's an evolved perspective, I will say. [1:42] So yes, he posted on TruthSoul, and he essentially said that countries, he singled out the UK, [1:49] like the UK, who cannot get jet fuel because of the situation going on with the Strait [1:52] of Hormuz and the war in Iran, should, in his words, and I'm going to quote here, say, [1:56] build up some delayed courage, go to the Strait, and just take it. [2:02] It has been the motto we've seen lately from the United States, that if you want change, [2:06] we saw this with Nicolas Maduro, we've seen this now with Iran, that the US has had, in [2:10] the last several months, quite an interventionist approach. [2:13] And so he seems to be encouraging the UK that if you can't get the fuel you needed, just [2:17] follow our lead and go ahead and take it. [2:19] He also, of course, called out the UK for refusing, in his words, to get involved with [2:24] the decapitation of Iran. [2:25] This is part of it. [2:26] I think a continuing frustration that the President of the United States and his administration [2:31] has had, where they feel that the UK has not stepped up and assisted the United States [2:36] sufficiently in this war. [2:37] I mean, obviously, everything Trump says, you can interpret it on multiple levels. [2:41] And there's an interpretation that everyone put on it that you just said there. [2:44] But I also wondered, is this part of his efforts to kind of internationalise the problem of [2:49] the Strait of Hormuz and basically get some help from erstwhile allies? [2:54] And actually, there's a more subtle. [2:56] Point there about some kind of like multilateral, multinational thing happening in that part [3:01] of the world further down the line. [3:03] Yeah, I mean, it's a really good question, right? [3:04] I mean, is this part of I mean, he told them to go get your own oil. [3:07] I mean, I think the thing that's hard with President Trump is that there are often true [3:11] social posts that he puts out. [3:13] They don't tend to jive always with official policy, to be honest. [3:16] Sometimes they do. [3:17] Sometimes they also evolve. [3:19] And so to me, this is one post. [3:22] It falls into a line and a continuation of a pattern that we have seen from the president, [3:26] which is. [3:26] He has been very frustrated with the United Kingdom writ large in its approach. [3:31] He's been very frustrated with Keir Starmer in particular. [3:33] He said so right, saying very publicly at the White House just a few weeks ago, saying he's [3:37] no Winston Churchill. [3:38] He feels that the UK has not stepped up in assisting the United States as a whole. [3:43] Look, I mean, I think a lot of this has been heightened because of the Iran war. [3:47] But we've heard from the Trump administration going back many, many months that they don't [3:50] feel like Europe as a whole has stepped up in their view to pay their fair share when it [3:54] comes to the Ukraine war and NATO's defence. [3:56] This has been a constant refrain. [3:59] And I would say in many ways, I see this as just the latest message we're hearing from [4:02] the president in that vein. [4:04] And Sean, just a little while after that post from Donald Trump on Truth Social, we didn't [4:07] get a post from Buckingham Palace, but we got a statement from Buckingham Palace about [4:10] the state visit confirming finally that it's going ahead. [4:14] And that's been a long time coming. [4:15] We finally had confirmation that it will go ahead. [4:18] And we heard today that it'll be a trip to at least to Washington in the words of the [4:25] Buckingham Palace statement. [4:27] They didn't give us a date. [4:27] They said late April. [4:29] And also there'll be a trip to Bermuda afterwards. [4:32] It was a fairly, fairly sort of frugal statement in terms of number of words, just set out [4:38] that it would go on. [4:39] But it comes after a long wait. [4:40] And I think we've been waiting for almost like a break in the weather in the diplomatic [4:45] row. [4:45] And each time we thought we might get an announcement, something else bad happened. [4:49] So this is a bit of a pause. [4:51] And now they've got it out there. [4:52] No doubt there'll be debate about whether this is the right thing to go or not. [4:56] But at least now. [4:57] We know it is going ahead. [4:58] And also we might now look back and think it was always really good to go ahead. [5:02] These dates have been talked about for for months and months before Christmas. [5:06] It had been in the mix that he'd be going around the time of year. [5:10] And if we want to know exactly when President Trump was there on hand, let us know. [5:15] And while the palace was reticent about saying when exactly it would be there, President [5:21] Trump was able to tell us on Truth Social that it was the 27th to the 30th of April. [5:26] And so he did the job for us. [5:28] It's like he's managed to play both good cop and bad cop in the same person. [5:31] So and also he said there'll be a state. [5:33] Well, we knew there's going to be a state banquet, but he said what day the state banquet [5:36] will be in the White House will be as well. [5:37] That's right. [5:38] I mean, I mean, I will say there'll be the King Charles will address Congress and that [5:43] will again will be an interesting political moment. [5:45] What speech will he touch on? [5:46] What will he carefully avoid? [5:48] You know, which buttons will he press and which ones will he keep hidden away on the [5:53] Buckingham Palace statement? [5:54] It opens with a phrase like, oh, on the advice. [5:56] Of his Majesty's government, this state visit is going to happen. [5:59] Is that how those statements are always phrased? [6:02] Or is this particular one like, oh, it wasn't our to say it wasn't our choice. [6:05] I think you call this a sort of distancing technique. [6:08] You know, we, we frame it very carefully by saying someone else has asked us to go and [6:13] we're going there on behalf of the country, on behalf of the government. [6:16] And I think they've always said that. [6:17] I think that that's always been their, their, their sort of quietly held [6:20] position that, that state visits are carried out on behalf of the government. [6:25] Yeah. [6:26] Where they go to, how long they spend there. [6:28] All the rest of it is, is effectively decided by the government. [6:31] And in this case they've made that really, really clear. [6:33] And so if anyone wants to shout, don't shout at them, they're saying we're going, [6:37] because we have to, it's our job to build bridges and if there are diplomatic [6:43] bruises from previous encounters, we're here to sue them. [6:47] Make sure everyone's nice to each other. [6:48] So they're going in as the sort of the friendly cops. [6:52] And I suppose Asma, people have in their mind a sort of stereotypical Donald [6:55] Trump event where he's just firing off on all cylinders about all subjects and it doesn't [7:00] matter who he's with. He's happy to embarrass whoever if it suits his purposes. But actually, [7:05] when it comes to the British royals, he does tend to be a little bit more respectful than if it was [7:11] a British prime minister. Yeah, I mean, he's had deep admiration, I would say, for the British [7:15] royal family for years. In fact, I was talking some time ago to a former Trump administration [7:21] advisor who said to me that, you know, there are few people who Trump sees as a real peer. And [7:26] I think they said it was Xi Jinping, perhaps maybe Putin, and also the British royal family. The [7:33] queen was in that list of people he really sees as a peer, deeply respects. He's referred to the [7:38] king as a man he deeply respects, used similar language as well for the late queen, you know, [7:42] referring to her as a wise woman. This is something that you've seen from the president over the last [7:47] several years. I would say he's had a deep admiration for the British royal family. [7:51] He also loves the pomp and circumstance, right? I mean, he loves the sort of, what would you say, [7:58] the royalty of it all. The pageantry. Yeah, the pageantry of it all. Coming here and being [8:03] feted in that way. There's two families that love buildings with gold in them. [8:05] You said that, but yes. And so I think that, I mean, that's certainly part of it. [8:11] But I will also say, to me, what I think is really interesting from a diplomatic perspective [8:15] is you're in this moment where the UK and US, let's say, special relationship, [8:21] isn't really going that well, right? I mean, there have been clear cracks in the political [8:26] relationship between Donald Trump and Keir Starmer. But you all have, and you are in the unique [8:30] position of having what I would describe as like a chief diplomat who can go and smooth this [8:36] relationship over. I mean, we in the US do not have someone who can do that, who can try to be [8:40] above the politics of the moment and say, no, no, this relationship is historic. It's important for [8:45] our nations. And this is why. And I'm just really intrigued in the role that the royal family can [8:51] play in this. Because, you know, politics come and go, Republican and Democratic Party leadership [8:56] will come and go. But there's this continuity that in many ways can provide, I think, the role of a [9:01] diplomat. And there's really nothing on par with it. Look, I'm not saying we want the royals back [9:05] in the US, but I think it's a really unique diplomatic role. [9:08] A good 250 year experiment without them. I mean, Sean, I mean, okay, the palace is quite [9:12] inscrutable on these things. But if you had to brainstorm how they would be walking this [9:18] diplomatic tightrope when the king and queen get there, what are some things that they might be [9:21] thinking about? [9:22] Well, I think they might think that last September went really well when Trump came to Windsor. And [9:29] Trump was clearly very starry eyed about the whole thing and was wowed by the spectacle. And [9:34] exactly that. He seems to almost be able to see separately between the political argument with [9:39] Keir Starmer and the sort of other relationship with the king. It's like a special, special [9:44] relationship. He feels like he has his own little track and he talks very fondly of him and he sees [9:49] him as being some sort of special in his life. [9:52] I suppose they want to play on that. That's where on leverage you want to recognize that Trump seems to sort [9:57] of, stand a few inches taller beside them. And he loves that, he loves the, the reflected glory. He likes the fact [10:03] that it's in a way, you know, the American is, is now sort of in the same way of borrowing some of the [10:08] language for these events. He's talking about a state banquet, state dinner. The sort of strange borrowing [10:15] from the event he experienced. I think you want to lean into that a bit, and I think also probably lean away [10:20] from complicated words like apples. [10:22] Epstein and also the Iran war, which could still be, we don't know what state it's going to be in, [10:28] it's not that far off. Can I jump on that? Because I thought it was really interesting [10:32] that we saw the congressman, Democratic congressman from California, Ro Khanna, [10:35] who's been very vocal as it relates to these Epstein files, write a letter, I mean, the BBC [10:40] is reporting this, encouraging the King to perhaps meet with some of these Epstein victims when he's [10:46] in the United States. You think that's totally unlikely? I think it's very unlikely, but it's, [10:50] you know, we don't know, but I'd say it'd be extremely unlikely. There's a legal process [10:54] going on. It's not, I just don't think there's something that's going to happen. Also, state [10:57] visits are incredibly tightly timetabled. They are trains that run on a ferocious timetable and [11:04] people move quickly through these various events. This will have been set out on some sort of [11:09] microscopic grid, second by second, what time people come through doors, what time they put [11:15] down their knife and fork, what time they, you know, they laugh at the first joke. It'll all [11:19] be timed. [11:20] Everything will be sorted out in advance. And even though Trump has the capacity to defy the [11:26] expected, I think this will be a very tightly controlled thing. There won't be sudden moments [11:30] where he could go off and meet people. [11:32] There will not be a joint regal presidential press conference, for example. I mean, I'd love to see [11:37] that. [11:38] That'd be amazing. [11:38] I think we would love it. They'll lie awake at night, sweating at the prospect of what wonderful [11:43] thoughts you might have about what we could do together. [11:46] Buckingham Palace has a lot of experience of sending out [11:49] subtle [11:49] signals, [11:50] that make a point, don't they? So if Buckingham Palace feels they need to make a point about, [11:55] I don't know, Trump's threats to Canada, or Trump's threats to transatlantic cooperation, [12:04] a way will be found to signal that. We'll be left in no doubt, even though it will be done in a sort [12:10] of deniable sort of way. [12:11] It might be some subtle symbol. And people often say there's nothing accidental in the royal [12:16] world. You know, it might be people look at the colour of ties and they look at the [12:19] colour of flowers, or a certain sort of hint or whatever. But sometimes it can be quite [12:24] brutal in terms of, there's a famous story about when Ceausescu, the former dictator [12:29] of Romania, came to Buckingham Palace, that the queen has to meet everyone, that the queen [12:34] at the time was on the throne. But when he came along, she hid behind a bush so she didn't [12:38] have to see him. And I think there are sort of, there are, you know, you have to, there's [12:43] so far you go to be polite and then you draw a line somewhere. So I think, I mean, King [12:48] Charles has been at this game a very, very long time. [12:50] He went to the White House when Nixon was president, when he was a young man. And, you [12:57] know, and Nixon, there was all talk about the then Prince Charles becoming friends with [13:04] Nixon's daughter. That shows how long ago this all is. He's seen them all come and go. [13:09] He's seen every single president since then. So he knows what the game is. He knows not [13:13] what to say. He knows he's not going to wander carelessly into any of these sort of minefields. [13:19] And speeches. [13:20] And speeches he'll deliver will have been written carefully with the foreign office [13:24] who will scrutinize every word and say, if there are any buttons being pushed, it will [13:30] have been agreed. That's what we're going to do. And it might be, I mean, in Canada [13:33] it was slightly different because he was there as King of Canada and sent quite a strong [13:38] message on behalf of the Canadian people and rejecting the aggression of the United States. [13:45] In the United States, he's there as a guest on behalf of the foreign office. It'll be [13:49] a very controlled, very careful. [13:50] Very warmly calibrated speech to try and show all the things we have in common, how [13:56] much we all love each other and all hold hands and smile, I think. [14:01] And Asma, welcome to being a journalist in Britain, trying to decode what the royal family [14:05] mean. Because as soon as I saw the statement saying the King and Queen are going to go [14:09] to the US and then the King will go to Bermuda, I thought, well, one part of my brain was [14:15] logistics like, well, same part of the hemisphere. Makes sense. Two for the price of one on the trip. [14:20] The other part of me was, oh, they can also say they're not going specifically just to [14:25] visit the US. They're also visiting another part of the Commonwealth. And then maybe both [14:31] those things are true at the same time. [14:34] That's right. I mean, things can be true at the same time. [14:36] Ambiguity. [14:37] Ambiguity. [14:38] A difficult thing for news, but can be the case. And I think I wouldn't overread much [14:43] into that. And I think that... [14:45] It's logistics. [14:46] It's part of that. But also, I think he has... [14:48] The price is high. [14:49] He has a bit of a list of... [14:50] Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. [14:51] Yeah. [14:52] Places he'd like to get to and he's there. And effectively within the space of a week, [14:57] he can get to two big visits. And I suspect that Bermuda will be more relaxing than the [15:02] one in Washington with all the potential pitfalls. But these things are quite dramatic and they [15:08] are quite exciting to watch. And that allows everyone to have their views on the relationship [15:15] aired. And it'll be a whole mixture of soap opera and high politics. [15:20] Well, I'll be back. [15:21] back in Washington. And drama and parades and it'll be, it's the circus but with politics and with [15:27] it's a bit of excitement for us in Washington. And in terms of the politics in the UK Ed Davey [15:32] the Lib Dem leader was straight out of the traps criticising this visit as he's criticised it as [15:36] an idea and the Greens have criticised it as well but then as opposed to the arguments that argument [15:41] has been settled now it's going ahead. And also public opinion seems to be divided perhaps leaning [15:47] more to cancelling the visit. I saw a YouGov poll fairly recently with more against the visit [15:52] than being for it. But I think people at the same time will, it's going to happen now isn't it? [15:59] And these arguments will carry on. What does it say about us having to go and if we didn't go [16:04] would it be a bigger call than letting it happen? I think that's ultimately once it's been set down [16:10] the tracks it's a very hard thing to stop. Now Asma at the weekend I was having a conversation [16:14] about what we're calling the 250th anniversary of America's [16:18] American independence because that's one of the reasons this state visit is happening. [16:21] I find that so strange though by the way that the state visit includes the British Royals coming. [16:26] Yeah but what I was getting at was what's it called and then I've just reminded myself it's the [16:29] semi-quincentennial. Semi-quincentennial. Semi-quincentennial. That doesn't roll off [16:34] the tongue does it? It doesn't roll off the tongue. Do we know what else is happening? [16:38] A lot is happening. I mean it's a big moment. You go around DC even I was just in Boston recently [16:42] and you'll see billboards up to celebrate the 250th anniversary of the United States. [16:48] I mean it's been a question that's been on my mind also a lot as I spent a lot a lot of years [16:52] out as a campaign reporter covering politics in the country and I think the United States [16:57] is certainly going through what some would describe as growing pains, internal civil [17:03] strife around the question of what does it really mean to be an American. Like we've seen this [17:08] quite literally explode in terms of some of our political conversations. There's not widespread [17:13] agreement on who gets to be an American, what it means to be an American and so I'm really [17:18] curious as to sort of who and how we celebrate even the idea of America at 250. You know we've [17:24] heard that there's going to be a big celebration on the National Mall. I don't know if you've been [17:27] to Washington DC but the National Mall is this big sort of grass green area in front of the [17:34] Capitol in the Washington Monument and they're supposed to be kind of a state fair festival. [17:38] State fairs, we love state fairs but there's also like fried food. Corn dogs. Yeah exactly. [17:42] So they're going to have fair stalls celebrating 50 states which I think is really exciting. I mean [17:48] it's a big celebration to celebrate I think in this moment but it's also happening I think at a [17:52] moment of really deep turmoil and political unrest and unease around some of these big questions [17:58] around American identity. I sort of laughed a bit when you talked about America having growing pains [18:03] after 250 years but I'm then reminded about our other podcasting cousin Justin Webb on AmeriCast [18:07] often makes the point that you've got to remember America's a young country. Yeah. We're talking of [18:12] young podcasts, the Global Story because have you celebrated a year of the new Global Story yet? No, [18:17] no, no. I haven't even been at the BBC yet. I haven't even been at the BBC yet. I haven't even been [18:18] at the BBC yet. I haven't even been at the BBC yet. I haven't even been at the BBC yet. I haven't even been [18:18] at the BBC yet. I haven't even been at the BBC yet. I haven't even been at the BBC for a year. [18:18] So it's still a young podcast. What is your latest episode? Would you like to do a little plug? [18:23] Well, thank you for that. Yeah, we have an episode we just were recording [18:27] an episode with my colleague who's normally I work with face to face in Washington DC and [18:31] that's Daniel Bush. He's a new colleague there covering Washington White House politics. He [18:37] over the years has interviewed scores of people who know JD Vance. He's met JD Vance, [18:42] the Vice President. And there are now reports that he is involved in some of the talks to possibly [18:48] to end this war in Iran. And so it's a look at how JD Vance sees the world and what it means that [18:55] this guy who really has had historically opposition to foreign interventions and foreign wars is now, [19:01] you know, trying to pick up the MAGA mantle and a key part of the MAGA movement has been [19:06] America first opposition to foreign wars. So that'll be our episode hopefully for tomorrow. [19:11] I'll be listening. Asma, thank you very much. [19:13] Thank you. My pleasure. [19:14] And Sean, thanks to you too. [19:15] Thank you very much. [19:16] Now in other news, [19:18] Keir Starmer has issued effectively an ultimatum to resident doctors, formerly known as junior [19:22] doctors, and more specifically their trade union, the British Medical Association, the BMA, [19:27] to call off some strike action planned for next week in their ongoing dispute about pay. [19:34] And then there was a plot twist because there could be another doctor strike as well. [19:38] The people who can explain all of this to us, because there's quite a few aspects to it, [19:42] are the BBC's health editor, Hugh Pym, who's here in the studio. Hello, Hugh. [19:46] Hi, Adam. [19:47] And Joe Pike is at Westminster. Hello, Joe. [19:49] Hello, Adam. [19:50] Westminster, has it got a sort of holiday feel? Because it is Easter recess, [19:53] or does the news keep coming? [19:55] The news keeps coming, but there aren't many MPs in the canteens and corridors of Parliament. [20:02] A very good assessment of the situation. [20:03] Right, let's talk about that. So there's two, well, there's one definite strike happening, [20:09] and that is with resident doctors who used to be junior doctors. [20:13] And then there's a strike that may happen later on with a different category of doctor. So let's talk [20:17] about that one first, because we kind of know more about that. Hugh, just sketch out what this [20:22] dispute is about. [20:24] Thanks, Adam. Well, of course, resident doctors were known as junior doctors, [20:27] just to confuse everything. But it's the same old, same old dispute that's been rumbling on [20:32] since March 2023, three years now in England. And it's essentially been about pay. The BMA, [20:39] the doctors union saying they've lost quite a lot of money over the years because of inflation, [20:44] the government saying, well, we've paid you nearly 30%. And then there's a new, [20:48] and then there's a new offer, as from last week, which took it to 35%. They said over three years, [20:53] come on, we can't afford any more. So that's the essence of it. And then there are lots of bits and [20:58] pieces about training places. Now, just to simplify that, training places in the NHS are for qualified [21:05] doctors to get them onto a pathway into a specialty area, like they might want to go into [21:10] anaesthetics or surgery, or whatever different type of medicine. But last year, there were 30,000 [21:18] applicants for just 10,000 places. So we heard from the BMA that some doctors were facing [21:23] unemployment, which seems absurd given all the money that's gone into their training. Then it [21:28] emerged that these included applicants from outside the UK. So Wes Streeting said, okay, [21:33] we'll try and deal with that. So that this year, doctors, UK qualified for medical school doctors, [21:40] will get priority. And that was quite a big move. And he also said, we'll create 4000 more places, [21:45] 1000 of them were due to take effect from the beginning of the new financial [21:48] year, i.e. the beginning of April very shortly. And all wrapped up in an offer, went to the BMA [21:55] last week, with other bits and pieces, they've rejected it. And Sir Keir Starmer, the Prime [22:00] Minister has now said, okay, if you go ahead with your strike, if by tomorrow, Thursday evening, [22:04] you haven't called it off, you can forget the 1000 new places, which would have started being [22:09] implemented from Monday. So Joe, is this the Prime Minister kind of throwing down the gauntlet? And [22:13] he did this in the form of an article in The Times on Tuesday morning? It absolutely is. [22:18] And it's not a completely new technique from number 10, the Department for Health. He did [22:23] something similar just before Christmas calling proposed strikes then dangerous. And actually, [22:30] what he is saying is not that much different from what was said last week by both the Health [22:35] Secretary, Wes Streeting, and the boss of NHS England. Of course, the advantage is Keir Starmer [22:41] has a sizeable megaphone, more people notice including us. And he is trying I'm told to get [22:47] the message across. Partly, it's the same thing, the message is trying to get the message across, [22:48] partly, it's the same thing, the message is trying to get the message across, partly, it's the same thing, [22:48] partly, it's the same thing, the message is trying to get the message across, partly, it's the same thing, [22:48] partly, it's the same thing, partly, it's the same thing, partly to junior doctors, [22:51] resident doctors, who haven't been given a say on this deal, government sources argue, [22:58] but also to explain to patients what the government's thinking is, especially as if their [23:04] care is likely to be affected. They argue, it's fair that patients understand why. [23:10] But Hugh, just on the technicalities of what the Prime Minister is saying. So [23:14] he is saying he's going to pull the plug on 1000 training places, [23:18] that was sort of going to go into the pipeline in a couple of weeks time, [23:22] if something doesn't happen in the next 24 hours. [23:25] That's broadly it. Although Downing Street were getting on to me, and I'm sure other [23:30] health journalists say, oh, it's not a threat. It's not a threat. [23:32] It sounded quite threatening when you read it. [23:35] It sounded like it. So what they're saying technically is these 1000 new places were going [23:41] to start coming on stream from essentially next week. But if there's a strike next week, then it [23:47] makes it much more difficult to start implementing that, they say. And if there are threats of [23:51] further strikes, why should they start implementing this at all? So it's a sort of, look, it's a [23:58] technocratic thing, we're not going to do it, with quite a loaded message. Sorry, folks, if you don't [24:03] accept the deal, here are 1000 places not going to happen. And the BMA's response is, hang on a [24:08] minute, we need more doctors in the NHS. The NHS is under a lot of pressure. So creating these new [24:13] posts should not be associated with a row over pay. It's the government who's putting [24:17] the two together. Yeah, they're saying it shouldn't be a carrot and a carrot and stick [24:20] negotiation. It should just be part of life in the NHS. Exactly. And also just on the government's [24:24] point about the BMA not putting this deal to their members. What's going on there? Why has it not [24:31] gone out to all the resident doctors for them to have a say? Why is it just the negotiators? [24:36] That's a very interesting point. Dr. Jack Fletcher is the BMA representative leader of the resident [24:42] doctors committee who's been negotiating with the government. Now, there's a supposition that [24:47] he said, okay, this deal, I'll go back and check whether people like it or not. But that meant the [24:53] resident doctors committee. Now, there was something like 50 or 60 people on that. And [24:58] it got a resounding thumbs down. So the BMA's argument is, well, that's 50 or 60 resident [25:04] doctors elected to be on that committee. If they say no, it's no. What's the point of going out to [25:09] the wider membership? Of course, the government would say is the wider membership might well say, [25:12] hey, not a bad offer. And just in terms of the timeframe, so we're recording on [25:17] Thursday afternoon at quarter past four. When does this 48 hour deadline, even though it's not [25:22] a threat, elapse? When does this need to be resolved? Well, it wasn't made clear when on [25:27] Thursday. So I think we take it to mean close of play on Thursday. But if the BMA pick up the phone [25:33] at half past 11 at night, I don't think Downing Street are going to go ahead with whatever they [25:40] were planning to do next week. It's been left a bit vague. I think talking to people this morning, [25:44] it seems highly unlikely that the BMA is suddenly going to come back. [25:47] And say, okay, let's talk. Of course, Wes Streeting's position, the health secretary [25:52] has always been my doors open. He's always said, come to me anytime. The previous government, [25:57] previous health secretaries have said, once you've caught a strike, we ain't going to talk to you. [26:01] Wes Streeting has always said, look, we can get back together. It's very annoying, this strike, [26:05] but we can sort of sit down around a table in future. [26:08] And Joe, where does this dispute, this long running dispute kind of fit in the political [26:13] context around the health service in England at the moment? Because I'm aware, [26:17] I haven't talked about health on an episode of Newscast for a little while now, [26:21] and normally when we do, it's a story like this. [26:24] Absolutely. I think what's important is that at the time of the next election, [26:29] the UK government wants to be able to argue that they have improved the NHS and brought down [26:33] waiting lists. Wes Streeting, if he were to be possibly a leadership contender over the [26:38] next few years, he also wants to be able to point to things getting better. And clearly, [26:42] strikes will not help with that. In terms of this battle over [26:47] training, [26:48] places, the argument that people in government have put to me is that there's £300 million to [26:54] spend here. Either we can spend that £300 million on those 1000 training places and the adverts for [27:02] those places need to be out on Thursday, or we use that money for the strike because the strike [27:07] is very expensive. Normally they cost, I'm told, about £250 million. But because this is Easter, [27:13] and the sort of hourly cover shift rates are higher, it will cost, [27:18] £300 million. A couple of other arguments I also hear. One is people in government pointing to [27:25] polling on resident doctors' strikes. Some suggestions that the public appetite for these [27:33] is waning, support is waning. But also we saw in that, in some of the BMA statements, reference to [27:41] geopolitical uncertainty, the war in Iran, what that could mean for interest rates and the cost [27:46] that a junior doctor has to pay. And I think that's a very important point. And I think that's a very [27:47] important point. And I think that's a very important point. And I think that's a very important point. [27:47] doctors, resident doctors and all of us could be facing. And the way that government officials [27:53] are responding to that is by saying, take the win while you can. We have the money to do this [28:00] now. But if Raquel Reeves needs to spend money providing support for people in their energy [28:07] bills, even though we know that will only be targeted. And if the economic situation [28:12] gets worse in this country, if there isn't growth, as the government wants to see it, doing this sort [28:17] of investment in the health service will be more difficult. So the message I've heard [28:24] from people in government to resident doctors is take that win now, don't wait six months [28:29] down the line and say I wish we'd taken it back in March. [28:34] Yeah, I mean the BMA response, and obviously I'm not here to advocate for the BMA, but [28:39] their response is well each time there's been a strike, there's been more talks or a threat [28:44] of the next strike and West Streeting has come up with more bits and pieces like these [28:48] training places last autumn and a bit more money. And you know, that's the way industrial [28:53] action works and it's each side, particularly the BMA, have got to work out whether what [28:58] Joe's been saying is take it, take it now or not. Incidentally, I think this issue about [29:03] the public support, I mean, it has been falling. I mean, that doesn't seem to have affected [29:08] the BMA's view of what they're trying to do, which is to get more money for their members [29:12] to compensate for inflation. [29:14] In terms of the cost of strikes, I think we need to probe into it a bit. Yes, it costs [29:18] the trusts more to bring in consultants and pay them overtime for being at the front door [29:23] of A&E and doing overnights and that sort of thing. There is this slightly perverse, [29:28] well interesting outcome, which is that A&E works a lot better during strikes or in some [29:34] hospitals because you've got consultants experienced enough to say, look, you're not ill, you can [29:38] go somewhere else or whatever. So there are lots of bits and pieces to it, but yeah, certainly [29:44] it's a good thing. [29:44] It comes at some sort of cost. [29:46] And Hugh, this is a very useful question from a newscaster called Chris in York, not Chris [29:51] Mason in Yorkshire, where I think he might be this week. And Chris says, I feel I'm missing [29:55] a key piece of context. The union says that doctors' real pay has fallen since 2008. How [30:01] does resident doctors' pay compare to the rest of the public sector and to pay in general? [30:07] Chris, you've asked a very broad question, but let's give Hugh a chance to do a spreadsheet [30:12] with words. [30:13] Well, let's give a partial answer to Chris. Let's [30:15] look at how much it's fallen in real terms or not. So the thing is the BMA use this RPI [30:21] version of inflation, which I'm sure all newscasters will know is a very broad measure. [30:26] It's not seen as statistically, particularly rigorous for most things, but it's used by [30:31] some parts of government. So they're saying even after pay rises in recent years, they're [30:36] still 20 percent down on 2008 in real terms on the RPI. Various people, including Nuffield Trust, [30:43] and other think tanks have said well actually if you look at cpi the more accepted version of [30:48] inflation which tends to come up with a smaller figure then the pay is only down about six or [30:53] seven percent looking at nurses but since 2010 down 10.7 percent on one calculation on the cpi [31:01] and all workers in the public sector down about 6.9 the rest of the economy i think has gone up [31:08] very slightly so that that sort of gives a bit of a comparative picture if not the whole picture [31:13] i hope chris had his notepad out to write all that down or he's got a very good memory to have [31:17] it lodged in there happy to uh correspond if he wants more details and i'll go to faisal islam and [31:22] his colleagues for anything about the whole economy and then hugh i sort of previewed the [31:26] fact that there was going to be another doctor strike potentially and it's a different category [31:30] of doctors this time consultants and this news broke at lunchtime actually while you were on [31:34] radio 4 talking about the previous strike it was and my phone just about stayed alive enough to get [31:39] the top line of it but um began to fade away after that but i've [31:43] got it all in front of me now adam so this is consultants and specialist doctors the specialists [31:48] who are pretty senior but have not gone on to get full consultant status so their pay dispute has [31:55] been rumbling under the radar a little bit we've focused on the resident doctors but consultants [31:59] have been just as fed up about their pay being eroded by inflation no they're very well paid [32:05] compared to most others in the economy but you know if your pay's really fallen in real terms [32:13] in most countries accents at yours companies they might just be saying don't kick your butt [32:17] you're honestly sixteen in there the national store i'm told was the 3.5 percent that was [32:22] announced from the pay review body and put into place by government last week they said just not [32:27] enough to to sort out our problem so they're going to have a ballot between the 11th of may [32:31] in england until the 6th of july to see whether they want to take industrial action they may say [32:37] no they did take action over pay a couple of years ago and it's very possible they will bring their [32:43] would be covered. But we don't know whether more than half and the 50% turnout level can be reached [32:49] for the consultants. And so when will we know? I think if it's the 6th of July, normally we know [32:55] that night. Right. So it's coming up to that sort of time at Westminster of quite sort of febrile [33:01] end of term stuff. So if they announce a strike, then two weeks notice if lots of ifs here could [33:07] be around about 21st of July. And I mean, my knowledge of doctors strikes is not as good as [33:13] yours. What's the history of consultants going on the picket line? Well, they did strike for a couple [33:20] of days. I mean, this has been going on since March 23, in late 23. But they didn't all walk [33:26] out of all care. So the residents were out and the consultant said, look, we'll do emergency [33:31] care. Yeah. But a whole shed load of planned treatment was was cancelled. Now, the [33:37] inevitable is that we're going to have to do emergency care. So we're going to have to do emergency [33:37] care. And NHS has got a lot better on strike days at carrying out planned operations and procedures [33:42] 95% they're getting to if there was a joint strike, or they sort of rumbled on, moved on with [33:50] one one week one the next, it could be that rather more operations are cancelled. And that hits [33:55] government waiting list reduction plans. Right, we shall see on that second potential strike. [34:00] Joe, we are now in firmly in the election period for the elections in Scotland, Wales and in local [34:06] authorities in England. [34:06] I mean, we've just been talking about an industrial dispute in England. What have the other political [34:11] parties been saying about this? [34:12] Well, of course, the SNP and Plaid haven't said anything because health is devolved. Nigel Farage [34:19] has said that Keir Starmer has taken a strong position. It is the right position, he says. [34:25] Kemi Bade, knock of the Conservatives, has called on Keir Starmer to ban doctor strikes and not use [34:31] training places as, quote, a bargaining chip. Meanwhile, I've not found anything yet from the [34:36] Lib Dems or Greens on this. Most of the press releases and comments I've got from them today are [34:41] their opposition to the King's state visit to the US. [34:45] Which takes us back to the start of this episode of Newscast. But that's pretty much it for this [34:49] episode now. Hugh, thank you very much. [34:51] Thank you, Adam. [34:52] Joe, thank you very much. [34:53] Cheers, Adam.