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Editorial Monday 18 January 2016: The wrong thing, righter

I'm loving the de-escalation of the junior doctors' contracts dispute.

No sooner has Sir David Dalton been drafted in to pour healing oil on the baby pool's troubled waters, than Jeremy Hunt threatens the 'nuclear option' of imposing the un-agreed contract.

So much for my theory about being shit at negotiating, eh? (Even if we "really hope that doesn't happen".)

Today, it was the Prime Minister's turn to tell the Today programme that there is a 20% higher chance of stroke death at the weekend.

Yes, despite the stinging letter on this topic in the most recent Sunday Times by a constellation of stroke doctors.

A farewell to arms' length managing of providers
Meanwhile, Friday saw Jeremy Hunt helpfully tell NHS trust boards that ensuring patient safety and achieving financial balance are both important, and must be done. And if they don't, he'll have them replaced.

Never mind that sacking provider trust boards isn't his job! That's only the legislation.

Not only is Jeremy unleashing his Johnson, he is going full Stevens in ignoring the legislation and doing what others in higher authority won't stop.

(Of course, any trust boards so dismissed would probably have a fairly potent case for judicial review in the light of this prejudicial-looking statement.)

(And then there's the question of who they could possibly get in to replace the sacked boards, overspent or poorly-performing NHS providers being the talent magnet for executive and non-executive directors and chairs that they demonstrably aren't.)

(I love a nice parenthesis, I do.)

No, Friday's announcement by Mr Hunt also featured the agency staffing cap - which probably isn't the root cause of deficits, and probably is something to do with lack of supply and high demand.

It also warned providers that they must have digital rostering, which has no guarantee of making the technical skill of rostering more widespread; nor of improving relationships with clinicians.

Meanwhile people have started to notice, as I pointed out last year, that the terms and conditions for the Amy Winehouse Fund hand Simon Stevens and Jim Mackey massive power to dictate directly to provider trusts what they must do.

HSJ reported on Monitor and the TDA's letter requiring the efficiency plans to be agreed by 8 February: clearly, they don't  want to run any risk of over-thinking things.

Mr Hunt's insistence on dubbing the Amy Winehouse Fund the "transformation fund", when NHS England's Sun King Simon Stevens called it the 'sustainability fund', is interesting.

Going against Simon Stevens' representation indicates the level of pressure that HM Treasury in general and George Osborne in particular are applying to Mr  Hunt.

A shit, fourth-rate Francis Urquhart impersonator
The reporting in The Sunday Times of the widespread Whitehall gossip that Mr Hunt will be replaced by Boris Johnson in the aftermath of the May local election reshuffle has all the hallmarks of the shit, fourth-rate Francis Urquhart impersonator who is Mr Osborne.

It is Mr Osborne who has been (mis-)advising Mr Hunt that the best strategy to adopt in the junior doctors' dispute is to be 'deeply muscular'.

Mr Osborne's inbuilt Gordon-Brownian motion makes him want to get any possible Tory leadership rivals to self-destruct.

And who knows? It might even be effective, were he able to be vaguely subtle about what he wants DH to do to the careers of Jeremy Hunt and Boris Johnson.

Sugaring the bitterest pill
In the midst of all this political incompetence-fest, the Sun King has given an audience to The Guardian in which he calls for an NHS super-tax on sugary foods, and delves into the realm of fiscal policy by stating that the NHS's 70th anniversary in 2018 needs to be the point by which a sensible funding arrangement for social care is reached.

For the umpteenth time, Simon is being canny and sending signals. He knows that the symbolism of making a move on unhealthy foods within the NHS may have scant practical impact short-term, but buys him more of a hearing on obesity and diet from the media and the public than might otherwise be the case.

On social care funding, his message is very simple: Simon is reiterating his point that his five tests on funding have not been met. He is getting his political retaliation in early for when the money blows up.

Which it will.