DoH charm offensive to herald change?

Are we about to see an outbreak of detente in the anything-but-cold war between the DoH and the BMA?

The appointment of new generals for both sides would appear to offer an opportunity for a new approach to negotiations.

New health secretary Alan Johnson certainly offers a change in style from the nanny technocrat Patricia Hewitt.

A former union general secretary, Johnson is known for both his charm and his calm negotiating style. Regarded as more of a people person than Hewitt, his appointment is seen by many as an attempt to win back the hearts and minds of health professionals following the problems of ongoing organisational reform, spending cuts and the media attacks on GPs.

In the opposite trench, Dr Hamish Meldrum has made the step from GPC chairman to chairman of the whole BMA. Also regarded as a smooth and canny political operator, it seems likely that relations between the government and doctors will take on a new tone.

This is not to say that all will run smoothly. Prime minister Gordon Brown has already committed himself publicly to the return of the Saturday surgery, and tough negotiations between the GPC and the DoH will be required if a deal suitable for GPs is to be achieved.

However, there are some indications that Mr Johnson will be seen as preferable to his predecessor by GPs.

He has indicated that he does not see private providers as an automatic solution to NHS woes and that their performance should be closely monitored.

He has also said that quality of care is more important than choice to patients - a statement that would have been regarded as sacrilegious by some in the previous regime.

We will also see the effects of Mr Brown's 'government of all the talents'.

For once the DoH ministerial team features health professionals, with surgeon and former adviser Professor Sir Ara Darzi taking up a post and former district nurse and Labour MP Ann Breen becoming a junior minister.

But Dr Meldrum and his successor as GPC chairman should not take this entente cordiale for granted. There is still much hard negotiating to be done to move on from the recent breakdowns over the GMS contact, but it seems that the approach will require an iron fist swathed in velvet rather than a Hewitt-style wrecking ball.

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