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Last Updated: Thursday, 28 June 2007, 10:50 GMT 11:50 UK
Taming the NHS workforce
By Nick Triggle
BBC News, health reporter

Alan Johnson
Alan Johnson replaces Patricia Hewitt

When new health secretary Alan Johnson sits down at his desk, he will find a file marked 'NHS staff' at the top of his in-tray.

Despite the record increases in funding the health service has enjoyed, those who work in it are still angry.

All week doctors gathering at the British Medical Association's annual conference have been stressing the need for the government to start listening.

Fairly or unfairly, not too many of the 1.3m staff in the NHS will be sorry to see Patricia Hewitt go.

Ever since the normally conservative nurses turned against her at their conference last year - the former health secretary was heckled throughout her speech - it has been clear she has not had the confidence of staff.

Mr Johnson's appointment has been widely interpreted as an attempt by Gordon Brown to get the workforce back on-side.

We should anticipate a charm offensive
Professor Chris Ham, former government adviser

His ability to charm is well-documented, but many believe he will have his job cut out if he is to make peace with doctors, nurses and other staff.

Professor Chris Ham, a Birmingham University health expert and former government adviser, said: "We should anticipate a charm offensive.

"Staff have been upset over all sorts of reforms, doctors over the new training system and nurses over the staging of their pay award.

"There is much to do to get them back on-side."

Indeed, NHS union leaders are already excited by the appointment.

Dave Prentis, general secretary of Unison, described Mr Johnson as "someone we can do business with".

And Dr Sam Everington, acting chairman of the BMA, has already said doctors will be seeking an immediate meeting with him.

He added: "Doctors have the ideas to realise change, we see patients every day and we know what works and what doesn't."

But staff - and doctors in particular - should be wary about thinking they will be getting it all their own way.

'Less reliance on private sector'

Professor Ham believes the new heath secretary, under the guidance of Mr Brown, will not look to revamp health policy.

"The ideas of competition and patient choice are likely to stay. We may see a little less reliance on the private sector, but don't expect a new direction."

Indeed, it could even be much worse than many predict.

Mr Brown and Mr Johnson face a dilemma. Polls show the Tories are now trusted more on the NHS than Labour - despite the NHS budget almost trebling since 1997.

One argument goes that to truly put patients at the heart of the modern health service, the government will have to pick a fight with doctors.

And if Mr Johnson's previous remarks are anything to go by, that may be just what he does, albeit using his charm to contain the rift as best be can.

Mr Johnson is reported to have said during the recent deputy leadership contest that the government needs to improve its dialogue with NHS workers.

But telling, he added: "We have listened a bit too much to the BMA and not enough to unions like Unison."

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