Today junior doctors in England stage an all-out strike for the first time in NHS history. Hugo Rifkind has written a piece in today’s Times in which he makes a working assumption that the junior doctors are right about their complaint but, sadly, totally out of their depths in the PR management of it and that it’s about to go horribly wrong for them. But this is not just about politics. It is about the failure of successive Governments, of all hues, to tackle their responsibility to lead and develop the people who work in our health service. The Minister for Health is the de facto, if not de jure, CEO of the NHS. His responsibility is, as with all CEOs, to create an environment in which the people working in the NHS can do their best work. He and successive governments have manifestly failed to do this. But it takes two to tango. The medical profession has also colluded in a fudge, the recipe for which confection was written by Nye Bevan at the post-natal party following the birth of the NHS. The “recipe” says that – wink, wink, nudge, nudge – the normal rules for leading and managing a not-for-profit professional services business do not apply to the NHS because we can’t afford to pay doctors what they should be paid. In return for under paying them we won’t “run” them like, say, the Police or the Foreign Office or any other normal function. The normal rules to which I refer include clear lines of responsibility and accountability. But the dogs in the street know that no one is running the NHS. Not the doctors who think they are, not the management who should be running it, and certainly not the Minister who can’t, because the PM will not let him. So my leadership advice to the Junior Doctors is this: either submit mass resignations today dated one year from today, and don’t bluff OR agree to sign the contracts subject to the non-negotiable inclusion of a clause which provides for the creation of a new Junior Doctors Service led by an experienced professional services CEO and Board with full power to hire and fire. Yes, I know, pigs will fly….