What if Jeremy Hunt gets sick of being Osborne's fall guy during the junior doctors’ strike?

If the Health Secretary’s commitment to patient safety is genuine, he must be lobbying the Chancellor very hard for extra NHS funding. Perhaps he should ‘do an IDS’

George Osborne on a visit to a hospital with Jeremy Hunt (Rex)

Man the barricades, bar the door of the Department of Health, the junior doctors – scalpels and syringes bared – are on their way to bring down the Government!

That’s more or less how one unnamed Government source summed the situation up yesterday. This week’s unprecedented emergency care strike is “political”, they said. The British medical Association (BMA) has “radicalised” a generation of junior doctors, and its goal is nothing short of toppling the Government.

The hysteria of such statements is testament to how fraught this dispute has become. But on one point the source is completely wrong: if anything, it is the rank and file of junior doctors that are radicalising the BMA.

Their fury has been bubbling under the surface for many years. Junior doctors have possibly one of the hardest jobs in the country. They carry on their young shoulders life and death responsibilities that most of us never even come close to. Throw into the mix long hours, unpredictable working patterns, high personal expense for examinations, and a training structure that means upping sticks across the country for your next job at a time of life when most others are trying to put down roots, and you can see how they might have hoped to be cut some slack.

Instead, over the past six years, they have seen NHS funding squeezed in a way unprecedented in its history while demand from an ageing and growing population has continued unabated. Staffing shortages mean that gaps on rotas when a junior doctor turns up for a shift have become routine.

Already, before this contract dispute, they – and all other NHS staff, for that matter – felt like butter spread over too much bread. Then came the Conservative’s seven-day NHS manifesto promise.

The NHS’s own plan to get through the lean times involved cutting £22bn from the budget by 2020, with only an £8bn funding boost to ease the pain. So how an expansion of much routine care to Saturdays and Sundays was going to be paid for was never clear. Junior doctors – trained for years think forensically, relying on evidence – were never going to be convinced by a contract that asked them to do their bit by working more weekends without the money to back it up.

The BMA deserves its share of the blame for the subsequent impasse, for accepting in the first place the premise that this contract could be agreed without any additional cost. Its members know it can’t, and sources close to the plans concede in private that the goal of the contract is to trim back the NHS wage bill in the long-term, by setting a precedent that weekends don’t attract as much extra pay as they used to.

In truth then, there is probably no single contract offer that could give junior doctors what they really want: an NHS given the money to train the tens, maybe hundreds, of thousands more doctors, nurses, carers, radiologists, physiotherapists, paramedics, porters, and others required to do their jobs properly, and actually enjoy some quality of life as well.

So on one level, our anxious unnamed Government source is right.

This has become political. It is about more than the terms of the contract, and is really a challenge over the Government’s commitment to a properly-funded health service.

That makes a solution very difficult, and brings into sharp focus the role of the Health Secretary, Jeremy Hunt.

While Mr Hunt has been the bogeyman of this dispute, he is really only the occasionally faltering frontman for a Treasury policy of austerity which appears to be reaching the limits of what it can achieve without stirring significant unrest. Consider, for instance, the backlash over the aborted attempts to cut billions more from support for the disabled, which led to Iain Duncan Smith’s resignation.

The difference between the two cases is that, in Whitehall circles, the Department of Health is seen to have received very special treatment from the Treasury.

While funding increases have slowed down, unlike other departments it has never faced an actual cut. But Mr Hunt – like anyone who knows the NHS well – must realise that this is not enough.

He recently said that he believed health spending would have to increase as a share of the national income. For a minister already seen to have had a generous deal from the Treasury, that’s quite bold.

Since becoming Health Secretary, Mr Hunt has demonstrated a genuine admiration for the NHS and its staff, and one suspects that their loathing weighs heavy on him. If his oft-professed commitment to patient safety is genuine, then he must be lobbying the Chancellor very hard for more money for the NHS. If he doesn’t get it, what will he do?

Might it be that the only way to end this dispute is for the Health Secretary himself to “do an IDS” and make a stand against the people really responsible – the Chancellor and the Treasury?