It’s worth actually reading a DDRB report to see what I mean by constraints. They contain phrases like:

“The Chief Secretary to the Treasury (CST) wrote to us to say that the last Spending Review budgeted for 1 per cent average basic pay awards, but that the Government recognised that in some parts of the public sector, particularly in areas of skill shortage, more flexibility may be required.”

Make of that what you will (2018 report).

As for how to go about it, I don’t know whether to favour one approach over the other. What I can see is that the government doesn’t appear to be inclined to do any actual negotiation (new strike dates are out - are they at the table yet?) and continues to burn through its credibility - the “we’re all in this together” and ensuing “jam tomorrow” of austerity of over a decade ago is yet to materialise; the government has shown that it cannot deliver.

Would the doctors find the way forwards easier by changing the demand? Or does potentially accepting less today carry vibes of “jam tomorrow” that’ll never come?

I’ve looked at the FT figures. I don’t see any of this going away soon. If the “brain drain” continues to pick up pace we will all be much worse off.