Just when it looked as though Britain's vacuum Government had enough on its plate, the junior doctors row - which many had hoped had finished - will now bubble on. BMA members have just voted to reject the Government's contract offer by 58 per cent to 42 per cent. The margin was convincing enough that the BMA's chair Johann Malawana, who proved an effective combatant against Jeremy Hunt during the dispute, has stepped down. In his letter, Malawana pointed the finger of blame at the Government, saying:

“ 'I believe the fundamental breakdown in trust caused by the government's actions over the last five years has resulted in a situation where no solution is possible, particularly when a government is so keen to declare victory over frontline staff. A government's priority should not be to declare victory over millions of workers.'

If the situation wasn't toxic before, it certainly is now. Of course, Malawana can't be blamed for trying to avoid responsibility here, and he is certainly correct to suggest that the Government's approaches in this dispute have hardly helped. But it seems a little disingenuous to forget that he did, in the end, support the now rejected contract settlement which went to a ballot.

So what happens now? An impasse seems to be the likeliest outcome, at least in the short term. Over the coming weeks, the Government is still persevering with its plans and 6,000 freshly-graduated junior doctors are starting on their new contracts in August. But what happens in the longer-term will largely depend on personalities. Who replaces Malawana at the helm of the BMA is key. If someone else is willing to take up the fight, we could see a dispute which has already been drawn-out and increasingly nasty continue in much the same way. However, if a new BMA leader doesn't have the stomach for a fight, things will be different. In that instance, we're more likely to see a quiet end to the dispute which does little to placate the many angry junior doctors who rejected this contract. The Government may have won if that happens, but there will be little to cheer about.

One thing seems clear, though, whilst there is turmoil at the top of the Tory party, it's unlikely that whatever happens in the Conservative leadership race will have much of an impact. Jeremy Hunt may have been pinned as the hate figure in this messy, vicious campaign. But it's the whole Government - Theresa May and the other candidates included - who have been pushing through this Tory manifesto pledge. And that's unlikely to change whoever gets the keys to Downing Street.