Will the 1st December see a winner in the junior doctor dispute?
Edmund Stubbs, 17 November 2015
In less than two week’s time, the first in a series of three strikes by junior doctors planned for this December is due to take place. Authorised by the British Medical Association, these short but unprecedented strikes increase in severity with the second and third being more comprehensive than the first. Unless avoided, the 1st of December will witness a walk-out of all junior doctors except for those involved in emergency services and the 8th and 16th will involve a total strike, emergency services included.
Doctors have practically never resorted to industrial action. To date there has never been a complete walk-out of NHS doctors despite ever-growing discontent within the NHS workforce. This discontent was exacerbated by the financial crisis as many NHS employees at all levels have experienced a wage freeze since 2008.
The BMA insists it has given the government ample time to prevent the necessity of industrial action by its members, and it is certainly true that the Department of Health was aware of the real possibility of strikes. Nevertheless, the severity of the proposals have taken many by surprise. For example, the normally impartial Chair Of The Health Select Committee, Dr Sarah Wollaston, claims that the planned action is too extreme.
Junior doctors have been consulted as to whether or not they might be prepared to take industrial action, but they have not been widely consulted about the form such action might take. It would be interesting to know the range of opinion amongst the 40,000 junior medics on this issue, and in particular the proportion in agreement with Dr Wollaston that current proposals are too drastic. It is naive to believe that patient safety will remain uncompromised especially during the second and third strikes.
Of course, there seems little point in engaging in strike action unless it is actually believed to have an impact that it is felt by both politicians and public. This series of three strikes, each lasting some hours on three separate days may in fact represent less of a safety hazard to the public than subsequent years of treatment from demotivated and exhausted junior doctors. The situation that junior doctors hold would result from the imposition of their new contracts; a claim that the Health Secretary Jeremy Hunt vigorously denies. According to the parties in the dispute both the imposition and abandonment of the new contracts will have implications for patient safety, but it is at least possible that the demotivation of junior doctors following their imposition has the potential to be most damaging.
Much seems to rest on public opinion. The public response to the first strike due in less than a fortnight is likely to determine whether the more major second and third strikes actually take place. Will Mr Hunt appear as dictatorial, aloof and completely out of touch with the NHS workforce, undermining safety? Or will the BMA be seen as equally uncompromising and willing to jeopardise patient safety simply to safeguard their own junior members’ interests?
The response to the first strike on December 1st might well prove a turning point, leading to either the Health Secretary or BMA backing down before the far more extreme strikes occur.
Edmund Stubbs is Healthcare Researcher at Civitas, @edmundstubbs1