It takes a lot to unite doctors. Put ten of us in a room together, and we’ll all have a difference of opinion. We all think we’re right. Yet somehow, the Secretary of State for Health, Jeremy Hunt, has managed to bring doctors together in an unprecedented fashion.
Junior doctors have voted to go on strike.
In a ballot of junior doctors by the British Medical Association (BMA), almost all respondents voted to go on strike. This is a decision that may polarise opinion, but is a decision that was not taken lightly. As a doctor, we have a duty of care to our patients. As a trade union member, we have the right to take industrial action.
The battle of spin and counter-spin, fought between Jeremy Hunt and the BMA, has been waged on the pages of newspapers, magazines and above all on social media. There have been protest marches in London and cities across England. Protesting against the imposition of a contract that would see many junior doctors working longer hours, for less money. The BMA have argued that more unsociable hours means tired doctors, and tired doctors make mistakes.
This is a problem for doctors in the NHS in England alone. Scotland and Wales won’t see the imposition of a new contract, and Northern Ireland is yet to make up its mind.
Over the summer, doctors have been described as money grabbing, lacking vocation, and more recently militant. Jeremy Hunt has been spinning out the same half truths about the “weekend effect”, that you’re more likely to die in hospital over a weekend. This is true, but the difference is small, and there is no evidence that this is down to staffing levels. Sicker people come into hospital at weekends, and most of the work carried out is for emergencies. Routine operations and out patients clinics don’t tend to run at weekends, so those admitted are more likely to be seriously ill.
Rather than deal directly with the BMA, Hunt has decided to negotiate via the pages of the press. His offers to the profession have be as changeable as our weather. They are as easy to keep tabs of as the stairs at Hogwarts. Constantly changing and confusing for all. First came refusal to negotiate openly without preconditions, then the promise of a mixture of pay rise and pay cut, then direct negotiations without preconditions. The BMA have offered to negotiate via the conciliation service ACAS, and with trust of Hunt at an all time low, is there any wonder no one wants to be in the same room as him.
The plight of my junior colleagues has garnered support from a host of different angles. Prominent medical negligence lawyer Peter Stefanovic has spoken out strongly against Hunt’s contract threat. Celebrities such as J K Rowling, Rufus Hound and the cast of Eastenders have leant their support. I’d even heard rumours that the cast of Holby City would take a break from filming out of solidarity. Previously anonymous junior doctors have been thrust into the spotlight, taking to stage, television and radio to speak out against the imposition of an unjust, unfair and unsafe contract.
This isn’t the first time junior doctors have been on strike. Forty years ago, junior doctors took to the picket lines to protest, again about the imposition of a contract. This would have seen a cut in pay for the more unsociable part of the job.
It takes a lot to make a doctor angry. By definition we must be calm under pressure, and possess a compassionate desire to ease suffering. I suspect many of my colleagues are the same. The purulent environment of the NHS, underfunded and overstretched, makes this ever more challenging. Like many of the severely unwell patients we see, the NHS is in danger of dying.
At present, industrial action is set to take place of three days in December. 1 December will see 24 hours of emergency cover only, with a full walk-out planned on 8 and 16 December. What effect might this have remains to be seen, but consultants across England have pledged support for industrial action, and have informed their juniors that they will cover the work. It is likely that routine, elective surgery and out-patients clinics will be cancelled. Emergency care will carry on as usual.
Jeremy Hunt still has time to sit down with the BMA and negotiate. Winter is a bad time for the NHS, and an even worse time for industrial action. Through wilful malevolence or political incompetence, Jeremy Hunt has driven doctors to strike. The first time in forty years. With an unprecedented turnout and a solid mandate.
Mr Hunt, it’s time to drop the bully boy posturing and get talking, for all our sakes.