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The Junior Doctors Strike

Posted on September 6, 2016 at 5:25 AM

I have never liked the term 'industrial action' because what is planned is always the exact opposite – industrial inaction. 'Strike' is better; it suggests a blow is being delivered. And that is precisely what the UK's junior doctors are planning; more blows. Blows to try and force the government to reopen talks about their contracts. When you heard the news, did your heart sink? Mine did.

During the junior doctors' strikes earlier this year, the banners on the picket lines did not read: 'doctors demand more money' but 'not fair – not safe' and 'save our NHS'. Clearly they felt there was more to this dispute than a simple spat about wages, the safety and even the survival of the NHS were at stake.

Before the strikes earlier this year the ballot of British Medical Association (BMA) members showed overwhelming support (98% voted for strike action with a turnout of 76%) and the number of doctors who walked out was very high (almost 100% downed stethoscopes in the hospital where I work). The junior doctors grievances had the overwhelming support of consultants and general practitioners. Many of whom felt that they would be next on Mr. Hunt's hit list. Most doctors expressed regret that it had come to strike action but felt that they were left with no alternative.

They justified the decision to strike on the grounds that it would not compromise patient safety. But this is disingenuous. Although consultants did cover the emergency work on strike days, in order to do this they had to cancel operating lists, outpatient clinics etc. And we know that some patients die while waiting for 'elective' procedures such as coronary bypass operations and prolonging the waiting time will inevitably increase the number of deaths.However, an agreement was eventually reached between the BMA and the Department of Health in July but was then rejected in a subsequent ballot by a much narrower margin of 58% to 42%, with a turnout of 68%. There has been no further ballot on strike action; that decision was made by the BMA council. Leaked sources revealed that the vote in favour of striking was very close. I doubt the next round of strikes will enjoy as much support from junior doctors as the ones earlier this year.

The Prime Minister said that the government was…'putting patients first' while the doctors were 'playing politics'. This sounds like an episode of 'Job Swap' I would really not want to watch. She went on to say that "the NHS enjoyed record levels of funding", and that there are "more doctors now in the NHS than we've seen in its history".

Both facts are true, but fail to recognize that many hospitals do not have enough doctors to fill the on-call rotas and 40% of advertised consultant posts remain unfilled. Patients are frequently extremely complimentary of the care they receive from the NHS and if you are on the receiving end of emergency treatment, I doubt it could be bettered by any other country. But if you are at the end of a three-hour queue in A&E or the bottom of a six-month waiting list for a hip replacement, you will see at first hand how poorly an underfunded, understaffed and overstretched health service functions.I was one of the many consultants who covered the emergency duties of striking junior staff.

At first this was a bit of a lark, nurses on the wards were amused to see me struggling to type out a discharge summary. But the novelty wore off. What ground me down was not the huge amount of tedious and repetitive work I was expected to do, nor the ludicrously disjointed IT systems (seven different systems, all with different log-ins) but the feeling that I was not furthering the junior doctors' cause. Indeed we ran the emergency services much more efficiently without them.

I have enormous sympathy for the junior doctors' plight and nothing but scorn for the secretary of state. My fear is that continued strike action will achieve nothing apart from a progressive decline in public support (an almost inevitable consequence of long industrial disputes) and a generation of increasingly demoralised doctors. Despite imaginative and evidence-free speculation on social media I see no sign of the government changing its position. Many UK trained junior doctors have already voted with their feet rather than the ballot box by leaving to work overseas. The majority have no intention of returning. If this stand-off continues I worry the exodus will escalate.

We need to replace ill-informed spin about the state of the NHS with honesty and realism that there is now a widening gap between what the NHS is being asked to deliver and the funding available. Former conservative health minister, Dr Dan Poulter, recognized this and suggested a 'health tax' generated by raising National Insurance contributions. We urgently need a plan to close this gap. The last thing we need is a protracted battle between the government and core medical staff.

Western Morning News 6th September 2016

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