11.02.2016

Don’t fall for the lies

Our action is aimed at the government and NHS employers, not patients, writes Richard Galen

The second junior doctors strike went ahead on February 10. As readers will know, the government is insisting on the imposition of new contracts despite the overwhelming opposition of the doctors and their union, the British Medical Association. Last-ditch talks between the BMA and the department of health broke down on the eve of the strike, leaving medics with no option but to press ahead with industrial action.

It is important to note that striking is a particularly difficult decision for doctors, given the effects it has on the ‘service users’ - for the most part ordinary working class people who need medical care. In the majority of strikes, the aim is to hit the employer where it hurts - through the loss of production and therefore revenue that results from an absence of workers. But, of course, in the public sector that does not apply, although usually the intention is still to pressurise the employer - in this case, the state, obviously - rather than inconvenience those who use the service.

However, when it comes to the health service, it is inevitable that patients will be inconvenienced at the very least. Yes, the standing of David Cameron and health secretary Jeremy Hunt will hopefully be damaged, but the effects of a doctors’ strike are mainly felt by those patients whose clinic appointments or elective operations are postponed. There is also the question of public support. An Ipsos Mori survey in January showed 66% of those polled thought the decision to strike was justified, but this support dropped by a third if emergency care was not provided.

The BMA had originally intended the February 10 action to involve a complete withdrawal of labour between 8am and 5pm, but, in my view correctly, it announced that, although the strike would be extended to 24 hours, junior doctors would provide emergency cover - what the BMA refers to as a ‘Christmas Day service’. This means that all emergency departments were to be fully staffed, and all of the ‘on-call’ doctors throughout the rest of the hospital were present as usual. Additionally, cancer services and maternity units were not affected.

Let me stress: our action is aimed at the Tories and NHS bureaucrats, not our patients. It is correct to try and minimise the disruption caused to hospital care, and to show the public that doctors are not willing to compromise patient safety if they can avoid it. Even more preferable would be a situation where other trade unions and sections of the working class took action on our behalf - but we all know how likely such direct solidarity is right now, thanks to the draconian anti-union laws, the need of union leaders to ‘keep things safe’ and the absence of any kind of political class-consciousness amongst the mass of workers.

I do not need to remind readers that the government has shown a complete unwillingness to negotiate over key points in the proposed contract. Sources close to the negotiations indicated that Hunt “personally vetoed” an offer from the BMA that would have allowed the strike to be called off - even though officials from NHS Employers saw it as an “opportunity to resolve the dispute”.

This is not surprising, coming from a man whose rhetoric included accusations on the Andrew Marr show earlier this week that the BMA is “behaving in a totally irresponsible way” and “spreading misinformation” - an interesting comment, given his oft-repeated ‘misinterpretation’ of Sir Bruce Keogh’s paper on weekend mortality rates in the NHS. Keogh concluded that the figure of 11,000 ‘excess deaths’ at the weekend (which actually includes Friday and Monday) is not down to staffing levels, despite Conservative propaganda - a claim described as “rash and misleading” by the authors of the paper themselves.

The truth is that we had no alternative but to press ahead with the strike, despite its impact on patients, because we know that not only will the proposed new contract result in worse working conditions for ourselves: it would also adversely affect patient safety in the long term. The drive behind the contract is the government’s push for what it calls a “seven-day NHS”, but in actuality it would mean an extension of routine and elective services into the weekend - emergency services, as always, are already “seven-day”. It would mean either doctors being shifted from weekday work (reducing the normal level of cover, obviously), being forced to work longer hours (making them more tired and prone to mistakes, thus affecting patient safety), or managers having to hire more doctors, as well as other healthcare staff, to cover the extra weekend services. The last option is most definitely not included in the proposal.

When faced with the accusation of not caring about the anguish and suffering caused by the strike to patients, junior doctors - who went into their chosen career specifically to help and care for ordinary people when they need it most - find it very difficult not to second-guess the motivation of Hunt and co in trying to impose a ‘contract’ that only one side wants. The fact that the union has made the decision to keep all emergency and urgent care fully staffed during the strike will hopefully go some way to reducing the doubts, in the minds of both the public and doctors themselves.

A final point: to put the level of reduced cover during the strike into context, a near-identical shortage of doctors occurred on April 29 2011 (a Friday), and again on June 5 2012 (a Tuesday). No concerns about patient safety and delayed operations were raised in the media, and there was no condemnation by the department of health of this surely “irresponsible” action. In those cases, however, it was not striking doctors who were responsible for the lack of cover, but the government itself.

The reasons behind these “disruptive” and “potentially dangerous” interruptions to normal service? The extra bank holidays declared for the royal wedding of William and Kate and the queen’s diamond jubilee respectively. Enough said.