The news on the evening of Monday the 4th January was met with a mixture disappointment and inevitability; industrial strike action amongst junior doctors was set to go ahead. Negotiations between the British Medical Association (BMA) and NHS employers broke down and an agreement could not be reached over new contracts for junior doctors. Despite continued negotiations, agreements cannot be reached over the security of pay for doctors, all the while eliminating safeguards against dangerously long working hours. The prospect of a continued demand for more work without the guarantee of proper compensation is not acceptable and, as a result, the UK is set to face the first industrial action by junior doctors since 1975.
The BMA issued a press release following the negotiations, blaming their breakdown on ‘the government’s continued failure to address junior doctors’ concerns about the need for robust contractual safeguards on safe working, and proper recognition for those working unsocial hours.’ Dr Mark Porter, the BMA Council Chair, added that ‘We sincerely regret the disruption that industrial action will cause, but junior doctors have been left with no option. It is because the government’s proposals would be bad for patient care as well as junior doctors in the long-term that we are taking this stand.’
The decision to strike by our junior doctors encompasses three of the most important battles facing our society today. Firstly, the fight against more. Since the election of the Conservative government in 2015, the frontbench has been all too willing to point out British laziness. The Health Secretary himself, Jeremy Hunt, used his appearance at the Tory Party Conference to criticise British workers for lacking a necessary work ethic. Tory Minister Matthew Hancock added similar comments on the announcement of the national ‘Living Wage’, suggesting that the reason it is not paid to under-25s is that they are not productive enough.
The BMA refuses to accept these new contract proposals because they expect too much from doctors with too little in return. The new contracts will not only make it easier for NHS employers to work doctors for longer hours (to potentially dangerous levels), but they will be paying less in the face of these increased demands. The contracts will restructure the definitive boundaries of ‘anti-social’ hours. As a result, this shifts the compensation associated with those time periods – meaning that, despite the promised 11% pay rise by the government, this will be lost (and then some) due to pay restructuring and limits placed on the progression of pay.
Secondly, our junior doctors take the student fight on their shoulders too. Ever since the election of the coalition government in 2010, the financial onslaught against students has been unyielding, and education has been transformed from a right into a commodity. This new government has been no different; proposing to remove bursaries for student nurses and making even more students answerable to loan companies for their education. The culmination of these factors has meant that, as a study late last year found, nearly half of medical students who become qualified as junior doctors go on to refuse work in the NHS due to significant resource cutbacks leading to heightened pressure on doctors.
Medical students like Demelza Beishon-Murley, who is a final year medical student at St. George’s, University of London, are frightened about the impact of the government’s proposals on the next generation of doctors: “Throughout my training I have developed a passion for the NHS. I love what it stands for, and I am passionate that it is worth protecting. However, the excitement to work in such an organisation dwindles with every new attempt from the government to put profit above patients.”
“As a group not known for taking this kind of action regularly, it should demonstrate to the public just how concerned we are.”
Thirdly, and perhaps most importantly, the industrial action stands for us all as patients in waiting. ‘Patient safety’ has been some abstract term banded about by commentators on both sides. But what we have failed to properly comprehend – as political commentators, as politicians, as citizens – is that the NHS remains at the forefront of public concern because we understand that at some point in our lives we will rely on its services. We are all temporarily able-bodied citizens and workers, and we rely on the action of our doctors to protect us outside the hospital, as well as within it. They are all that stands between us and the creation of a new political group of precarious patients.
The insecurity and risk generated in everyone’s lives due to increased cost-cutting, the proliferation of part-time and zero-hours contracts and the disempowerment of trade unions, is at serious risk of being replicated in our hospitals too. This is met with news that suicide is now the leading cause of death for British men under 50, with the Prince’s Trust finding in 2015 that over half of young people classed as NEET (Not in Employment, Education or Training) display heightened levels of anxiety and worthlessness. But what hope of rehabilitation can we offer, when the workers and students that can provide the services to help, find themselves under the same pressures?
So why should we support today’s action? Because our doctors, our students and ourselves as patients deserve better. Because the chance to work at a comfortable pace is not too much to ask, and to be properly remunerated for stressful work is a reasonable demand. Because education ought to be dictated by passion and not by loan repayments. And because one’s situation as a patient ought not to be met by further precariousness.
“Doctors and other healthcare professionals are taking a stand to protect the patients we serve.”
– Demelza Beishon-Murley.