Junior doctors and consultants in England are on strike together for the second time in the history of the National Health Service (NHS). The joint action will last for three days until 4th October. Hospital dentists from the British Dental Association are set to walk out during the same time frame, providing emergency care only, whereas radiographers at 37 NHS trusts in England will also join picket lines for 24 hours from 8 am tomorrow morning. Junior doctors have staged 21 days of strike action since March.
This is momentous. Not only for the patients who may already have waited months for treatment, if not years in some cases, but for what it says about morale and the level of anger in the NHS.
A decision to take strike action is always a last resort. This is particularly the case for those in the caring professions. The fact that they are not capitulating to this bullying government says all we need to know about the breakdown of trust between the two sides.
The government has implemented a 6% pay rise for consultants and 6% plus a lump sum of £1,250 for junior doctors and has said there will be no further offers. The BMA, in response, said that wages for junior doctors have fallen 26% between 2008 and 2022, with newly qualified doctors making less than a barista in a coffee shop. It has called for a 35% pay rise for junior doctors to bring salaries back to 2008-2009 levels, calling this “pay restoration”. The consultants are not demanding pay restoration, but an above inflation uplift.
Pay is clearly at the heart of this dispute. A junior doctor earns a basic salary of £28,243 compared to the average wage of £31,772, according to the Office of National Statistics (ONS). They are therefore not inured from the impact of the cost of living crisis. A recent BMA survey warned that in 2022 nearly half of junior doctors struggled to afford their rent or mortgage and half had difficulty paying their energy bills.
The government has made much of the fact that consultants have what would look to many like an enviable salary, ranging from £77,769 to £126,281. However, using this in their propaganda war against the medical profession has only achieved a hardening of support for the strike. For consultants, it is about fairness and a recognition of their skill and levels of responsibility. For all staff, it is about the need to feel valued.
Other factors in the dispute are the working conditions all NHS staff have been forced to cope with as a result of years of funding cuts. They are constantly firefighting, trying desperately to find beds or treat patients within a reasonable and safe time frame. The Royal College of Emergency Medicine found that long A&E waits, due to a shortage of staff and a lack of hospital beds, contributed to 23,000 excess deaths in 2022. It is perhaps no surprise then that a report by the King’s Fund found that NHS staff are 50% more likely to experience chronic stress than other workers in the general population. A recent survey by The British Medical Journal found that one in three medical students plans to leave the NHS within two years of graduating.
The Guardian reported a junior doctor, Veness, who was on the picket line saying that the hospital where he works in Trafford is being routinely understaffed.
“I have seen days where we have had, I would say, dangerous [levels of] staffing. We haven’t had a registrar on call, and we haven’t been able to find a locum, so it’s just been the most junior members of staff, including myself, looking after an entire hospital, without a consultant or a registrar, which is terrifying, not only for myself, but for patients.”
So behind the pay demands is the need for recognition of the pressures the NHS staff are working under. They need to feel valued for the job they are doing day in and day out to keep the NHS functioning with inadequate resources, and they also hope that highlighting these pressures will result in a properly publicly funded NHS.
Instead of which, the government has decided to follow the worst practice ‘How to Negotiate’ handbook. Not only have they refused to meet the BMA for over six months to talk through the issues, they have embarked on a propaganda war to try and turn the public against the doctors..
The Prime Minister has repeatedly used striking doctors as scapegoats for his failure to bring down waiting lists, one of his five pledges for 2023.
And yet, despite this, some 42% of the public blame ministers for the growing delays, with just 15% of people blaming the doctors.
Time after time we are presented with evidence as to how ill-equipped this government is to run this country. Choosing to alienate and antagonise key groups of workers on whom the health of the nation depends seems foolhardy in the extreme. Adopting a bullying approach to workplace negotiations is rarely successful. So, while this government plays at being the ‘tough guy’, tens of thousands of people will continue to wait for much needed treatment and the NHS will fall further and further into decline. Meanwhile, the greedy private investors sit silently, licking their lips and waiting.