Gale's View - Junior Hospital Doctors

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September 7th 2016

It is less than five months since the doctors` trade union, The British Medical Association, reached an agreement over a new contract for junior hospital doctors. That agreement was arrived at following a recognition by the Secretary of State for Health that the doctors had a number of genuine concerns and those concerns were addressed in concessions made by the Department of Health. The agreement was recognised by both sides as being fair, workable and, most important of all, safe.

Since that time only two things have changed. First, the junior doctors voted against the recommendation of their Union and rejected the agreed settlement. Second, and in the light of that vote, the Junior Doctors` Chairman, Dr.Johann Malawana, resigned on 5th July and a new Chairman, Dr. Ellen McCourt, who had been party to and who had agreed the terms of the settlement, took his place.

During the course of the original dispute, which involved damaging but not fatal industrial action, I spoke publicly and communicated privately with Johann Malawana on a number of occasions in the course of the discussions. I believe him to be a decent and highly professional man, who wanted to negotiate, reach a fair deal, and get back to his job treating his patients as an obstetrician. He recognised that the Government had made an electoral commitment to create a 24-hour-a-day seven-day-a-week hospital health service that provided the same very high level of care to patients at midnight on a Sunday as might be available at mid-day on a Wednesday. He also understood the not widely-reported fact that while the Government had an electoral mandate to introduce this round-the-clock service it understood that it could not and would not be done overnight.

If junior doctors were not to face a cut in income and if they were to be required to work fewer rather than still longer hours, as the Government had pledged and the new contract offered, then more doctors and nurses, currently recruited and in training, and more support staff at every level, were going to have to be available and paid for before changes were made. That, clearly recognised by Jeremy Hunt as the Secretary of State for Health, was understood by all sides in the dispute and it was upon that basis that the agreement was reached.

In that context it is clear that the present and proposed “rolling programme” of five-day strikes is unnecessary, unwarranted and irresponsible. This industrial action, which has the support of a minority of perhaps one-third of all junior doctors, will, if it proceeds, cause the cancellation of tens of thousands of operations and a similar number of appointments. It may well put lives at risk and it is being implemented on the back of a narrow vote for strike action that was taken months ago and was never intended to embrace the kind of potentially life-threatening and prolonged disruptive action that a militant minority of junior doctors have now embarked upon.

Of course, faced with a choice between “those nice, dedicated and professional doctors” and “dishonest and self-serving politicians” the public has hitherto sided with the medical profession. This time is different, however. This time not only the Government but the Academy of Royal Colleges of the medical professions have stated very clearly that these proposed strikes are unsafe and unacceptable and we have to hope that informed public opinion will send a clear message to those leading the militant action within the BMA that neither right nor reason is on their side.

Let us be clear: this proposed action by the junior doctors is not about `patient safety`. It is a 1970s-style industrial dispute over working hours, pay and conditions. It is using a public in need of healthcare cynically as a pawn in a struggle against a democratically elected government and it is demeaning and undermining its own professional reputation in the process.

I hope very much that the majority of junior doctors that do not support the action instigated by what at present passes for their leadership will have none of it. Let us accept the contract agreed between the Department of Health and the BMA back in May, put it to the test and give it, say, two years to settle down and work. No agreement is ever perfect first-time around and it may well be that the deal will have to be fine-tuned to avoid the law of unintended consequences. With good will between the Secretary of State and a responsible leadership of the British Medical Association there is no reason at all why that should not happen. The alternative, I fear, is a protracted dispute with the patient, and very probably the doctors themselves, as the losers. It is still not too late to avert a tragedy.

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