Here’s the rub: It’s about an exhausted, demoralised group of professionals who feel neither respected nor valued by their employer

Sometimes a short letter comes up with the truth. Other letters are posted as an update to NHSreality’s previous post. (Keep the moral high ground…. Do something but don’t go on strike. It’s the public support which matters.. ) When I was a junior I did 120 hrs some weeks, but it was nothing like as intense as today, and there was a Doctors’ mess, a pool table, and many other “extras” to make one feel valued….. The pay is and was sufficient, and is not fundamentally what “junior doctors” (some with over 10 years experience) are bleating about… Finkelstein’s article is reproduced below.

Sir, Daniel Finkelstein misses the point when he describes the junior doctors’ dispute as a dispute about overtime pay. It’s about an exhausted, demoralised group of professionals who feel neither respected nor valued by their employer.

Kathryn Wood

Sevenoaks, Kent

Moderate doctors must defeat the militants (11th Nov 2015) – Daniel Finkelstein

Threatening patients’ wellbeing for the sake of overtime pay is typical of the BMA’s cynical rabble-rousing behaviour

On July 26, 1945, the British Medical Association was meeting in the great hall of its impressive Lutyens headquarters in central London when exciting news began to filter in from outside. The gasps of astonishment it provoked from the assembled doctors soon turned to cheers.

This July 26 was not like any other. It was the day on which the Labour landslide result was announced, which ushered in the Attlee government that was to create the NHS.

Yet the cheers were not for Clement Attlee. They greeted instead the news that Sir William Beveridge, the man who had first called for a National Health Service, had lost his seat in Berwick.

A little bit of history helps when considering the latest dispute between the BMA and the government, this one over new junior doctor contracts. At every turn and with every change to the provision of medical services, the BMA has fought its corner aggressively, always claiming to act for patients but always, in reality, acting in its own interests.

When the NHS was formed, Dr Alfred Cox, for 20 years the secretary of the BMA, wrote to the British Medical Journal calling it: “Uncommonly like the first step, and a big one, towards National Socialism as practised in Germany.” He said that the NHS established the minister of health as “Medical Führer”.

The minister of health, Aneurin Bevan, didn’t take this lying down. In the Commons he called the BMA “this small body of politically poisoned people”. And he laughed at the suggestion that the battle between him and the doctors was caused by him being intemperate and unreasonable. “It is a quality,” he said, “which I appear to share with every minister of health whom the BMA has met.”

He provided a brilliant analogy. It was like the argument between Chesterton and Belloc over the cause of drunkenness. One night they drank whisky and water, the next brandy and water, the next gin and water. Each night they got drunk. They concluded that the water was responsible.

To an astonishing, almost uncanny, degree, every aspect of the junior doctors’ dispute with the current government was present in the BMA’s assault on the creation of the NHS. The refusal, then as now, by the BMA to negotiate, the calling of ballots (in the 1948 ones, the doctors voted overwhelmingly against the NHS), the claim that doctors were victims being given “duodenal ulcers” by an uncaring government, the sheer aggression and winding up of members, the blaming of everything on the minister’s disrespect and temperament (which might just about fly with the fiery Bevan but is self- evidently preposterous as an allegation against Jeremy Hunt).

Yet one thing is different this time. The BMA junior doctors are readying themselves for a strike. And this is to go too far. Far too far.

The BMA is a trade union, and like any union it fights hard for its members. The people at the top of the union stay in post by stoking the grievances of their members. There are always grievances in any job, everyone has them, and they can be a formidable weapon in the hands of intelligent, respected professionals with a monopoly position.

The organisation is within its rights to behave like that, however unattractive it sometimes is. But a strike is a different matter.

To go on strike is to harm patients, to withhold from them the best possible care. To go on strike is to seek to undermine the health service so that it cannot operate properly in the best interests of the sick and the dying. It is something no doctor should be willing to contemplate.

Deep down I think that the BMA knows this. It even (astonishingly) sought an injunction to prevent the General Medical Council providing doctors with advice on their professional duties before the ballot. Fortunately it failed.

It is, I suppose, just about possible to imagine circumstances in which you could morally justify a strike against ill and vulnerable people. Maybe if we had a fascist government insisting on racial experiments. Or some incredibly extreme government measure that might harm medical care.

But this isn’t about anything like that. Not even remotely. It’s a dispute about overtime pay, for goodness sake.

The Department of Health wants to agree a new contract that ensures that people are paid more for basic work and less for overtime. This will allow hospitals to roster staff more safely and sensibly. It is obviously necessary and this sort of stuff happens with every job. But equally, I can see why any change is unsettling. Doctors are worried they might lose out, and are seeking reassurance.

The Department of Health has tried to provide it. It has offered payment protection — the guarantee that the pay of each individual will not go down — to all but a tiny minority (fewer than 500 doctors) who now work extreme and unsafe overtime. And they have made promises on hours and the overall wage bill too.

This reassurance hasn’t worked. The BMA has stoked its members for a fight and no concession seems good enough. At one point the doctors union put a pay calculator on their website telling members their pay would go down by 30 per cent, even though no figures had been announced, let alone agreed. By the time they took it down, it had done its damage.

They also confusingly suggest that somehow the new contracts will be unsafe for patients because doctors will be exhausted. There is not a scrap of evidence to support this charge, which is designed merely to excuse militant action against patients by arguing that it is really on their behalf.

The idea that doctors have not been treated with respect is also absurd. No other profession is treated with more respect.

But let’s say I’m wrong about all this. Horribly wrong. I am certain that someone can cast doubt on the government’s offer or show that more guarantees are needed, or more money, or more grovelling. Yet I am equally certain that negotiation is possible and a strike would be grotesque.

Where are you, brave moderate doctors, to tell the leadership that this has gone far enough? When all your associates are in such a lather, of course it is hard to stand up against it. But it’s your duty. To harm patients over your pay is outrageous.

I am not asking junior doctors to agree with me about contracts. But about striking? Yes, I am asking that.


This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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