In post-industrial Britain, large scale strikes have become a rare occurrence. I struggle to recall a strike in my lifetime which has captured the public’s imagination in a similar fashion to those industrial disputes of the 1980s. That’s why the recent junior doctors' strike in England - the first one by these workers in 41 years - is so peculiar.
Healthcare is one of Britain's main concerns, so when medical professionals are picketing outside the wards they're supposed to be working in, the public sit up and listen. At present, the striking medical workers enjoy the support of most of the public. Ultimately, if they press on with further strikes unless negotiations bear the fruit they desire, this support will dwindle.
I can predict with some confidence that when the dust settles upon this dispute the British Medical Association’s (BMA) aims will not have been met. Eventually the BMA will agree to a deal, meaning the current system which they are striving to keep will be gone. To mask its embarrassment, the BMA will pretend it has defeated Whitehall, yet, the deal will resemble largely what the government wished to achieve in the first place. It is the recurring outcome of nearly every labour dispute. The modernising reforms of the NHS in England will be carried out.
Most importantly though, the NHS will continue to exist. Those placard-waving doom-mongers prophesying its imminent death will be proved wrong, as they always are. They shall join the long list of special interest groups aggrieved by government policy who choose a hyperbolic response to progress instead of embracing it. Indeed, has there ever been a government since 1945 that hasn’t been accused of ‘killing the NHS’ or ‘ending the welfare state’?
In the autumn of 1981, around 13,000 aircraft controllers in the United States began an illegal strike demanding a $10,000 pay increase and a 32 hour four day week. President Ronald Reagan told the strikers that if they did not return to work in 48 hours they would forfeit their jobs and their contracts would be terminated. While 1,300 returned to work the rest laughed at the president and awaited their $10,000 (equivalent to $26,109 today) pay rise. Like their fellow middle class professionals in England in 2016, they believed that without their presence the world would stop spinning. President Reagan however stayed true to his word and the rule of law. Two days later he handed the now 11,345 striking federal employees their notices.
Not a single plane fell out the sky that autumn. There was disruption, yes, but air travel continued to exist and thrive. The reality was that the ‘tired’, ‘overworked’, and ‘underpaid’ workers (sound familiar?) were actually not as important as they believed. In the months ahead new controllers were trained and recruited and the strike became a footnote in American history.
A strike is a battle fought on two fronts: on the shopfloor and in the media. The BMA’s public relations strategy has been superb, the government’s paling in comparison. On the day of strike, the health minister, Jeremy Hunt, chose to hide rather than face the cameras, leaving the BMA bosses a free run on the airwaves; on his most important day as a minister, Hunt did not answer his call of duty.
Hunt should have been on the front line presenting the case for reform. He could have been pointing out that ‘junior doctors’ are not merely fresh faced graduates on £23,000 - like the BMA are happy for the public to falsely believe - but all non-GP doctors below consultancy level, some of whom have over 10 years service in the sector and a £70,000 wage to go with it. Hunt should have stared down the camera lense into every living room in Britain and told the public how he is offering these middle class professionals a staggering 11% pay increase in their normal hours pay.
Modern Britain has replaced Christianity with a newer national religion, the NHS. The NHS though is not a religion, it is nothing to be adored and glorified; it is a government system for the distribution of medicine and health care in society. An excellent egalitarian innovation but not a sacred cow, it is a government programme like any other.
For it to endure and improve as more of us live longer and Britain’s population continues to grow we must stop looking upon criticism and reform as blasphemous. The irrational placard wavers remind me of those who line up at embassies after a cartoon or a book has been published which challenges their deeply held religious convictions. They take criticism of their belief system is as an attack on them individually.
To the BMA’s annoyance there are blasphemy laws to protect the NHS - you can critique it, its clergy and say the system needs a reformation.
The NHS in England does need tailoring to fit a country whose society lives longer, works on all days and at all hours and one whose population grows every year. A patient should expect the same quality and level of care on any day of the week, a Sunday or a Wednesday should make no difference. We live in society where supermarkets import Southern Hemisphere-grown strawberries to satisfy British consumer demand in the winter. How can we organise the supply of fruit to satisfy changing demand but it is unthinkable to organise the distribution of medical services for changing and increased demands?
Illness does not recognise arbitrary boundaries like ‘weekends’ and neither should those who choose a career which aims to care for those who fall ill. The NHS does not exist to serve the interests of workers first, but patients - the people who pay for the NHS, who rely on the NHS and for whom the NHS was built.
If you stand in the way of modernising the system, you stand in the way of patients. Put down the placards, accept your 11% pay rise and get back to serving the people you took an oath for.
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