Illustrated resident doctors protesting for fair pay and NHS support with bold signs and raised fists.

Sigh

Twenty years ago, one of the ugliest and bloodiest industrial confrontations was being fought, literally, at the Orgreave coking plant in South Yorkshire.

Five thousand pickets from the National Union of Mineworkers faced six thousand police officers, amassed forces from all over the country.

A medieval battle ensued. Armed with batons, bare hands and horses, the two sides charged, skirmished and fought toe-to-toe.

By sundown, the green fields were stained red with blood. Industrial relations were never the same.

Public opinion was initially divided but, over time, turned largely against the miners.

Why?

The strike was not backed by a national ballot, weakening democratic legitimacy. Violence on the picket lines alienated the public.

Media coverage portrayed miners as aggressive and unreasonable, allowing the government to frame it as a battle for law and order.

The government of the day knew the strike was coming. Some say it provoked it. They stockpiled coal to outlast the strike. Power cuts didn’t materialise, and the public became less sympathetic.

Within a year, the confrontation fizzled out. Miners drifted back to work. The strike collapsed.

In 2002, UK firefighters went on strike.

The public were initially supportive, but it declined. The use of antique Green Goddess military vehicles was a PR masterstroke that drew attention to the risks of reduced fire cover.

HMG successfully portrayed demands (a 40% pay rise) as excessive. Media focused on public safety and disruption. The upshot—a smaller-than-demanded pay deal.

Strikes end if public support is lost. When:

  • Essential services are disrupted
  • The demands appear excessive or unreasonable
  • There is violence or militancy
  • There’s no clear justification or legal basis

Which brings us to the resident doctors’ strikes.

Streeting can’t ‘store-up’ operations like piles of coal in the miners’ strike.

NHSE policy started out as, ‘business as usual’, essential services would not be disrupted… ‘come in for your operation as normal’.

Then it became, the strikes are perilous, putting lives at risk.

Over the weekend, it changed again to; ‘brace yourself’, this is disruptive and will carry on until Christmas.

It’s a brutal fact: if the public experience no disruption, their opinion is unlikely to crystallise one way or the other. That benefits the resident doctors’ claim they ‘do no harm by striking’.

NHSE’s confused policy and mixed messaging will prolong a strike they have no power to settle. Only Streeting and the DH+ can do that.

NHSE should quietly go about their business. Focus on the best productivity they can muster. Not become embroiled, as they will have to restore some sort of collegiate working when these divisive strikes are over.

Excessive demands? The £numbers in the resident doctors’ claim are disputed and complex, making it hard for the public to judge.

Their actual message is: ‘pay restoration over time’… they’ve said they don’t expect it in one go… that opens the door to a three-year deal and could keep the public neutral.

There’s no violence.

BMA militancy is carefully gift-wrapped by their spokespeople, who are articulate and better informed than most journalists. There are no loud, shouty, macho voices… smart move.

The strikes are perfectly legal, right up to Christmas.

Generally, people sympathise with NHS staff—especially post-pandemic. There’s a sense resident doctors’ conditions are poor and they are responsible for life-and-death decisions.

Trust in government is at an all-time low.

Starmer has little support for anything.

Streeting is seen as belligerent. Resident doctors’ claim that he has not delivered on the ‘conditions’ element of the settlement from their last strikes is correct.

Confidence in HMG to handle the NHS is low…

… unplanned, chaotic NHS reorganisation, redundancies and all the stuff you know, only too well, have soured staff attitudes. Other unions are rumbling about more strikes.

Applications to become a nurse are one-third down.

Do the resident doctors risk losing the room?

Sympathy is fragile… but…

… if Streeting is seen to do nothing constructive, public opinion will turn on him.

At the moment, doctors still have something HMG doesn’t… public trust.

Streeting can’t shift the headlines to say… ‘cancer ops delayed’, because NHSE have said they won’t be and are hell-bent on keeping the lights on in the operating theatres and patients wheeled through the system.

Look carefully. Opinion polling is not conclusive:

  • 49% say salaries are about right
  • 51% say they ‘deserve’ more, or ‘could be’ paid more but not 29%

This is a quiet nod of sympathy.

And… mobilising anti-strike sentiment isn’t easy. At any given time, only ~3% of the population is actively using NHS services.

Most people’s view of the NHS will be based on their last encounter, which is likely to be a picture of hospital staff rushed off their feet and struggling.

If the BMA can keep their strike as a battle between medics and ministers… Streeting loses.

If it becomes a fight between medics and the public… it’s already lost.

Strikes don’t end when people shout.

They end when people sigh.


News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.


Discover more from The Training Network

Subscribe to get the latest posts sent to your email.

Previous Posts

An empty NHS hospital changing room with neatly folded navy-blue nursing scrubs on a wooden bench beneath grey metal lockers. One locker stands open as natural daylight enters through a window. NMC fitness to practise delay

Regulate

Roy Lilley challenges the NMC over extraordinary hearing delays, mounting costs, failed regulatory standards and safeguarding concerns, calling for Council resignations, legislative reform and collective action by Britain’s nurses.

Read More »
Early-morning scene outside a busy NHS GP surgery, with staff and patients arriving, bicycles parked by the entrance and warm light from a consulting-room window. NHS performance improvement

Them

The NHS has mountains of performance data, but improvement means more than finding failure. Find the organisations succeeding against the odds, understand why, share it and help others improve.

Read More »
NHS mobile CT scanning unit in a supermarket car park, with shoppers and trolleys in the foreground as patients enter the unit. NHS prevention success

Works

From lung scans in supermarket car parks to vaccination and diabetes prevention, the NHS shows how science becomes valuable when skilled people organise services that patients can actually reach and use.

Read More »
Four classical musicians performing a string quartet in a nineteenth-century rehearsal room, illustrating Baumol’s cost disease and the limits of NHS productivity. NHS productivity and patient pathways

Anita

NHS productivity isn’t simply about working harder or treating more patients. Roy Lilley explores how shorter patient journeys, fewer interfaces and smarter pathways could transform healthcare efficiency without compromising care.

Read More »
Unfinished concrete bridge ending abruptly above a valley while a high-speed train races along a separate track towards the distant horizon. AI transformation in the NHS

Horizon

AI has arrived before the NHS is ready. Regulation, infrastructure, accountability and digital foundations remain unfinished, leaving healthcare racing to complete yesterday’s modernisation while tomorrow’s transformation accelerates beyond it.

Read More »
Overhead view of a senior management meeting room after a meeting, with a long table covered in briefing papers, notebooks, laptops, water glasses and coffee cups. Empty chairs surround the table while two officials leave the room in the background. NHS England abolition feasibility

Responsibilities

Abolishing NHS England was supposed to simplify management and save billions. Instead, workforce, legal and financial complications raise an awkward question: who decided this enormous reorganisation was actually feasible?

Read More »
NHS finance staff working on spreadsheets in a hospital office beside a busy clinical ward. NHS pension contribution £5.4bn saving

Spreadsheet

Britain may be run less by ministers than Treasury spreadsheets. NHS pension assumptions could release £5.4bn, raising a bigger question: will the NHS benefit, or will Treasury take it back?

Read More »
Staff outside Quarry House in Leeds, the NHS’s northern headquarters. NHS devolution and regional power

Power

Moving NHS managers and ministers from London to Leeds is not devolution. Real reform means transferring power, budgets and authority to regions, not simply relocating command-and-control bureaucracy further north again.

Read More »