Take the hit

Here we go again…

Once more, with feeling…


… the junior doctors have joined the queue of health workers with a Gov-Grudge and are going on strike next month.

They know how to do it. They did it in 2016.

At that time their beef was principally about weekend working. In October of that year, in my eLetter of the 29th., I tried to summarise what’s what.

The, then, Health Secretary, now the Chancellor, Jeremy Hunt had said he wanted;

‘England to be the first nation in the world to provide a truly 7 day NHS… with hospitals properly staffed, so the quality of care is the same every day of the week.’

He sighted Salford Hosptial, who were pretty much doing it.

Getting on for eight years later… it still isn’t the same each day of the week.

Staffing and funding, the Bonnie and Clyde that rob management of the wherewithal to implement meaningful change.

I wrote, at the time;

‘Doing it… [seven day working] … across the NHS will require a realignment of junior doctors hours and a redistribution of the salary budget.

As a nurse pointed out; ‘We don’t get paid extra for weekends, why should the doctors?’

Err, tricky question.’

The junior-docs balloted, went on strike. It was a curious affair.

The strike passed uneventfully and press interest waned. The hidden damage was to the waiting lists. By the end of the dispute over 101,109 outpatient appointments were cancelled, plus the knock-on effect on elective lists.

The Patient’s Association was all-but silent. As they are today. Their President, Robert Francis’ safe staffing recommendations, long since sidelined.

The doctor’s claims that their hours were extended and their pay cut, were patently not true. In the end Hunt imposed the new contract and the aggro fizzled out.

The patients were the losers.

This time the strike is easier to understand. Not an arcane argy-bargy over a complicated contract. Just plain and simple, ‘more money’. The JDs are reported as looking for a 26% up-lift.

This is not correct.

The BMA claims that junior doctors’ pay has fallen 26% since 2008/9, and asked the government to restore it to this level.

This would amount to a rise of about 35%.

Their beef is encapsulated in this short film. A grumpy looking young man does his best to sound determined and sinister. It’s the usual; ‘they’ve made us do it’… ‘it’s the only way’… blah… blah…

I felt compelled to point out that the polemic made no mention of patients only to be reminded (by a Dr Qureshi), that; ‘the BMA was a union and not a patient safety service.’


The General Medical Council remind doctors that whilst they may take part in a legal strike, they must;

‘…make the care of your patient your first concern.’

Not according to Dr Qureshi and his mates, who is shoving the responsibility onto Consultants.

They might do well to have a look at the BMA’s guidance that makes the point; consultants have no obligation to ‘act down’.

The BMA say it’s all up to the employer to sort out the mess. How? They tell us;

‘… the only feasible way … is for your employer to cancel almost all elective care prior to, during, and after the junior doctors’ action.’

They are right, it is the only option and in 72hrs probably 200,000 patients will take the hit, again.

I wonder, doctors, instead of unleashing their discontent on the luckless patients and Trusts, neither of whom have any power to increase a doctor’s wages, they might ask; if the value of their pay has so badly stagnated… why have the BMA been asleep at the wheel and allowed it to happen.

JD’s beef is really with a failing trades union.

Structural failings in workforce planning in the NHS, political choices and poor representation are not something to punish patients for.

Moral and ethic codes are the concepts we chose to live by. Mostly founded in our religious beliefs, our upbringing, family and experiences.

Can it be argued;

Deliberate damage to another human being is an offence in law.

Denying treatment from those who need it and have paid for it, from their taxes, might be regarded, at the very least, as aggravated robbery.

Rules and guidance, about strikes, is man-made, by organisations founded on nothing but a desire to manufacture their own morale codes… to suit themselves.

In the case of the BMA, the RCN and their regulating bodies, NMC and GMC, codes and guidance are contradictory, fail in any test of practicality and at any level of ethical challenge.

… but if you are a striking doctor, that’s ok. A couple of hundred thousand patients can take the hit.

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.