Recognise this is more than a strike

What are we here for?

Perhaps I’m naive…

… by now, I really did hope that there’d have been a grown-up in the room and some last-minute-breakthrough ending to the BMA’s battle with HMG…

… after all, it’s not really a just a doctors’ strike anymore, is it? Now, it’s about politics.

No one seems to want to point out; whilst it is true, the huge majority of BMA members voted for a strike, the actuality is; in total more than half of all junior doctors have not.

If my in-box is anything to go by, there are rank-n-file strikers starting to worry.

As one correspondent put it;

‘… I can’t say anything because I have to work with people who have been on strike, when this is all over…’

It’s an important point and a legacy issue that we’ll have to deal with.

Now, a row has broken out about ‘derogations’… the permissions a striking union gives to its members to return to work.

Derogation arrangements worked sensibly with nurses and paramedics. The BMA, however, require hospital managers to ‘apply’, on a form… for help.

I think I’m right in saying over 20 applications have been refused by the union’s hierarchy and the BMA has implied, hospital managers are someway in cahoots with HMG asking for unnecessary derogations, to make the situation seem worse than it is.

I spoke with one Trust boss who pointed out… a derogation application is instigated by the clinicians working at the sharp-end in the Trust, not managers… don’t shoot the messenger.

At the time of writing the BMA have made a big-thing of granting one derogation.

It’s on Twitter;

‘We have granted a derogation for one junior doctor for the neonatal unit at University Hospital Lewisham for the day shift on 5th January… our priority is patient safety…’

You can make of that, what you will.

If you think the NHS is being run from a backroom at BMA HQ, you are probably right.

In this time of great uncertainty, there is one thing I am absolutely certain about… the resolve of the doctors running the strikes. Don’t underestimate them.

Is there any way of getting to a resolution?

The BMA want a 35% restoration, based on a claims that pay has fallen by about 26% in real terms since 2008-9. That is true and restoration would mean a 35% rise.

They’ve used the Retail Price Index measure of inflation. A yard-stick criticised by some economists.

Using the Consumer Price Index as a measure of inflation… doctors have experienced a roughly 14% fall since 2010.

Both measures have their critics but it seems to me, there might be wriggle room.

Another is timing. A three year deal seems doable… but not without problems…

… there’s a 12-ish% settlement on offer, well above the nurses’ 5% and the consultants’ unfathomable 4.95%.

This has already stirred up the nurses and anything higher will, for sure, reignite calls for industrial action and the possibility of ‘coordinated’ strikes, with the junior doctors, all on the same days.

The BMA have no reason to believe an incoming Labour government would honour a deal… Charmer won’t tell us diddly-squat about the cost of a parking ticket never mind how he’d end the strikes.

That leaves us with three issues;

• the moral and ethical dilemma of medics striking,
• finding out just how elastic is public tolerance for strikes bearing in mind pretty well everyone has suffered wage value erosion, and
• HMG’s risk appetite.

The answer? Minnesota University…

… their R.I.G.H.T method, of unpacking and unpicking ethical dilemma.

Recognise this is more than a strike; it is an ethical dilemma for HMG whose job it is to keep the nation safe and juggle the economy, and doctors, whose job it is to do no harm.

Both sides are culpable. So…

… change the perspective; the NHS is a safety critical industry and should be run like one.

Identify points of view; the Doc’s are right to claim they’ve been neglect by their dozy union and exploited by successive governments.

HMG have legacy problems with the economy and inflation.

We have to create much better industrial relations mechanisms that benefit both sides.

Gather resources and assistance; HMG should step away and ask ACAS for help. Number 24 went from uni, to the Bar, to politics no experience of running anything as big as the NHS and no industrial relations experience… looks bewildered.

ACAS are neutral and good at this stuff.

Have a plan; as part of the solution… stepped changes, improvements to working lives, rota flexibility, debt forgiveness, hot food, car parking… a package not just for doctors… for the whole workforce.

Instead of spectating the Confed and Providers could be working on an employer’s charter, now.

Take action based on ethical standards; strikes in the health sector are not ethical, neither is bullying industrial relations.

Implementation of a deal means accepting that and identifying success indicators…

… and…

… can we agree that patients have the most to lose but the least influence…

… and further agree…

… because of that, this must never happen again. Otherwise, what are we all here for?

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