The “Junior Doctors” might have my support, but not for reasons that they’ll like.


I weigh into the doctors’ strike with a little trepidation as anything involving the NHS seems to provoke violent emotional (rather than rational) response.

By way of context, my understanding is that the government desires that the health service should run fully for seven days a week. By run fully they (and I) mean performing all sorts of surgery, not just emergency stuff, at the weekend. This seems eminently sensible. Operating theatres are expensive things, and having them stand idle for 2 days out of 7, (28% of the time), is wasteful. May other businesses with highly expensive fixes asserts, such as airlines, car manufacturers and hotels operate seven days a week and I see no reason why hospitals can’t either. Indeed, given the increasing number of patients and the increasing number of operations that can be performed it seems that more operating theatres will be (and may already be) a medical imperative. Switching to seven day a week working is going to be far cheaper and far quicker than building 28% more operating theatres.

And yes, sorry, money is important. The NHS costs £140 billion per year. That’s the entire deficit and change, or the entire education, defence and transport budgets. Any numerate health professional should be affronted that over a quarter of its capacity us unused.

So the next problem is money. In this context remember that “junior doctors” includes registrars earning £70,000 per year as well as the newly qualified, who scrape by of £25,000. The arcane working practices of the NHS don’t help, but it seems that the doctors beef is that if they have to run hospitals seven days a week they will have to work longer hours. Well, yes they might. Welcome to austerity and the real world. The wealth creators who provide the tax that doesn’t quite pay for everything are working very hard too. And without the benefit of cosy student loans, virtually guaranteed employment and a very generous pension, nor with the immediate prospect of almost tripling their wage as their experience progresses.

So the argument becomes one about safety. There is some fining mechanism which prevents NHS trusts allowing junior doctors to overwork. As part of the proposed reform this is being scrapped. Junior doctor claim that this will make hospitals more dangerous as they will then be allowed to overwork. Really? If they feel over-fatigued and incapable they should have the moral courage to stop and take rest. If these highly trained, very intelligent individuals don’t feel that they have that courage then they can copy airline pilots and HGV drivers and have statutory limits on the hours they can work. It’s a non-problem. As long as I can remember there has been whining about the hours worked by junior doctors, if the BMA and RCS want to be taken seriously they would come up with a solution – which will inevitably be that senior doctors (who presumably are paid somewhat more than the mere £70,000 of a registrar) do more work. As a tax payer I don’t see a problem with that. Worst case, recruit some more doctors – there are plenty of applicants in UK.

Apparently it is not only hospital junior doctors that are caught in this, so are GPs. Again, it would help me (and much of the working population) if GP surgeries were fully open at the weekends as we would not have to take time off work for routine stuff. Presumably it would also deduce the intensity of demand during the week, allowing for more flexible working for the GPs themselves. Who knows, a consultation length may also increase.

Of course, the devil in all this is in the detail. Sadly, as the NHS is a nationalised industry any change becomes a political event, thence to a media fest and somewhere along the line the detail gets lost (c.f. Does Saddam have WMD?) An professional speaks only in the negotiations and does not run to the media claiming that the way to save “our NHS” is to change nothing and throw more money at this (known as the Gordon Brown solution, I understand). At some stage the BMA will have to thrash this out; it is in the national interest that this happens sooner rather than later. All the junior doctors have achieved is a bit of publicity for an arcane argument that will never be settled in public.

But they have also done something worse. Like I guess a few hundred thousand others, I had an appointment cancelled. I still had to go to the hospital to collect some stuff (3 hours wasted) and of course the appointment will have to be rescheduled. As I needed a form filling in for some other government department, all their time has been wasted too.

What has been demonstrated is that the NHS is unmanageable and that the BMA is nothing more than another trade union putting its member’s interests ahead of the country’s. Arthur Scargill did that, and it ended badly for the miners. The longer this dispute goes on the more the BMA will be seen as a trade union rather than an expert body or trade association (it tries to be all three).

If the junior doctors’ strike has hastened the breakup of the NHS then, ironically, I suppose I support their actions but not their reasons. But my instinct is that they are wrong to fight this battle, and even more wrong to do it in this silly way.