home Europe Junior Doctors Deadlock with UK Government as More Strikes Threatened

Junior Doctors Deadlock with UK Government as More Strikes Threatened

The National Health Service (NHS), established in post-war Britain as a fair way to ensure that good healthcare would not only be available to those who had the means to pay for it, is well-loved, as the ongoing #ILovetheNHS Twitter hashtag has demonstrated for years. British healthcare is far from perfect – mistakes and misjudgements are inevitably made – but treatment that is ‘free at the point of delivery’ is integral to our society.

Healthcare should not be a privilege afforded only to the rich, and the NHS is a living, breathing example of how things should be. Paid for out of taxation, the NHS provides free healthcare for all citizens. A private alternative is available for those who want to pay but, for those who can’t or won’t, the NHS offers high-quality, essential care for everybody. It is cherished and valued by most Brits, who believe in the importance of the nationalised system.

The current Conservative government, made up of men so rich that they cannot imagine being unable to pay for surgery, or even antibiotics, has a different idea. Snapshots of the costs of US healthcare frighten us, as a nation, as a sign of things that may come in the future. Yet Jeremy Hunt, the government’s Health Secretary and subject of many a Freudian slip (NSFW), co-authored a book in 2005 that promoted the idea that the private sector should be brought in to run the health service. Direct Democracy: An Agenda for a New Model Party states, ‘Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of healthcare in Britain’.

Junior doctors take to the streets in defense of the NHS

This is the context that has seen junior doctors go on strike for the first time in over 40 years. Hunt wants the NHS to provide a seamless service, seven days a week, without providing additional funding (or additional staff) to make this happen. Furthermore, under the contract Hunt wants to impose, some junior doctors will face pay cuts of up to 30%.

As Dr Rachel Clarke points out, ‘It’s one thing for Jeremy Hunt and David Cameron to say they would like better services at weekends, but it’s quite another to actually deliver those if they are not willing to provide one single extra pound of funding towards achieving those extra services’.

She continues, ‘They’re not providing any more doctors, so how do we have safer services at weekends? Either they will make us work longer and harder than we already do, or they will take us away from the NHS Monday to Friday, and both those examples are manifestly unfair to my patients, so it’s my duty, as a doctor, to protect my patients from this contract’.

Dr Johann Malawana, chair of the junior doctor committee at the British Medical Association (BMA), which represents the doctors, says, ‘If the government wants more seven-day services then, quite simply, it needs more doctors, nurses and support staff, and the extra investment necessary to deliver them’.

Instead of this extra provision, the government wants existing staff to extend the hours they work, while cutting the hours classed as unsocial (that are therefore subject to higher wages) so they effectively receive a pay cut for their efforts. The contract wants to make Saturday shifts between 7am and 5pm ‘normal’ working hours, and change weekday ‘normal’ shifts to 9am to 9pm. Overtime pay would no longer be available for these times, something the BMA strongly opposes.

The Tory government is endangering patient care

The concerns are not merely about doctors’ pay packets. The BMA is concerned that ‘the new contract will jeopardise patient care as it will remove safeguards preventing junior doctors from having to work dangerously long hours, and will also adversely affect pay and morale’.

Junior doctors have carried out three 24-hour strikes over the past few months; 98% of the 38,000 doctors represented by the BMA voted in favour of this action. Emergency care was still provided during the strikes and consultants (senior doctors) covered many clinics and procedures in support of their junior colleagues. Following the third strike, after months of failed negotiations, Hunt and the government imposed the new contract on the doctors, leading to promises from the BMA of three more strikes, each 48 hours long.

The BMA has refused to accept the imposed contract, launching a judicial review. This is based on the lack of an equality impact assessment having been carried out, which is required under the Equality Act 2010. Equality impact assessments are designed to ensure that actions taken by public bodies do not discriminate against members of minority or oppressed groups.

By apparently failing to follow due process, the Tory government has again demonstrated its lack of commitment to equality and diversity issues. The government has failed minority groups and, in a society where attitudes to disabled people have barely improved in 20 years, the role of equality impact assessments, especially where healthcare is concerned, must be central to any public policy decisions.

Image: sasastro/Creative Commons

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Philippa Willitts

Philippa Willitts is a British freelance writer who specialises in writing about disability, women's issues, social media and tech. She also enjoys covering politics and LGBT-related topics. She has written for the Guardian, the Independent, New Statesman, Channel 4 News, Access Magazine, xoJane and many more publications. She can be found on Twitter @PhilippaWrites.