Junior doctors: waving or drowning?

The real solutions to juniors' conditions lie beyond pay

Last week junior doctors' representatives in the United Kingdom voted unanimously to ballot on industrial action.1 Such action may be some way off, but this is a serious preliminary step. The last industrial action by junior doctors was 25 years ago. Since then juniors have been paid for their overtime working; limits have been set to their hours ofwork—although they are not fully implemented; and specialist training is better organised. Yet, as before, morale for some is in a critical state, and pay and conditions are the stated problems.

Junior doctors as a group are hard working and dedicated, and this move towards industrial action is a clear signal that things are not right. But in seeking to respond effectively to their problems we should not be blinded to the crucial issue of “conditions” by the smokescreen of concernsabout pay. The secretary of state for health has offered to consider changes to the structure of juniors' pay “if that is what they want.”1 Junior doctors need to consider that challenge carefully. Is changing the pay structure really what is needed? A vast body of evidence shows that pay is not the most important aspect of job …