Intended for healthcare professionals

Careers

I will feel no guilt on strike day

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i72 (Published 06 January 2016) Cite this as: BMJ 2016;352:i72
  1. Janis Burns, trainee anaesthetist, northwest London 
  1. Janis.burns{at}cantab.net

It is my firm belief that no junior doctor wants to strike. But it is a fact that junior doctors in England are poised to take industrial action next Tuesday.1 Should the action go ahead, 12 January 2016 will become a historic date for the medical profession. Having reached this stalemate for a second time, junior doctors and the government have both already lost. Damage has been inflicted on both parties, and the wounds will be enduring.

The words “doctor” and “strike” are each emotive. That a caring professional, relied on to do the right thing and uphold moral standards, would deliberately engage in an activity that seeks to inconvenience society and vulnerable people who need their service is seen by many as inherently wrong. Herein lies the problem with our dispute and our collective need to have public approval for it. At best, this dichotomy—striking doctors—is emotive to the general public; at worst, it is frightening and unjust to people who may need our service. For our profession to have reached this stage something must be seriously wrong.

However, I will be free of guilt on 12 January for I will be one of the many thousands of junior doctors providing emergency care. Just as on Christmas Day there will be at least 17 000 doctors working in our NHS. I won’t be withholding my labour, and—I can’t deny it—I feel relief. I am also relieved that thousands of my colleagues will be standing our ground on behalf of all junior doctors.

The dispute between the Department of Health and junior doctors has become more and more complex as the central issue of our terms and conditions of employment has become intertwined other with other issues, such as the long term sustainability of our NHS, patient safety, training, privatisation of healthcare, austerity, party political point scoring, and the ability of the health secretary to interpret statistics.2 There is simply too much emotion involved.

So as 12 January fast approaches I will be parking all my emotion. I will be remembering that first and foremost this is a dispute about a contract of employment. The terms and conditions of our contract are being changed, to our detriment. As junior doctors we are members of a highly skilled professional workforce who depend on a single monopoly employer. While this makes us vulnerable to exploitation, it also makes us a mountain that cannot easily be steamrolled.

Regardless of background, training, or profession, all employees will oppose any change to a contract of employment that is to their detriment. Doctors are no exception, and we should not be ashamed or feel guilt for doing so. No one in their right mind would sign up to a contract that imposes longer, more unsociable hours while being told that the blow of a pay cut will be softened by “pay protection.”

We live in a society that has a five day working week and a two day weekend. I embarked on this amazing vocation knowing full well that I could be called on to work day or night on any one of the 365 days of each and every year. So, for all the difficulty I’ve had swapping shifts to get a weekend off for all the social events that happen at weekends, I refuse to accept that working on a Saturday is not antisocial.

Profound cultural consequences will follow if Saturday is considered a normal working day, because what applies to junior doctors will swiftly follow for other groups in the NHS, and let’s not forget that the NHS employs 1.3 million people.

So while I remain committed to the NHS, I am not a martyr to it, nor am I a saint. The government can’t have its cake and eat it. If it wants the best healthcare system in the world, it needs highly motivated professionals to staff it. Imposing detrimental changes to terms and conditions of employment is not the way to achieve this.

Although I’m a doctor, I am also an employee with a right to oppose detrimental changes to my terms and conditions of employment. While we talk about saving the NHS, and all manner of other things, let’s put emotion to the side and remember that 12 January 2016 is about our terms and conditions of employment and nothing more.

Footnotes

  • Competing interests: I have read and understood BMJ’s policy on declaration of interests and declare that I am a junior doctor in training and member of the BMA.

References