Between 7am on Friday 25 July and 7am on Wednesday 30 July, there will be a significant deterioration in healthcare in England and Wales. Whatever else may be claimed about patient safety protocols and safeguards, people in pain and distress will suffer more than they would if the resident doctors were working and not going on strike.
After all, if the coming five days of industrial action were likely to go unnoticed, the strike would not be taking place. It is hard to see how, over the next week or so, lives will not be put at more risk than if the hospitals and clinics were working normally – and that is still, sadly, an unsatisfactory situation to start from.
Indeed, there will be unwelcome extra pressure on the NHS for some time to come, because of the backlog of postponed procedures that will have to be cleared. These may not be as severe as after past disputes, because this time hospital managers are not prioritising emergency care to the same extent, and are protecting scheduled, “elective” surgery to a greater extent. There is clearly a will on the part of management to ensure that those who cause this interruption in service do not then go on to receive generous overtime for reducing the backlogs they themselves have created.
None of this is anything that the striking doctors desire, and there’s no reason to doubt that many feel they are being forced into this position. Those on duty will still do their very best for their patients. Nonetheless, the doctors should ask themselves whether all of the misery, and worse, that will inevitably occur is necessary this time. There are strong reasons why this round of industrial action will not be worth it.
First, no group of strikers can succeed without public support. In the past, under the Conservatives, the incessant NHS strikes by resident doctors, nurses, support staff and consultants were, in fact, solidly backed by the public, who sympathised with their cause even if it meant that the medical treatment they needed might be postponed. Now, the support is much softer, and a majority of the population opposes the strikes.
There have been major changes, too, since the previous round of strikes, all connected to the election of a Labour government committed to the survival of the NHS. One of the first things the new chancellor, Rachel Reeves, did on arriving at the Treasury last July was to pay the salary increases recommended by the independent pay review body in full – a 22 per cent uplift over two years, a startling settlement by comparison with most other workers. Not long after that, Ms Reeves raised taxes to pay for an immediate programme to reduce waiting lists, recruit and train more staff, and invest for the longer term in the NHS.
The new health and social care secretary, Wes Streeting, also announced his plan to abolish NHS England, and to implement radical reforms to improve productivity. Taken together, these developments should have signalled to NHS staff that this was a government that wanted the best for the service.
In this context, at the start of the journey to a renewed NHS, and with that sizeable pay rise having been implemented, it feels very wrong that the doctors should undermine these efforts, and the progress that has already been recorded, by setting things back again for weeks, if not months, to come. Worse than that, to many it will seem as though the NHS is unfixable, and that it needs more fundamental change.
If it appears that Labour can’t do much better than the Conservatives at making the NHS work, people will wonder whether it is time for a more radical approach. If they cannot get the treatment they need, when they need it, then they will be more receptive to the siren calls from figures such as Nigel Farage for a French-style insurance system (but, he never adds, without French-style funding). The doctors, in other words, may or may not win a bigger pay award, but they are gambling with the future of the very thing they profess to love – the National Health Service itself, free at the point of use, and paid for by general taxation.
The striking doctors should also examine once again the merits of their claim – for a 29.2 per cent award. To everyone else, this looks like an outlandish figure, even as a starting point for talks. It is not part of any pay review recommendation. It is based on a calculation of how much doctors’ pay scales would have to change (on a disputed measurement of inflation) to bring them back in real terms to levels prevailing in 2008, before they were eroded.
But how many groups of workers would like their pay restored in real terms to some advantageous point in the past, when times were better? The doctors reply that they’d love for everyone to get such a rise, but everyone knows that’s not possible – and, given public sentiment, it’s not realistic for them either.
In short, the chances are that the doctors will not win their strike. Any improvements they do secure will be modest when set against their tarnished reputation and the damage they will do to the trust the public want to place in the NHS. If the doctors do force a pay increase that requires another hike in taxes and causes a reduction in NHS services, then it is not going to be sustainable – because the public will not tolerate it, and the NHS won’t survive for the coming decade.
The more this strike hurts, the more chance there is that it will, in the long run, fail. It is not worth it.
