In Defence of the Doctor’s Strikes m_horses

London In the latest Minister's Questions for the Secretary of State for Health and Social Care - BasedChurchill - a member of the Conservative Party asked whether the secretary agreed that the recent doctors strikes “put patients at risk” and that a solution must be found asap” [sic]. This is a fair enough question and one expected from many benches in the house following the strikes however the answer from the secretary - produced in full below - leaves much wanting.

“Deputy Speaker,

Whilst I support the right to strike by employees in some capacity, I do believe that it's immoral for those in the medical profession to put the lives of patients at risk and abandon all commitments to uphold non-maleficence. It is my belief that disputes should be settled in a manner that is more diplomatic and benign, and I will always prioritise this.”

Firstly “I support the right to strike by employees in some capacity” obviously the member making this comment is a conservative so one does not expect them to enthusiastically support workers rights including that to strike but the right to strike should be universal and despite the nuance of “some capacity” this sets the tone for what’s to come.

“I believe it is immoral for those in the medical profession to put the lives of patients at risk and abandon all commitments to uphold non-maleficence” I’ll start by applauding the member’s ability to link this back to the four pillars of medical ethics reductive though they be however this is deeply insulting and insensitive to striking Doctors. “Abandoning all commitments to .. non-maleficence is language more fitting for Harold Shipmanesque murders than strikes for the bare minimum in working conditions and pay, this shows a key and perhaps chronic lack of understanding of the monumentally of a Doctors decision to strike and of how bad conditions have become in the NHS to warrant this. Quite simply going on strike is not an abandonment of a key principle of good clinical care - do no harm; in fact one could argue it is the opposite because one of the best things for patient care in the NHS would be a well rested, happy and relaxed staff. At this time of national crisis where burnout and depression run rife, striking is arguably the moral thing to do because an increase in pay will only lead to better treatment and more doctors as less will be forced to emigrate for higher wages and better working conditions.

This brings me to my second point from this extract: the suggestion that doctors strikes put patients' lives at risk. This is a disappointing comment from one I would expect to know better or at least have looked at the data before announcing this to the house. Literature has consistently shown mortality is paradoxically not effected by strikes with data from as far back as 1950 showing even a lowering of death rates. (Cunningham, Solveig Argeseanu et al. “Doctors' strikes and mortality: a review.” Social science & medicine (1982) vol. 67,11 (2008): 1784-8. doi:10.1016/j.socscimed.2008.09.044) The reasons for this are varied and not fully understood however the lack of elective procedures is significant and nevertheless this is a well recognised phenomenon and I hope this is simply a lack of research or understanding on behalf of the Secretary and not anything more sinister as it is deeply concerning this misinformation has been presented to the house in this manner.

Next we have the suggestion that disputes should be settled in a benign and diplomatic way. Aside from the semi insulting naivety of the suggestion the BMA hasn’t already tried that the idea that the strikes are not a benign way to carry out industrial action is additionally problematic - yes they are challenging for all involved and yes they are almost the final tool the trade unions have but Doctors are not striking out of hatred or anger for / with anything but a system which has let them down and one they wish to see improved.

Further the comments about which routes the secretary would engage with are morbidly intresting and whilst I can not speak about the content of closed door negotiations between the BMA and the government however since the secretary is suggesting they would prioritise diplomatic routes does that mean an end of the strikes is in sight? One can only hope the government realises the folly of trying to out last the incredibly motivated and organised strikers and comes to the table with a serious offer that does not insult the intelligence and honour of the profession.

(M- If there’s an issue around points made redundant by meta issues please ignore however vast majority of points based around original answer stand regardless)

I do hope that the issues I find with this response are not representative of the secretaries actual views on the nuances of this issue and are simply down to me reading too much into one throw away response to MQs however we shall see the responses given to other questions asked on the issues pressing the NHS at this time and conclusions drawn from there. It is paramount that at this time of national stress with the cost of living crisis and many challenges such as climate change, poor diets, an aging population etc further and further impacting our health service all clinicians are given the resources they need to do the vital work they do and frankly there is a highly disappointing trend of our Doctors are being let down and the secretary’s answer only feeds that cycle.

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