Tom Goodfellow

Most juniors are going to find a five-day strike unacceptable and unethical

This nation, like much of the West, has largely abandoned and indeed trashed our Judeo-Christian heritage.

This started in the Victorian era, and has reached its full flowering in the incoherent, belligerent ramblings of the militant atheists like Richard Dawkins.

When considering this I often think of the Monty Python Life of Brian sketch where they ask the question, “What have the Romans every done for us?”, and the answer is quite a lot!

Whether or not one agrees with Christianity’s basic tenants one crucial thing which it has provided is a basis for morality, whether individual or national. And many of our basic freedoms and benefits in society flow from this, including a health service which is free for all, irrespective of the ability to pay.

But while many will welcome the marginalisation of Christianity as evidence of human progress it has had some very significant consequences which are becoming increasingly apparent in our society.

If we amputate our cultural roots we should not be surprised if the tree starts to wither!

Specifically, morality and truth are now seen as relative and subjective, largely based on the fatuous notion that we should be free to do and become what we like – as long as we don’t “hurt” anyone in the process. Of course this ignores the obvious fact that if all meaning and morality have gone out the window then the concept of “hurt” becomes equally subjective, as do the concepts of good and evil.

In this relativistic age, morality – like gender we are told – has become fluid and self-determination the new religion.

What I am stating is not new. All this was accurately predicted by the brilliant German philosopher Friedrich Nietzsche (1844-1900) the father of nihilism who stated, “There are no eternal facts, as there are no absolute truths”. He later went mad.

It is against this rather gloomy backdrop that I view the BMA’s fight with the Government. Whatever the rights or wrongs of the conflict, it is my view that the BMA’s decision to hold a series of five day strikes is deeply immoral and unethical. It is beyond question that individual patients will come to harm – you cannot run a service the size of the NHS for five days if large numbers of medical staff walk out and refuse to work. People will die.

I think specifically of the neonatal intensive care unit (NICU) to which I was a regular visitor during my consultant career. These babies are the sickest and most vulnerable patients in the hospital, and they can deteriorate very rapidly requiring the most urgent medical interventions. If all the juniors were to walk out they would leave a minimal consultant body to run the service who, in addition, would need to cover emergencies in the obstetric suite and Caesarean sections.

The pressures on them would be immense. They might cope for a day or so, but for five days? The same scenario may be applied to other emergency departments and ICUs.

The BMA by their decision have clearly decided that the principle they are fighting for, which remains unclear to me, is more important than patient well-being. There will, of course, be the usual virtue signalling that they are fighting for the future of the NHS, but this claim is significantly undermined by the fact that in May the BMA leaders recommended the new contract to their members.

I am not always a great fan of the GMC, but Good Medical Practice is an excellent ethical guide to the duties of a doctor.

“Make the care of your patient your first concern” should be a principle firmly embedded in the practice of the most junior medical student to the most senior professor. The GMC has indicated that it may take action against striking doctors if harm to patients occurs through their actions.

It saddens me that the BMA, the largest body representing the profession, has turned away from this fundamental principle and has lost its moral compass. But then I think this is a symptom of our current morally confused culture where what is right rapidly descends into what “I” chose it to be – the selfie generation.

However, I have some confidence in our junior doctors with whom I always enjoyed working. I believe that many will also find the proposed five-day strike unacceptable and unethical, and that they will ignore the BMA, brave the picket lines and carry on working.

I urge them to do so, whatever the difficulties – and there will be difficulties. It is never easy to swim against the populist tide.

But if thousands do forsake their posts and their patients then I believe that the moral and ethical crisis in the NHS will far exceed the financial one.

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