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“It’s time to call off the strikes and find a Plan B on the new juniors’ contract”

I was channel hopping the other day and chanced on the film version of “Les Miserables” (wasn’t Russell Crowe awful). However the story soon got me thinking of the current “miserables” i.e. the junior doctors and their fight with the SoS, Mr Hunt.

Now as a retired old git with a good NHS final salary pension, I have refrained from commenting on the controversy for obvious reasons; the medical landscape has changed significantly since I was a junior doctor. Sure I worked the 120-hour week, but that only lasted for about 18 months and, at that time, medicine was much less pressured.

We all lived together in a doctor’s mess, and there was good peer support which seems to be lacking these days.

But – trigger warning – I am about to upset many. Regretfully, I think that the juniors and the BMA have lost the battle with the SoS, and that they should cancel the further proposed industrial action.

My reasons are as follows. As we know the Secretary of State has announced that he plans to impose the new contract and rotas as from August 2016. I acknowledge that there is an ongoing legal challenge to this, but I suspect it will fail – after all they are the Government and can change the law if they choose.

The reality is that, despite the picket line clamour, the vast majority of junior doctors are likely to accept the new contract.

The F1’s will have no choice if they want to be fully registered with the GMC. The size of their student loans will concentrate their minds wonderfully!

The more senior doctors will have mortgages to pay and children to feed, and they will have already made a huge investment of time, money and energy in their careers. They could, of course, refuse to sign the new contract, but if they start to work it then “custom and practice” comes into play – they have de facto accepted it. (I admit I have only a basic knowledge of contract law, but I think I am correct in this).

If a doctor refuses to work the new rotas then their employers may take disciplinary action against them on the basis that they have refused to carry out reasonable instructions (I accept the term “reasonable” may be debatable in this situation). The outcome of such disciplinary action could be dismissal which would be disastrous for the individual.

The prospect of mass resignation and relocation to other climes is also a bit of a pipe dream. The recruiting agencies have stated that although there are openings overseas for some trained specialists, the number of jobs available has plummeted. So streams of doctors migrating to the antipodes is not a solution for most.

There are those who have stated that they would give up their career all together rather than collude with an unacceptable way of working. However to give up what is for most a fulfilling and rewarding career would seem a very foolish reaction.

It is stated that 65% of the public currently support the junior’s stance. However public opinion is very fickle and once grandma’s hip replacement has been cancelled for the third time due to the strike then opinion will start to change. It was very noticeable that during the last 48 hour strike very little attention was paid to it by the media; the story has now moved on to the in/out of Europe debate and what Michael Gove did or didn’t say.

I am not particularly impressed with the way the BMA have handle the situation, I think they have seriously misjudged the resolution of the Government.

They also do not have a particularly good record when it comes to contract negotiations – the current consultant contract (negotiated by one Dr Mark Porter among others) is a pig’s ear which, in my opinion, has resulted in a profession being converted into a clock-watching workforce!

Mr Hunt’s attempt to turn the NHS into a full seven day service on a cost neutral budget is doomed to failure; anyone with half a brain can see that. But he holds all the cards and will likely win a pyrrhic victory by simple attrition, although the issue of unsafe rotas will come back to bite him on the bum.

Defeat is a bitter pill to swallow but the juniors and the BMA need to take their medicine and find another way through this mess.

Does the BMA have a plan B? No sign of it yet.


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One Response to ““It’s time to call off the strikes and find a Plan B on the new juniors’ contract””

  1. Mark II says:

    To back down now, would break any resistance to adverse change in the NHS in the next few years. We’re the last line of defence. No one else is fighting for the NHS.

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