The doctors’ strike, or ‘industrial action’, as the strikers prefer to call it, has happened. On the day after the longest day (2012 is a leap year), a smaller than expected number of striking doctors turned up for work sporting ARP style armbands declaring ‘I’m caring for patients’, which was a bit rich if you happened to be a non-urgent patient, and smugged their way through their day. As own goals go, it was a corker, more Rear Admiral Hamish McMayhem taking his entire fleet the wrong way up the Windward Passage, than a solitary cocoa bean going the wrong way up Bournville Boulevard. On the radio, you could hear Langho rubbing his hands with glee at the gift of anti-doctor propaganda, while the media at large took turns to shy coconut after coconut at the ‘my pension or your life’ protesters. If proof was needed that Dr No’s former colleagues had lost the plot, then this was that proof.
Don’t get Dr No wrong – he fully accepts the doctors have a grievance. Having accepted new and less favourable pension terms four years ago with the last government, doctors now face the imposition of even less favourable terms by today’s government. To add insult to injury, doctors have been singled out for special treatment: harsher terms than comparable groups. All that much is true, and all of it is indeed unfair.
The trouble is – and this is the first point on which the doctors lost the plot – while it is indeed true and unfair, it is only one part of the broader picture: that doctors, once out of training and in career grade posts, are not only handsomely paid in post, they also have, however you look at it, remarkably lucrative gold-plated pensions. To the vast majority looking at the broader picture, the doctors’ whinge looks somewhat like the man with two Aston Martins whingeing at a hike in payments for the third Aston Martin. Many ask, very legitimately, how many Aston Martins does one man need?
To which the doctors will no doubt reply: that’s not the point. We agreed it was going to be three, on such and such terms, and now the government wants to renege on the deal, in what amounts to a breach of contract, in spirit if not in law. Again, on the narrow picture, this much may be true; but to the outsider, such moans sound little different to the banker moaning that losing his bonus is a breach of agreement if not contract. To the outsider, the cat is already quite fat enough. What the outsider sees instead is greed – unbridled and unprincipled greed.
So the public and the media, it can confidently be said, were never going to be sympathetic, in anything but the narrowest sense, if at all, to the doctors’ concerns. The failure to grasp that few, if any, would warm to the woes of the wealthy being forced to pay more for their wealth was Big Mistake Number One. Big Mistake Number Two was to decide to take action that would directly affect, and so harm, innocent third parties: patients.
Dr No fully accepts – see above – that the doctors (Dr No excludes himself, since his NHS pension is deferred, and so unaffected – but don’t even think about commenting that that is why Dr No is unsympathetic, because he is not; he just thinks the doctors have made grave tactical errors) have a grievance. But it is a private grievance, about money, between doctors and government. There cannot be any justification for taking action that will cause – whatever the striking doctors may say – direct harm to patients. Not only is there the inconvenience, not to mention considerable distress, of cancelled appointments, tests and operations; there is also the inescapable risk that a number – albeit a small number – of patients with red-flag symptoms, say passing or coughing up blood, who had reluctantly decided to see their doctor last Thursday, will further delay, with potentially disastrous results. Even if only one such patient is so delayed, it is one too many; and the doctor with the armband ‘caring (but not caring) for patients’ will bear the mark of it on his conscience.
Dr No does not, as it happens, support an absolute ban on doctors’ strikes. If a strike is directly related to a threat to patients, then, somewhat paradoxically, a careful case can perhaps be made for limited striking, on the grounds that not to strike will in the longer term cause greater harm. But the doctors’ current grievance is not about threats to patients, it’s about money. Far smarter, if only the doctors had the brains to see it, would be not to indulge in a midsummer’s day of madness (not to mention what happens next? more days of madness?) but to take action that will seriously irk the government, but leave patients unaffected. There is even an obvious candidate: block revalidation.
Most patients care not one jot about revalidation, preferring instead to make up their own minds about their doctor’s competence. Why – some might even support a stand against revalidation, seeing it as a futile exercise that distracts doctors from looking after patients. Heaven forbid! – it could even deliver a win-win: the doctors hurt the government in support of their pension claim, and the public support (or at the least don’t object to) the doctors’ action. Instead of appearing like Bottom in the play, an ass and yet unaware of it, not to mention being away with the fairies, doctors at last might be seen to have their heads screwed on right over their pension dispute.