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Junior Doctors’ Dispute-What is Actually Going On?

About a couple of weeks ago I put together a blog with the above title. The intention when I wrote it was to highlight the differences between the way the media portrays strikes and the reality of what the issues actually are in a dispute.

The Junior Doctor’s strike seemed a good example as it appeared to me that the bulk of what had gone into the public domain was the amount of disruption it would cause, that it had “something to do with a 7 day a week NHS” and that Jeremy Hunt reckoned that the Doctors should not be striking as 15 out of 16 points of disagreement had been resolved.

With a view to providing a more detailed and accurate analysis of the strike I contacted the British Medical Association (BMA) who immediately sent me a ten page briefing outlining their position and including a 3 column chart which set out the key points of the dispute, the position on these points between the two sides when they went to ACAS in November, the position following a revised offer in January and the stance currently taken by the BMA.

Key elements of disagreement were:

a)    The BMA was concerned about pay and conditions and work scheduling and was looking for “a set of safe limits on junior doctors' working hours to ensure that patients are not treated by tired, overworked doctors“. In particular the BMA wanted work scheduling to include annual leave and study leave and a proper mechanism for “exception reporting” and “work reviews“ whereby regular breaches of an agreed schedule would lead to reporting to a Guardian and possible reviews of working hours.

b)   The “Guardian” referred to would be an individual appointed to be responsible for ensuring safe working practices. A key point here is that the BMA stated that they had understood that it had been agreed in the Acas talks that the appointment of a Guardian would be made jointly by the relevant local NHS Trust and the BMA .When the final written offer was made in January, however, the situation appeared to have changed and the proposal was that a Guardian would be imposed by NHS England.

c)   There was also a significant disagreement about what constituted a “Night Shift. “and issues on training, proper time off and gender disparity on pay.

d)   Finally there was an outstanding disagreement about whether Saturday working should attract overtime pay.

So I duly wrote my article, pointing out that clearly Jeremy Hunt’s statement that 15 out of 16 matters had been resolved was nonsense but also taking the view that, having had some experience of negotiations myself in the past, I felt that this was a dispute that would be resolved amicably in the fullness of time.


My confidence in an eventual mutually acceptable resolution lay in the fact that the BMA information indicated many areas in which agreement had been achieved (e.g. the maximum number of consecutive night shifts, a maximum 48 hour week etc etc). I therefore contacted the BMA again this week to check that the Saturday working issue was the sole sticking point as the Government was saying. The BMA reply said there were also a few “finer points” unresolved but essentially the sticking point was indeed the Saturday working issue. This presumably means that the other matters have reached some kind of resolution since January and that the question “what’s going on?” now takes on an entirely different meaning.


For me the first rule of negotiating is that you keep going if some progress is being made and it is difficult therefore not to conclude that Jeremy Hunt has taken leave of his senses. Either that or, as the BMA suggest in their current press release,there is a wider political agenda and perhaps the Tories want to provoke an escalation.

In essence it would seem to me that the BMA is not by any means implacably opposed to a 7 day NHS but wants to make sure that, in the process, Junior Doctors (already in many people’s eyes overstretched in terms of both numbers and hours) are not railroaded into a deal which places impossible conditions upon them. The issue of Saturday overtime pay might well, I appreciate, provoke different responses from different people (when I worked in the private sector Saturday working was normal, in the public and voluntary sectors it was not) but it must be seen in the context of the BMA doing its job in attempting to secure a fair deal for its members. Or as they put it in the press release;

Junior doctors already work around the clock, seven days a week and they do so under their existing contract. If the Government want more seven-day services then, quite simply, it needs more doctors, nurses and diagnostic staff, and the extra investment needed to deliver it. Rather than addressing these issues, the Health Secretary is ploughing ahead with proposals that are fundamentally unfair.


The Labour Party and Strikes

It is, I think, fair to say that the media almost entirely proceeds on the assumption that strikes are “A BAD THING!!”. You have to study the pages of Socialist Worker or the Morning Star to find an alternative view usually based on the strike being perceived as an example of the working class rising up against the system presumably as a prelude to an inevitable revolution.

Admittedly anyone awaiting said revolution would be wise not to hold their breath but the current Labour position is that the Junior Doctor’s strike is “A BAD THING!!” but it is the Government’s fault. Not an unsupportable position to take but when was the last time Labour went the whole hog and actually said to a union:

Yes, we are with you all the way and are prepared to say so publicly.

(This is not a rhetorical question by the way-truthfully in 40 years of political involvement I cannot recall a single instance of it happening. Especially during the miner’s strike of course-but don’t get me started).

It is worth recalling that the Party came into being because trade unionists in particular and working people in general felt that the then existing Conservative and Liberal parties simply did not have the vested interest and motivation to adequately represent working people in Parliament. I feel that this was a reasonable viewpoint at the time and cannot see that the situation is ultimately any different over one hundred years later.

Working people still desperately need representation as incidentally do the unemployed and the most vulnerable in society.

Some will point out that society is more sophisticated these days and that Labour has to also reach out for middle class votes. Fair enough but if we are not the party of LABOUR (i.e. of working people) then it is difficult to see what point the name of the Party retains. No one is suggesting a complete volte face involving a knee jerk defence of any and all strike actions.

Nonetheless I do not see why, if a thorough and rational research of the issues suggests that the striking workers have a genuine case, have made reasonable efforts to resolve the dispute prior to action and are conducting the strike in a reasonable manner, then the Labour Party cannot give an official blessing to a strike.

The Junior Doctor’s dispute would be a good starting point. I believe that  the BMA has made a genuine effort to accommodate the Government’s agenda whilst legitimately protecting the interests of its members, has made every effort to negotiate-it was the BMA which pushed the government to go to Acas, and has behaving responsibly by conducting only single days of action.

This latter approach does not inconvenience patients too excessively but still serves to remind the Government who it is that actually does the work and enables  the NHS to function at point of delivery. In addition to all of the above what could make more sense than the Labour Party defending its greatest creation-the NHS?

I would therefore call upon Jeremy Corbyn and the party leadership to actually officially support the BMA should it, as appears likely, choose to continue the fight and to make this another step in the direction of the Labour Party recovering its proper and historical function.

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