It is no exaggeration to say that one of the main reasons the nation voted less than two years ago to elect the first Labour government since 2010 was to end the chaos in the National Health Service.
The promise made by the party in 2024 was clear: “Too many patients have seen their treatment affected by strikes. Labour will reset relations with NHS staff, moving away from the Conservatives’ failed approach.”
Whoever’s fault it is, this “reset” has simply not happened. Nor, as the resident doctors launch a six-day strike on Tuesday, is there much sign of it happening for the foreseeable future. Indeed, as The Independent reports today, this industrial action, the 15th such disruption in three years, is generating tensions not only between resident doctors and ministers but also within hospital trusts and the medical profession itself.
Consultants who feel obliged to cover for their colleagues are feeling the strain, while NHS trust managers, much maligned, are themselves facing intense pressure to reform and improve productivity. They now have rather less time to prepare for strike action under the government’s new employment laws. Over the past few years hospital administrators had become adept at juggling appointments and minimising the impact on patients, but longer actions with shorter notice periods and less consultant cover will obviously make this more difficult.
The inevitable upshot is that patient welfare will be impacted, even if usual arrangements cover emergencies. After all, if there was no effect on care, including agonising waiting times, then there would be no point in the resident doctors going on strike. Longer wait times means slower diagnosis and worse outcomes: an inconvenient fact.
The perverse effect of the extra demands being made on consultants through frequent strikes is that they too feel that they must improve their own terms and conditions to compensate for the incursions made on their own lives. Like their less experienced colleagues, these consultants and so-called SAS doctors (speciality, associate specialist, and specialist) have also seen their real wages eroded through inflation over the years, their lives made harder by an underfunded service, and are swimming against the rising demographic tide of people living longer but less healthy lives. So the consultants too are considering withdrawing their labour, with a ballot next month on their own strikes.
So what chance a “reset” in relations with the government? In the immediate future, there is none, and things could conceivably get much worse for patients, especially if consultants and SAS doctors decline to work at the same time as resident doctors.
It is almost too awful to contemplate what might happen if, as was the case under the Conservatives, the nurses, the paramedics and auxiliary staff also decided to go in strike around the same time. Yet such a prospect is perfectly plausible, looking ahead over the next year or two.
This should not be happening, given the resident doctors’ exceptional pay award of almost 30 per cent since Labour came to power. It is also a fact that the independent pay review bodies were set up after the “winter of discontent” in 1979 to obviate the need for conventional pay bargaining and strikes. Yet both sides tend to ignore the review body recommendations when they don’t suit them. At the moment, it is the physicians who wish to discount them and seem to push on with their own agenda.
Times are changing, however. Public sentiment these days is much less sympathetic to the doctors’ cause. People are getting fed up with the incessant disruption, and they feel that the doctors have already had a substantial boost to their earnings. Rightly, the public cannot understand why one particular group of workers should be entitled to have their real-terms pay backdated to some arbitrary, but advantageous, point in the past. Put bluntly, most of the British working population would be overjoyed with a 28 per cent pay rise.
There are also signs of fatigue among the resident doctors. Support for the strike looks solid, at 93 per cent; but the turnout for the ballot was scarcely more than half those eligible as BMA members, and that has declined over the past three years. It will be interesting to see how many decide to work as usual this time round.
Some of the more politically realistic of the resident doctors should be coming to realise just how much damage these strikes are inflicting on the very concept of the NHS and thus its future. In other words, if Labour, which claims such ownership of the NHS, cannot succeed where the Conservatives failed, what hope is there for people to get the treatment they need when they need it?
To some, especially those forced to “go private” already, a private insurance-based system might not look so bad an alternative to perpetual waiting. They would be wrong, but understandable. Nigel Farage and others would be happy to implement such radical reform – and it would be rather more painful for the doctors than Wes Streeting’s “reset”.
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