24 September 2023

Weekly briefing: Revolutionaries in white coats


The details of the allegations against Russell Brand are shocking, but the idea this obvious misogynist might be a total creep is perhaps the least surprising news ever to dominate headlines. 

Nonetheless, it has drowned out the more significant story of the week, at least in terms of the sheer number of people affected: doctors’ strikes.

Consultants and junior doctors walked out, leaving the health service with Christmas Day levels of cover for four days. Almost a million appointments had already been rescheduled due to industrial action before this strike, which is the first of its kind in NHS history. That number will now be significantly higher. 

The pay deal their union, the BMA, has rejected would see a junior doctor in their first year of practice earn £41,300 rising to £71,300 by the end of their training. Consultants would make an average £143,100. The BMA say they are seeking ‘pay restoration’, claiming members have had a real-terms pay cut of 35%. The result is an impasse that is now entering its tenth month.

So what can be done? The Health Secretary has been making noises about introducing minimum service agreements, but as Len Shackleton argues on these pages, that’s little more than displacement activity. Far more effective would be a complete ban on NHS strikes, as exists for prison officers and the police, but there’s little chance of such a thing ever making it through Parliament, and certainly not in time to end the current unrest. Meanwhile, Labour has said it would resolve the dispute by ‘treating NHS staff with respect’ and ‘open[ing] its door for talks’. Frankly, that’s pathetic. This deadlock won’t be broken by being nicer. One side is going to have to move – and in their own interests, and out of basic human decency it has to be the doctors.

First, their demands are absurd – 35% is an unconscionable figure when average pay is going up by 7.8%. And while it’s true that doctors’ salaries are lower in real terms than they were 12 years ago – the Nuffield Trust estimates a 14-15% drop – they are higher than they were three decades ago. Even accounting for the wage reductions they have experienced over the last decade, consultants are still between the 98th and 99th income percentile. For wealthy people to agitate for even more is an insult to all those who are genuinely struggling.

It’s counterproductive too. As Daniel Finkelstein argues, any wage increases will likely be paid for through taxes on high earners, like consultants. ‘They want to move money from their right pocket to their left pocket. And in order to achieve this pointless manoeuvre these dedicated, hard-working, skilful people are imposing real discomfort and distress on patients.’

Which brings us to the second point – these strikes are immoral. All industrial action is predicated upon causing the maximum possible inconvenience to the general public, but the people being put at risk here are the sick and the dying. Refusing to treat patients for days on end is not a reasonable interpretation of the principle of ‘do no harm’.

How then, have so many reasonable people embarked on this destructive course? Part of the explanation is that the BMA has been taken over by a group of hard-left entryists calling themselves DoctorsVote. One council member, Becky Acres, has attacked the Labour Party as ‘proto-fascist’ and the Conservatives as ‘almost genocidal’. Emma Runswick, Deputy Chair of the BMA council, is an ‘unashamed socialist’ and former Momentum activist. In a nakedly political move, they have timed the next wave of strikes to coincide with Conservative Party Conference. These revolutionaries in white coats don’t want a better NHS, they want regime change.

Doctors who care about their patients must not allow them to be held to ransom by dangerous ideologues. They should end their abusive relationship with the BMA.

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Alys Denby is Editor of CapX.