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Offline: Standing down for patients
Comment
Offline: Standing down for patients
Corbis
Reuters
By an overwhelming majority, doctors in Britain voted to take industrial action for one day on June 21. In answer to the question “Are you prepared to take part in a strike?”, 32 455 doctors voted “yes” out of 52 068 valid votes cast (72%). The reason? Hamish Meldrum, Chairman of the British Medical Association’s (BMA) Council, put it this way: “this clear mandate for action—on a very high turnout—reflects just how let down doctors feel by the government’s unwillingness to find a fairer approach to the latest pension changes and its refusal to acknowledge the major reforms of 2008 that made the NHS scheme sustainable in the long term.” The last time doctors took industrial action was in 1975. They are clearly extremely angry about the proposed changes to their pension scheme. More angry, it seems, than they were about the Government’s Health and Social Care Bill, which doctors also opposed, but not quite enough to consider industrial action. How will this strike appear to the public? The news media in Britain have given their verdict: “The shameful self-interest of doctors”, said one newspaper. “Inexcusable”, “baffling”, “mistaken”, “unseemly”, “a massive own goal”, and “greedy” were words used by others. Doctors are rightly nervous about a negative public perception. The BMA’s press release announcing industrial action claimed their decision “does not constitute a strike”. This is wordplay. The ballot explicitly invited doctors to vote on strike action. Doctors resoundingly said they would—and now will. Hamish Meldrum has tried to pacify public anger by publishing an open letter in which he writes that, “It is with great regret that we, UK doctors, have been forced to take industrial action in order that our voice is heard by the Government.” When most workers in the private sector have much less secure pension arrangements than doctors, when most of the public is facing much worse financial hardship than doctors, and when most employees have considerably less job security than doctors, Dr Meldrum might reflect that the headlines he is so keen to dispute might contain a kernel of truth. *
Reuters
How different it was just a few months ago. Doctors then took a principled stand against Andrew Lansley’s Health and Social Care Bill, gaining widespread public respect and support. The arguments the BMA (and others) marshalled were based on a single concern— 2134
the impact of the proposed reforms on the quality of care that would be offered to the public. Although doctors lost the first political battle in that fight, they won the moral argument. Restoration of the NHS as a truly National Health Service should remain their— and the BMA’s—most important political objective. Some suggest that pension reforms are part of this government’s privatisation strategy. But not even Dr Meldrum makes this tortuous connection. The BMA’s strap line is “Standing up for doctors”. The BMA has, strictly speaking, done its job well. In doing so, it may have lost the respect and goodwill of a large section of the British public, especially those who are affected by the strike action. The public should not accept Dr Meldrum’s reassurances that “our action will not impact on your safety”. In a guide to doctors about strike action, the BMA says: “the intention of taking industrial action is to have an impact.” As patients have operations postponed, as clinic appointments are cancelled, and as monitoring of long-term conditions is stopped, patients will certainly feel that intended “impact”. There is still time to stop this reckless action. Dr Meldrum: please have the courage to call off this strike. * And instead pledge yourself to do something much more useful. Last week, Alan Milburn published his review of social mobility in the UK. His particular target was the professions. He found that doctors “have withstood the economic downturn more robustly than other forms of employment”. Becoming a doctor “is a surer guarantor of economic security and social progress than it was even three years ago. And that will continue into the future”. But medicine is badly behind other professions when it comes to trying to break the transmission of disadvantage from one generation to the next. Doctors’ leaders have not taken fairer access into medicine seriously. There has been too little action to ensure that young people from less advantaged backgrounds succeed in joining what are, by any standards, the privileged ranks of the medical profession. Here is a cause that doctors should be voting for. Richard Horton [email protected]
www.thelancet.com Vol 379 June 9, 2012
Offline: Standing down for patients
Corbis
Reuters
By an overwhelming majority, doctors in Britain voted to take industrial action for one day on June 21. In answer to the question “Are you prepared to take part in a strike?”, 32 455 doctors voted “yes” out of 52 068 valid votes cast (72%). The reason? Hamish Meldrum, Chairman of the British Medical Association’s (BMA) Council, put it this way: “this clear mandate for action—on a very high turnout—reflects just how let down doctors feel by the government’s unwillingness to find a fairer approach to the latest pension changes and its refusal to acknowledge the major reforms of 2008 that made the NHS scheme sustainable in the long term.” The last time doctors took industrial action was in 1975. They are clearly extremely angry about the proposed changes to their pension scheme. More angry, it seems, than they were about the Government’s Health and Social Care Bill, which doctors also opposed, but not quite enough to consider industrial action. How will this strike appear to the public? The news media in Britain have given their verdict: “The shameful self-interest of doctors”, said one newspaper. “Inexcusable”, “baffling”, “mistaken”, “unseemly”, “a massive own goal”, and “greedy” were words used by others. Doctors are rightly nervous about a negative public perception. The BMA’s press release announcing industrial action claimed their decision “does not constitute a strike”. This is wordplay. The ballot explicitly invited doctors to vote on strike action. Doctors resoundingly said they would—and now will. Hamish Meldrum has tried to pacify public anger by publishing an open letter in which he writes that, “It is with great regret that we, UK doctors, have been forced to take industrial action in order that our voice is heard by the Government.” When most workers in the private sector have much less secure pension arrangements than doctors, when most of the public is facing much worse financial hardship than doctors, and when most employees have considerably less job security than doctors, Dr Meldrum might reflect that the headlines he is so keen to dispute might contain a kernel of truth. *
Reuters
How different it was just a few months ago. Doctors then took a principled stand against Andrew Lansley’s Health and Social Care Bill, gaining widespread public respect and support. The arguments the BMA (and others) marshalled were based on a single concern— 2134
the impact of the proposed reforms on the quality of care that would be offered to the public. Although doctors lost the first political battle in that fight, they won the moral argument. Restoration of the NHS as a truly National Health Service should remain their— and the BMA’s—most important political objective. Some suggest that pension reforms are part of this government’s privatisation strategy. But not even Dr Meldrum makes this tortuous connection. The BMA’s strap line is “Standing up for doctors”. The BMA has, strictly speaking, done its job well. In doing so, it may have lost the respect and goodwill of a large section of the British public, especially those who are affected by the strike action. The public should not accept Dr Meldrum’s reassurances that “our action will not impact on your safety”. In a guide to doctors about strike action, the BMA says: “the intention of taking industrial action is to have an impact.” As patients have operations postponed, as clinic appointments are cancelled, and as monitoring of long-term conditions is stopped, patients will certainly feel that intended “impact”. There is still time to stop this reckless action. Dr Meldrum: please have the courage to call off this strike. * And instead pledge yourself to do something much more useful. Last week, Alan Milburn published his review of social mobility in the UK. His particular target was the professions. He found that doctors “have withstood the economic downturn more robustly than other forms of employment”. Becoming a doctor “is a surer guarantor of economic security and social progress than it was even three years ago. And that will continue into the future”. But medicine is badly behind other professions when it comes to trying to break the transmission of disadvantage from one generation to the next. Doctors’ leaders have not taken fairer access into medicine seriously. There has been too little action to ensure that young people from less advantaged backgrounds succeed in joining what are, by any standards, the privileged ranks of the medical profession. Here is a cause that doctors should be voting for. Richard Horton [email protected]
www.thelancet.com Vol 379 June 9, 2012