The last time doctors took industrial action was back in 1975. Among them were consultants who objected furiously to the decision of the then Labour Government to outlaw their treating private patients within NHS hospitals. Dr Ron Singer, the president of The Medical Practitioners' Union section of Unite, has written an article contrasting that "selfish" withdrawal of labour with this Thursday's strike called by the British Medical Association. This, says Dr Singer, will be "just", whereas the consultants in 1975 "took action for their own monetary advantage".
I may be missing something, but isn't the BMA organising the withdrawal of all "non-emergency" care precisely in pursuit of "their own monetary advantage"? This is not inappropriate, by the way: the sole purpose of the BMA – which it does not disguise – is to further the interests of doctors. It is a trade union: why else would it be collecting dues from members? In this case, the interest being defended is its members' pensions. The terms are being made less attractive by the Government. Doctors will now have to put 14.5 per cent of their salary aside to fund their index-linked pension, rather than the current proportion of 8.5 per cent; and the age at which they will able to draw their full pension will rise by two years.
There's no doubt that this is a significant change in the arrangements; yet even after that, the average doctor's pension if he retires at 68 will be £68,000 a year. To put that in context: if you wanted to buy a joint annuity which would provide that sum in retirement (and for your spouse after your death), it would cost about £2m on the open market. I wonder how many of the up to 30,000 patients who will have their operations cancelled on Thursday could ever imagine having such a sum set aside for their own retirement, and of which over 85 per cent would come courtesy of the taxpayer?
I would imagine that those who have are most likely also to be those who go private, if they can't face the delay and inefficiency which characterise the producer-dominated NHS – even when it is not deliberately caused by industrial action. Indeed, it is sometimes forgotten that no medical practitioner is obliged to work only for the NHS (part of the deal to which Aneurin Bevan was referring when he declared he had "stuffed their mouths with gold" back in 1948). So when you read that the average GP's salary is around £110,000 a year, bear in mind that many will be receiving significantly more than that, either because he or she has an especially lucrative NHS practice, or because of additional private sector work, which does not get included in the figures released annually by the Department of Health.
It is partly for these reasons that Dr Richard Horton, the Editor of The Lancet, has just delivered himself of an excoriating editorial in the current edition of the leading medical journal; and in a further statement was even more scathing. "The BMA's decision is a betrayal of its professional obligation to put patients first above all other concerns. Doctors are one of the most well-paid groups in society. While almost everyone in Britain is having to accept the financial challenges we face, the BMA seems to think that its members have a God-given right to exempt themselves... I just hope that their recklessly selfish decision does not diminish the public's view of the very fine doctors we have in this country."
Actually, I think the public's view of the innate saintliness of our very fine doctors had already been diminishing, even before this petulant spasm of militancy. Under a remarkably good "productivity" deal it negotiated with the Blair administration in 2004, doctors managed to get up to 45 per cent more pay in return for giving up working at night or over weekends. One of the BMA's negotiators, Dr Simon Fradd, told the BBC some years later that GPs were so amazed by the terms offered for their out-of-hours opt-out that they thought it was "a bit of a laugh".
There is no doubt that the old arrangement in which doctors were on-call effectively all day and all night, and at weekends, was brutally tough; and now that the medical profession is no longer an overwhelmingly male sinecure, it is completely understandable that the hours had to be reduced – a woman doctor cannot be expected to look after her patients to such an extent that it damages the wellbeing of her own children.
Yet the fact is that the public, while still seeing doctors as life-savers (or at least life-prolongers), has for some time stopped viewing them as under-rewarded – and not just because they now get a disembodied voice from a call centre when they ring up in a crisis at weekends. Thus a recent opinion poll carried out by YouGov showed that 92 per cent believe doctors are "well paid" and only four per cent thought they were underpaid – or deserved a higher pension. Those are strikingly adverse figures for any group wishing to take industrial action which will mightily inconvenience the public.
Nor is it as certain as the BMA claims that there will be no deaths as a result of the withdrawal of "non-emergency" operations, check-ups and other appointments. As Dr Angus Ross, a Cumbria-based GP who voted against the industrial action, explained: "What constitutes an emergency? I don't know until I have examined someone – 24 hours can mean the difference between life and death. I have lost count of the times that someone has come in for a routine appointment and I have privately thought, 'Thank God they came in today', before sending them to hospital for immediate admission. It might be a gentleman who has a pain in his chest and thinks he pulled a muscle, but is actually having a heart attack... I am in no doubt that there will be patients whose health is compromised by these strikes."
Doubtless if there is such a tragedy as a result of the industrial action, the BMA will either deny the connection, or else blame it on "the Government's refusal to listen to our just demands". Indeed, it already insists that it "regrets having to take" the action... against its patients. Well, who else is being made to suffer? It will not inconvenience the Government one iota. When their day of action is over, and the Government has not budged a millimetre – what then? Another Thursday spent subversively on the golf course?
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