Junior doctors’ winter of discontent: public needs to know why striking is necessary
Authors: Roshana Mehdian
Publication date: 20 Nov 2015
Junior doctors have voted overwhelmingly in favour of strike action over changes to their contract. Roshana Mehdian explains why doctors must make it clear to the public why they feel forced to act
I have always been a fairly typical junior doctor: passive, hardworking, and a bit of a goody two shoes. I’ve never even had so much as a speeding ticket. Why then have ordinary junior doctors like me taken to the streets in droves and voted overwhelmingly for strike action? Why haven’t we just kept our heads down and kept quiet?
We are about to enter a critical period for the NHS and for the medical profession. Six months from now the public will be left with one of two very different versions of events. They will believe either the government’s narrative, that junior doctors are protesting because they are militant, extreme, or being misled by the BMA, or the doctors’ version of events, that junior doctors are caring professionals who are not prepared to allow their future patients to be put at risk by dangerous politics.
The ballot result was eagerly awaited, but I am sure the outcome came as no surprise to junior doctors. A 98% mandate for strike action is an historic result. We now have a duty to explain our decision to our patients. We have a duty to clarify, qualify, and quantify it to the public.
Like many other junior doctors I’ve been on a crash course in politics and spin over the past few months. As a profession we tend to focus on the material facts of a case, but in doing so we can miss the power that ideas and narratives can have in determining outcomes. The future of the NHS will depend not only on our ability to diagnose its ailments but also on our ability to effectively tell our side of the story.
Junior doctors’ core values of truthfulness, caring, and integrity mean that they want to safeguard the future of the NHS for their patients. But these same values mean that we tend to avoid the world of politics, allowing our story to be defined by others. Instead, we should use these values to define our own narrative so that it is clear to our patients and the public, because they are the ones who will affected by the outcomes. After all, these values are also our greatest strength. As I would present it, our story is as follows.
We cannot allow this contract, in this form, to be imposed. We desperately want to negotiate a safe and fair contract. We don’t want to strike, but for the good of our patients, colleagues, and the NHS we may have to.
We believe that it is our duty to oppose the imposition of a contract that, in its current form, would threaten patient safety and stretch junior doctors to breaking point. We cannot allow the scrapping of safeguards that limit doctors’ working hours. Long working hours put patients at risk. What possible motivation could there be to remove these safeguards?
We fear that the contract would mean that doctors who work the longest and most antisocial hours will suffer the biggest pay cuts—this amid understaffing, with up to half of emergency department and general practice training posts unfilled. A deterioration in working conditions would undermine recruitment and retention of junior doctors. Doctors will leave the NHS, and this will further affect patient safety.
We are also concerned that the proposed contract changes will penalise part time workers and those who choose to start families, and that it will deter doctors from undertaking vital lifesaving research.
I am sure there are many more points of contention, but most of my colleagues agree that these are the key points.
This is our narrative, and we have a responsibility to the public to ensure that it is heard.
Is this a winter of discontent for junior doctors? Or is it spring for grassroots junior doctors? I hope it will be the second. It’s time to outline a positive narrative about the future of the NHS and the profession. I hope the health secretary, Jeremy Hunt, will want to own it with us, to work towards a safe and fair future for patients and doctors.
Competing interests: I have read and understood BMJ’s policy on declaration of interests and have no relevant interests to declare.
- Rimmer A. Overwhelming majority of junior doctors vote for strike action. BMJ Careers 19 Nov 2015. [Link] .
Roshana Mehdian orthopaedic registrar, South West London Deanery