Doctors' Strikes

Doctors have taken industrial action twice in recent years; both were significant, marking the first industrial action from doctors in almost forty years. The first was in 2012 when the British Medical Association (BMA), which is the trade union for doctors in the UK, took the decision to strike over ‘major changes to the NHS pension’. 

The second, which you may remember more clearly from news reports at the time, centered around junior doctors’ contracts in 2016. In a bid to help deliver ‘7 day services’, plans were drawn up to change what constituted unsociable working hours for junior doctors and to reduce the pay enhancements for working these hours, as well as other changes to pay. Junior doctors voted ‘overwhelmingly in favour of strike’ action and carried out four separate strikes, including the withdrawal of junior doctors from emergency care during the final strike, which had previously not been done. 

Ethical considerations & wider issues

Some key points to consider in regards to the wider issues surrounding industrial action by doctors and the ethical implications are:

1. Workers ‘have the right to take industrial action’
   Provided that trade unions, in this case the British Medical Association (BMA), follow protocols in relations to ‘properly organised postal vote[s]’ or ballots, their members have the right to take industrial action if there are ongoing disputes with their employers which haven’t been resolved through negotiations. Therefore, in these instances, where there were disputes over changes to the NHS pension and to junior doctors’ contracts, doctors had the right to take industrial action.
2. ‍Doctors must ‘make the care of [their] patient [their] first concern’
   As part of their duties outlined in the GMC’s ‘good medical practice’, doctors must make patient care their priority. Of course, each industrial action by doctors was planned in advance with provisions in place to ensure patient safety, particularly in emergency situations. However, routine care, including elective operations (i.e. planned operations) and GP appointments (during the GP strikes in 2012), were affected as a result of doctors’ industrial action. This opposition between doctors’ right to strike and their responsibility to put patient care first is a discussion point in relation to this topic, and therefore it’s worth researching this further so you can present both sides effectively. ‍
3. Doctors must maintain public trust
   ‍Again, the GMC’s ‘good medical practice’ guidance instructs that doctors must ensure that their ‘conduct justifies [their] patients’ trust’ and ‘public’s trust in the profession’. That isn’t to say that industrial action should automatically be considered damaging to the public’s trust, as arguably there was much support for doctors; however, there was inevitably a disruption to services, so it’s important to consider how this may have affected the public’s perception of healthcare and the NHS. Again, being able to discuss this, and in relation to doctors’ right to strike, will be useful should you be asked about the topic.
   

Further research

Where you’re using articles to support your discussions within your interview, it’s always advisable to use reputable sources, for example articles within medical based journals. Having said that, in this instance, where you may want to discuss things like public opinion, mainstream media can be useful at times. This source of information could be used to demonstrate how the media portrayed public perception of the strikes at the time, therefore you may use this when discussing public trust and doctors’ duties. However, it would still be preferable to also include articles from medical journals to give a more rounded discussion of the topic. 

While it’s necessary to draw upon articles relating specifically to the NHS strikes to support your discussion, you can also bring in articles which analyse medical strikes more generally, for example examining the ethical debates of the topics; you’ll find some examples of these below. 

The following are articles which you may find interesting in relation to the doctors’ strikes: 

• The BMJ – ‘2016 junior doctor strikes in England had ‘significant impact’ on healthcare provision’
• BMC Medical Ethics – ‘Protest of doctors: a basic human right or an ethical dilemma’
• BMC Medical Ethics – ‘Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?’
  

These may be used as a starting point for your consideration of the topic of doctors striking, but we would recommend undertaking further research, to develop your understanding of the wider impact and to provide supporting materials for your discussions, if you receive questions relating to it during your interview.