Keeping up a theme of political commentary, I have to say that the junior doctor’s strike this month is overdue. I suppose that they weren’t sure about how the government was going to react at the beginning, but the perilous state of the NHS has only become more clear over the past 6 months, and the real need not just for safe-guards over the amount of hours existing individual doctors work to be clear, but the need for more total “doctor-hours” just to keep standards up.
I bought into the negative narrative around the wasteful government NHS spending being talked up around 2000, mainly because of the media’s emphasis on wasteful projects and overpaid doctors, but also because of the short-term PFI hospital projects and the nightmare IT database (I think that came later though). I know see that for all the things I disagreed with (and still do), like the need for patient choice, PFI, the internal market, and the pointlessness of large IT projects, New Labour didn’t waste money on the NHS, it greatly improved the NHS temporarily, the positive after-effects of which continued to be felt throughout the Coalition government years, allowing for a reduction in spending with minimal (short-term) problems.
Now that the Tories are back in power they have the problem that all their earlier decisions are coming back to haunt them, and the NHS just cannot provide what it is directed to do by parliament, government and NICE. Small-scale efficiencies are great ideas, but I don’t buy into the idea that the extreme pressures that are present now are better places for efficiencies to be made than the halycon days of the 2000s (for some hospitals). The NHS needs money first and foremost, and it needs minimal central-government projects for a while to allow the system to settle. Quality checks are vital, but grand new political measures or systems are not going to sort things out overnight, and I say this as a big supporter of long-term reform.
So, given that I believe that the NHS has to have some pressure released financially, I think that the Junior Doctors’ strike is the best thing that could have happened to try and achieve this aim. In many ways these doctors, and those following behind, are those with least to lose in that they are high-quality graduates who will almost be guaranteed a pay-rise if they go abroad. Some won’t be as good as the others, and others will be tied to the UK for personal reasons, but a significant proportion of junior doctors will move abroad if they are not happy with their lot, and that does not mean just pay, but for more and more of our generation that means a good work-life balance. Many doctors want, or will already have families straight after graduation, and the anti-social hours will be particularly hard for these doctors without our traditional gender roles. Obviously doctors used to work hard, and many were women even 50 years ago! (Well not so many, but a significant minority), but as many have pointed out, the support measures that were in place then to help junior doctors through the hardest early years are no longer in place – cut out of the system as “waste” to improve the efficiency of all doctors’ roles.
So, if this strike fails, our NHS is doomed and with it the long-term health of the country. Nevertheless, I am an optimist and I believe that if the strikes fail, even if the JDC buckle, there are too many weak points in the NHS currently for the government to manage to hold out on funding increases indefinitely, and things may get worse in the short-term, but they should improve in the longer-term. I would go so far as to say that if the Junior Doctors lose this strike action, then Corbyn would be my odds-on favourite to win a general election in 2020 as I don’t think any fall-out would have resolved itself by then.
Come on Jeremy Hunt, Theresa May, et al. Much as it pains me to say it, do it for yourselves, as destroying the NHS is something that could tarnish the Tories for a long long time. If you could genuinely understand how little the junior doctors have to lose (and from here on in all medical graduates will have 50-90k of debt to content with as well), then I think you might see things the same way I do.