The most crucial statistic relating to the current threat by resident (formerly “junior”) doctors to go on strike is derived not from the inflation indices, or even the pitiful state of the UK public finances, but from the latest readings of public opinion.
In a dramatic shift from where it stood during those long-running disputes under the Conservatives, when the medics were cheered on even by disappointed patients, support for their cause has collapsed.
A year ago, some 52 per cent of the public felt that strike action was justified. Now that figure has exactly halved, to a mere 26 per cent. Without the backing of public sentiment, or the political pressure it brings to bear, it is much less likely that the doctors will win this time round. Nor, despite widespread sympathy for their complaints, do they deserve to.
The doctors, or rather their representatives at the British Medical Association, have badly misjudged the mood of the public.
Since the general election, resident doctors have seen their wages rise by much more than most other working people, and – in the case of the award they won shortly after Labour came to power – with few (if any) commitments to improving productivity.
The newly installed chancellor, Rachel Reeves, wanted the strikes over and done with quickly because of the damage they were doing to the NHS and the wider economy. So did the public.
The government did the right thing in immediately honouring the recommendations of the independent pay review body, though they should have insisted that progress be made on productivity. Instead, they hoped that the BMA would join them in rebuilding and reforming the NHS to make it once again an institution that people could rely on and the country could be proud of.
Now, the five-day strike scheduled for the end of July – with no doubt more to follow – puts all of that in jeopardy.
All the signs are that the health secretary, Wes Streeting, will resist the pay demands – and he is right to do so. The pay of doctors in the NHS – as with other groups providing a vital public service, such as the police and the civil service – should be insulated from politics and determined by the independent bodies tasked with deciding a fair settlement, taking all the factors into account, including affordability.
This has been done, and will be done again. The BMA always submits its own evidence and arguments, and these are fully accounted for. The whole process is designed to avoid the kind of damaging industrial action that is now about to take place. Mr Streeting is being pragmatic and sensitive in agreeing to hold direct talks with BMA representatives, but he is under no obligation to submit to their demands. He has a duty to protect the patient and the taxpayer, too.
What is too little noticed is just how arbitrary the central demand of the BMA is. The doctors want their pay to be further boosted such that it regains the real value that prevailed in 2008, as determined by the movement in the retail prices index – so by around 29 per cent.
Other indices suggest a lower adjustment, but that’s beside the point. Not only does this “non-negotiable” figure look outlandish to people who are struggling with the cost of living crisis, many of whom have no hope of ever earning as much as a doctor, let alone a consultant; it is also illogical.
There is nothing special about 2008, except that – as the resident doctors (fairly) point out – it was when their salaries began to decline in real terms. Well, that broadly applies to many other jobs, albeit some more than others, in reference to various points in the past.
But there is no law, of man or of nature, that can guarantee a given level of income for any group in perpetuity – and certainly not in a dynamic economy. It is absurd.
For reasons that are sometimes obscure, productivity and real wage growth in the UK – and to some extent across other advanced economies – have generally stagnated since the global financial crisis of 2008. Doctors are not alone in experiencing a painful squeeze, and in fact, many have suffered more – including nurses.
The doctors seem very out of touch with their public. They thereby risk losing the very thing they profess to love – the National Health Service itself – by making it look unreformable, unsustainable, and unworkable.
If Labour can’t rescue the NHS from its own staff, who can?
Politically, the voters will conclude that Sir Keir Starmer, Rachel Reeves and Wes Streeting are no more able to fix it than were Rishi Sunak, Jeremy Hunt and Victoria Atkins. They will simply note that the endless strikes are back, as the waiting lists once again begin to grow longer. The electorate may then be more ready to listen to radical siren calls from Nigel Farage for the NHS to be dismantled.
If the public finally lose faith in it, and the health service ends up privatised, then the doctors’ world will change radically – and not necessarily to suit their own interests.
