Doctors need to work with the NHS, not against it

Resident doctors have a strong case for a generous pay rise. Their average pay has fallen by one-fifth since 2008, taking inflation into account, even after last year’s 5.4 per cent rise. But to demand a 29 per cent increase, and to rush into a strike ballot to support it, is a counterproductive and damaging tactic.

Last year, they secured a better deal than most public-sector workers, and there were no strings attached requiring more efficient working practices. They should believe Wes Streeting when he tells them: “You will not find another health and social care secretary as sympathetic to resident (formerly junior) doctors as me,” according to The Independent.

Mr Streeting secured a funding settlement for the NHS over the next four years that is generous compared with other departments. But a real-terms increase of 3 per cent a year is only around the long-run historical average. It is half the rate achieved in the New Labour years. So there is no scope for utopian pay settlements (such as the excessively generous GP contracts negotiated in Tony Blair’s time).

If the British Medical Association, the doctors’ trade union, really wanted to promote the interest of its members, it would work with Mr Streeting to plot a gradual real increase in doctors’ pay over the next few years allied to a plan to modernise the NHS and increase health service productivity.

Instead, it is seeking to repel public opinion with the threat of another round of strikes in pursuit of a pay claim that most reasonable people regard as pie in the sky.

Already public opinion is narrowly opposed to doctors being allowed to go on strike at all (opposed by 49 per cent to 44 per cent, according to YouGov), but the one thing that will ensure that the doctors lack public support is the demand for such an unrealistic increase.

Of course, it is only the opening bid in a negotiation – but this is a negotiation with public opinion as much as it is with Mr Streeting.

The BMA is pleased, as militant trade unions usually are, with the “resounding majority” in favour of strike action in its ballot: 90 per cent certainly looks like an impressive mandate. But the turnout for that ballot was only 55 per cent, which means that just fewer than half of those eligible to vote supported strikes — a less than “resounding” margin.

This is not how the allocation of resources in a public health service should be decided. The idea that one NHS interest group should use its old-fashioned, Seventies-style industrial muscle to secure a larger share of a limited budget is one that belongs in the past.

The very idea of the NHS is in danger. Years of Conservative underfunding have weakened it to the point that many younger people have become used to paying for private GPs and minor procedures. If the waiting lists left over from the coronavirus cannot be cleared, support for the idea of social insurance systems such as those formerly advocated by Nigel Farage will grow.

Perhaps they should. Continental Europe seems to do well enough without a universal tax-funded model such as the NHS. But that is not what the BMA purports to believe. It believes in an NHS free at the point of need. And if its members believe that too, they should drop the threat of strikes and work with Mr Streeting to modernise the NHS and make it work.