This strike is not going down well. Or to quote the Daily Telegraph, this “unseemly spectacle” is not going down well. And it’s not just the Telegraph. “There is no gold left and the doctors need to recognise that this applies to them,” says The Times. “Doctors should be ashamed of themselves,” says the Independent. “It’s enough to make you feel ill,” says the Sun. And even the most pro-union and anti-government Daily Mirror is not happy: “Doctors must resist this midsummer madness.”

“Strike threat is sick,” “Patients won’t understand,” “Breathtaking arrogance,” “Defending the indefensible,” say the others—can you remember the last time the whole of Fleet Street sang any such resoundingly unified tune?

Hamish Meldrum, chairman of BMA council stressed at great length when announcing the action that the grievance is not with the public but the government. But doctors will have to get used to the fact that although their argument is with the government, the government is elected to represent the people and the people haven’t got much truck with this strike.

So for the next three weeks doctors will have to mount a public PR campaign of epic proportions if this action is to make any difference at all, and at the very least not inflict significant damage on the profession’s relationship with their patients.

But the argument is not unwinnable, and if it can be correctly conveyed, doctors do have a strong case to argue that they, above other public sector workers, are being unfairly treated.

Firstly, doctors’ pensions were renegotiated in 2008 precisely to ensure they were sustainable. The normal pensionable age was raised by five years, doctors’ contributions were significantly increased (from 6% to 8.5%) and employer (read tax-payer) contributions were capped against future increases.

Secondly, and as a result of the changes in 2008, the NHS pension scheme is indeed very sustainable. It more than washes its face. A Public Accounts Committee report in May 2011 found that the 2008 reforms to the scheme are bringing substantial savings each year, and it will be affordable for many years to come. An increase in doctors’ pensions now is not in order to make them affordable, it is to take away their earnings in order to support completely separate and unaffordable schemes.

And so thirdly, as a result of this affordability, the public is not financially supporting this pension scheme beyond what is reasonable, even though it may be public. It is not an issue of tax-payers supporting well off doctors. It is whether the public thinks it is right to simply take away doctors’ earnings under the guise of pensions when it is effectively a tax to be redistributed elsewhere entirely.

Reading the above, surely any reasonable person can see the government is being unfair? If only it were that simple.

Because, you see, the government has a pretty strong case too and even the Labour opposition backs it. And it’s much simpler: “We’re in the biggest economic crisis of our lives, everybody else is having their pension reformed, and your doctor (who may well earn more than the prime minister, don’t you know) is striking because he feels £68 000 is not a good enough pension. What do you think?”

Given £68 000 is triple the average salary, let alone the average pension, most people will struggle to see beyond this figure. It doesn’t really matter what the back-story is or how that compares to now, it’s just a lot of money. And even if they can see beyond that figure, how many of your patients will want to read about the back story of some four-year-old pension negotiations and pension scheme sustainability to fully understand the “fairness” of the situation?

Doctors have a lot of credit in the bank with the general public, and a lot more than the politicians they are fighting, but they are going to have to work very hard over the next three weeks to make sure that good will isn’t squandered.

You can find the full back story on the pensions saga on the BMJ Careers website, as well as information on what the changes will mean for individual doctors in the full pensions archive.

Key articles from the archive:

• Government confirms final proposals for reform of NHS pension scheme:
• How the pension reforms will affect you
• Doctors must attend workplace and provide emergency care during industrial action:
• Pension stitch up
• Doctors take industrial action over pensions
• Podcast: Doctors on strike

Edward Davies is editor, BMJ Careers