Henry Murphy: The Moderate Doctor

Jeremy Hunt recently told Twitter that “Moderate doctors must defeat the militants,” quoting the title of a Times article about the current war between the Department of Health and the BMA. My first response was to sit back and enjoy a flurry of hilarious responses (the reason I look at the @Jeremy_Hunt Twitter page so often). Comments included “Moderate doctors must defeat Jeremy Hunt,” ”If your definition of militant is standing up to protect the NHS against tyrants like you…,” and “So where are all these ‘moderate doctors’… I don’t know anyone who doesn’t think you are wrong and doesn’t support junior drs.”

Since then, 98% of a vote in a BMA ballot called for full strike action, and 99% for industrial action. This at first glance appears to be a profession united, but I have started to feel more and more moderate as the days go by, and slightly less willing to associate myself with that majority.

Jeremy Hunt claims that doctors are being bullied on social media, and I have to agree with him. A Facebook group with 62000 members has been a funny, poignant, and thought provoking forum for discussion of this issue. However, I have noticed that recently, as soon as a doctor or member of the public asks a question about strike action, its morality, its safety, their conscience, or training needs, there is a sudden attack. Some unsure about striking have been asked to “be a man,” and I have been called “very naïve” and “premature” over a comment about avoiding a strike. Some doctors who have objected to taking strike action have found themselves having to delete their original posts or even remove themselves from the group as a result of hounding. This to me is not the behaviour of a group of professionals, and calls to avoid discussion is tantamount to censorship. A nurse concerned about this issue wrote “After following the now deleted last two posts… consider me alienated.” Someone replied “This forum was set up with the explicit aim of preventing this disaster of a contract from being implemented. Removing posts that are a liability to this goal is a really good idea.”

One doctor, in reply to a comment I made about trying to avert a strike, stated “We’re all (98%) in this together, mate.” But is that true? When interrogating the first question in the ballot result, 99% of voters (28,120) chose industrial action. 76.2% of junior doctor members of the BMA voted. 37,155 junior doctors are members of the BMA. There are 54,074 junior doctors in England, that leaves 16,919 who are not members of the BMA, plus 17 spoiled papers, 179 who voted no, and 8843 who are members but who did not return their voting papers. 25,958 junior doctors therefore did not choose action on the ballot day. When reviewed again, of 54,074 doctors in England, 48% did not vote for industrial action in the ballot and 52% did. Rather a different story.

I do not intend to undermine the vote, as clearly this is one of the most resoundingly extreme majorities seen in politics outside of a dictatorship. It was almost too good to be true, and gives the BMA the power required to represent the profession to ensure a fair and safe contract. My point is that doctors should be careful when assuming they speak for everyone, and should respect the other half of the profession who do not call for industrial action.

For me, this vote was an extremely personal decision, and it seems all doctors are on a spectrum of feeling. Some of us chose not to strike. Some of us will choose to come to work if our reasons for voting yes cease to exist. Some of us are keen to strike to show solidarity, whether or not Jeremy Hunt re-enters negotiations with an independent mediator.

I trust the BMA and The Advisory, Conciliation and Arbitration Service (ACAS) to draw up a sensible contract, putting patients and doctors before any political mandate.

So to Jeremy Hunt I say this: I am the moderate doctor and we have a few days to avoid this strike. The door of BMA House is wide open.

Henry Murphy is an emergency medicine CT2, Ealing Hospital.