Should healthcare workers vote to strike?

By Ben Saunders.

As I write, in August 2023, junior doctors in the UK are once again being balloted over strike action. While the ethics of strikes by healthcare workers has been hotly debated, less attention has been given to the balloting procedures. This is unfortunate, since the requirements imposed by the Trade Union Act 2016 are complex and potentially undemocratic (as I have argued elsewhere).

Counterproductive votes

One might assume that one should vote in the ballot according to whether one believes strike action justified. That is, one should vote in favour of a strike that one considers justified, and against a strike that one considers unjustified. However, this is not always the most effective strategy. Perversely, the terms of the 2016 Act mean that voting against a strike can result in it achieving a mandate.

This odd result arises because strike ballots require at least 50% turnout to achieve a legal mandate. (There is also a further requirement for 40% support, which is specific to important public services, including healthcare.) A ballot that fails to meet the turnout threshold does not achieve a mandate, even if those who do vote strongly support industrial action.

Consider a simplified case, of a union with 101 eligible members. Suppose that 50 of the members vote to strike, while the other 51 do not vote. This would not be sufficient for a mandate, since the turnout threshold would not be met. This strike ballot would therefore fail, even though there was unanimous support for a strike from those that voted.

Note that the failure in this case is not down to lack of support from voting members, but rather due to not enough members voting. The turnout threshold would have been met had one more person voted. Moreover, this would be true regardless of how that person voted. Had one of the 51 abstainers instead voted against the strike, then this would have satisfied the turnout requirement. Since the vote would still be in favour of striking, by 50 votes to one, this would have resulted in a legal mandate to strike.

Voting against a strike can thus be counterproductive, resulting in a mandate for strike action that would not otherwise have existed. On the other hand, the same examples demonstrates that abstaining can block a strike more effectively than voting against it.

Why this is problematic

These findings may seem paradoxical. They also pose dilemmas for some potential voters. Matters are straightforward for those who support strikes; they should vote in favour of action. But things are less clear for others.

First, consider those who are neutral or undecided on the merits of strike action. Ordinarily, abstaining from a vote means leaving the decision to others. This can be respectful. For instance, someone who is unaffected by a particular decision might decide to abstain, thereby leaving the decision to those who are more affected. However, the turnout threshold means that abstention is not a ‘neutral’ option here. By not voting, one may block a mandate for strike action.

I would suggest that those who are undecided should submit blank or spoiled ballots. This counts towards meeting the turnout threshold, without affecting the vote for or against the strike. While this makes it somewhat more likely that a mandate will be achieved, it does so only by overcoming the undemocratic obstacle posed by the turnout requirement. The decision whether or not to strike is still left to other members of the union. If they oppose the strike, then it will be defeated, but this will be down to a democratic vote, rather than legal restriction.

As for opponents of strike action, the problem that they face is strategic. If turnout is low, it may be more effective to abstain, rather than to vote against a strike. However, if turnout is high but the vote close, then it might be better to vote against the strike. Thus, it may be unclear how best to prevent a strike.

Again, however, I would suggest that opponents of action ought to vote, even though this may make a strike more likely. While abstention may be effective, it relies on the undemocratic turnout requirement to block action. If we want the decision to be democratic, then it should be determined by the votes of union members.


The Trade Union Act 2016 imposes various restrictions on the right to strike in the UK, including a turnout requirement on ballots. I consider this undemocratic, since it means the mandate does not simply depend on how members vote. In these circumstances, I suggest that union members have a moral obligation to vote, whether or not they support a strike, to ensure that the matter is decided by the membership, rather than by anti-union legislation.


Paper title: Healthcare strikes and the ethics of voting in ballots

Author: Ben Saunders

Affiliation: Department of Politics and International Relations, University of Southampton, UK

Competing Interests: None declared

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