{"id":4536,"date":"2024-01-10T13:43:02","date_gmt":"2024-01-10T12:43:02","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4536"},"modified":"2024-01-10T13:43:02","modified_gmt":"2024-01-10T12:43:02","slug":"beyond-the-call-of-duty-nhs-doctors-and-industrial-action","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/01\/10\/beyond-the-call-of-duty-nhs-doctors-and-industrial-action\/","title":{"rendered":"Beyond the call of duty: NHS doctors and industrial action"},"content":{"rendered":"

By Darren Mann and Doug McConnell.<\/p>\n

The year-long industrial action by National Health Service (NHS) doctors in England has been divisive, with the unedifying spectacle of government using a strategy of undermining public trust in medical professionals as policy to avoid a negotiated settlement with the British Medical Association (BMA).<\/p>\n

While the headline demand of a 35% pay restoration by junior doctors has been criticised as unrealistic, this group of medical professionals has undeniably been subject to a significant diminution of income<\/a> – even beyond that experienced by other healthcare professionals in the decaying public service.<\/p>\n

Low pay has had a deleterious impact on workplace professional satisfaction and wellbeing – and has resulted in medical staff leaving in numbers<\/a> to work in better run and remunerated systems overseas. The effect has been to increase the already intolerable burdens of a failing healthcare system on those that remain, which exacerbates the cycle. Consultants have also taken strike action to maintain inflation-level pay and to re-establish a pay review-body more independent of government fiscal influence.<\/p>\n

The British public bore witness to the sacrifices made by doctors during the pandemic, however, their support for the medics\u2019 case has been partially effaced by doctors seemingly acting out-of-professional character and the direct consequence to patients of postponed and cancelled appointments, treatments and procedures.<\/p>\n

The UK Government has sought to undermine public support for doctors by attributing burgeoning NHS waiting lists<\/a> to the strikes, despite overseeing a decades long policy of austerity and year-on-year \u2018efficiencies\u2019 which have resulted in a capacity-service mismatch subsequently exacerbated by the pandemic and a \u2018cost-of-living crisis\u2019. This calculated mischaracterisation has further polarised positions at a time when resolution should be sought.<\/p>\n

Some commentators have questioned the legitimacy of doctors withdrawing their labour, with extreme views holding that \u2018givers of care and mercy\u2019 are never ethically permitted to withdraw their beneficence<\/a> once they have chosen this vocation. In our paper<\/a> we show that this position is untenable. Although doctors must safeguard public health and have a duty of care to their patients, this doesn\u2019t preclude striking but only raises the threshold for when striking is morally permitted.<\/p>\n

Industrial action by medical professionals can be morally permissible even when pursued purely in the interests of fair pay and conditions. But, where strikes aim to correct unfair pay and conditions, they will typically also be in the public interest because fair pay and conditions promote good healthcare by reducing staff-turnover, understaffing, and burnout.<\/p>\n

We also argue that there are cases where doctors\u2019 strikes are supererogatory. In a national health service, the government has a duty to ensure that the healthcare system is suitably funded, staffed, administered, and maintained in a suitable estate. If the government is negligent in this duty, then public health is threatened.<\/p>\n

Doctors\u2019 duty to public health obliges them to bring this threat to the attention of parliament and wider society. However, we argue that this duty does not extend so far that they are obliged to strike to pressure the government to properly fund the healthcare system. Where the predominant motivation for a doctors\u2019 strike is to pressure the government to meet its own obligation to public health, then the strike is supererogatory.<\/p>\n

 <\/p>\n

Paper title<\/strong>: \u00a0UK doctors’ strikes 2023: Not only justified but, arguably, supererogatory<\/a><\/p>\n

Author<\/strong>: Doug McConnell (Macquarie University) and Darren Mann (King\u2019s College London)<\/p>\n

Competing interests<\/strong>: Darren Mann has been a member of the British Medical Association since 1986.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

By Darren Mann and Doug McConnell. The year-long industrial action by National Health Service (NHS) doctors in England has been divisive, with the unedifying spectacle of government using a strategy of undermining public trust in medical professionals as policy to avoid a negotiated settlement with the British Medical Association (BMA). While the headline demand of […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8108,8094],"tags":[],"class_list":["post-4536","post","type-post","status-publish","format-standard","hentry","category-healthcare-workers","category-nhs"],"yoast_head":"\nBeyond the call of duty: NHS doctors and industrial action - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/01\/10\/beyond-the-call-of-duty-nhs-doctors-and-industrial-action\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Beyond the call of duty: NHS doctors and industrial action - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Darren Mann and Doug McConnell. 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