NHS Heresy, Part 4 – Junior Doctors Would Sell Out The NHS In A Heartbeat, If The Price Was Right


Brave and principled defenders of Our NHS? The junior doctors would knife Aneurin Bevan’s vision in the back and happily serve an Evil Tory privatised healthcare system (how awful) if the price was right

Few people have been pronounced more saintly in 2016 than the holy NHS Junior Doctors, whose brave, principled and not-at-all-about-money industrial dispute with Jeremy Hunt and the Evil Tor-ee government has seen these humble, altruistic folks fight bravely and against the odds to safeguard the future of Our Blessed NHS.

Oh, wait. Nope. Turns out that most of those cherub-faced stethoscope swingers would throw the NHS under the bus and see the National Health Service privatised if it meant more money flowing into their pockets.

Kristian Niemietz of the IEA reports:

While I never believed for a second that the junior doctors’ strike was a People’s Struggle against the demonic forces of neoliberalism, I did believe that most junior doctors had convinced themselves of it. I was under the impression that they sincerely believed that that they were fighting The Just Cause on behalf of The People. Slogans like “Save our NHS” were everywhere, after all, and we always find it easy to convince ourselves that what is good for us also happens to be good for everybody, even if in roundabout ways.

And yet, in a recent survey of almost 10,000 junior doctors, 93% said they would accept “complete privatisation” of the NHS if it resulted in “substantially” increased salaries. Surely, some will dismiss these figures as a vicious smear, while others will accuse junior doctors of hypocrisy and opportunism. I think neither response is appropriate.

In practice, many doctors already act in accordance with the preferences expressed in this survey. Last year, about 8,600 UK-trained doctors went to work abroad, with Australia being a particularly popular destination. Australia has a universal public insurance system, in which the government commissions and pays for most healthcare, but in which the delivery is largely private and market-based. They are not doing anything immoral, because there is nothing immoral about private, market-based healthcare; in fact, the Australian system produces some of the best outcomes in the world. Come to think of it, even in the UK, most GPs are self-employed, not NHS employees. This means that technically, they are part of the dreaded – whisper it – private sector.

It would, however, suit junior doctors to quit the populist, anti-capitalist posturing. And the rest of us should try to keep our anti-capitalist knee-jerk responses in check. Even when it comes to healthcare.

My emphasis in bold. And you read that correctly – 93% of all those doctors who love to paint the NHS logo on their faces and protest Jeremy Hunt would happily live in an Evil Tory dystopia of privatised healthcare if it meant they were paid a market wage.

Niemietz is kinder and more understanding in his piece than I am inclined to be. Personally, I think that the junior doctors’ strike was just another example of the NHS Industrial Complex – that vast connected web of connected special interests who have a direct stake in the world’s fifth largest employer continuing to operate along broadly the same lines as it does at present – flexing its muscles and throwing the entire country under the bus for their own economic gain. But that’s just cynical old me.

There is no disputing, however, that nearly every tawdry public (and private) sector dispute in modern history has been justified by the protagonists on the supposed grounds of “public safety”, whether it is London Tube drivers suddenly becoming concerned about safety on the Underground in time to tack an extra day onto their Christmas holidays, Southern Rail train drivers convinced that taking over responsibility for opening and closing their train doors will lead to regular platform bloodbaths, or the sainted junior doctors.

We have known since May that pay was the only real red line for junior doctors, though surprisingly none of their placards made reference to the desire for more cash – they chose instead to go with their “Save Our NHS” angle instead, to elicit maximum public sympathy (by whipping up maximum public fear). We have also known, thanks to the steady stream of junior doctors moving abroad to work for other, better healthcare systems than our own anachronistic NHS, that their supposed high-minded commitment to socialised, government-provided healthcare is often outmatched by the desire for a bigger pay cheque and a larger slice of finite taxpayer funds.

But now we find out that not only would many junior doctors consider abandoning the NHS and selling their services to hospitals in other countries, but that they would actively support the tearing down of Our Blessed NHS and its replacement with a privatised system here in Britain. The commitment to socialised public healthcare is literally tissue paper thin with these people, even more flimsy than the home-made banners on which they proclaim themselves to be tireless warriors fighting to defend the Best Healthcare System in the World.

Will the revelation of this hypocrisy change anything? Probably not. The Guardian and other sycophantic leftist outlets will no doubt continue to gush over the various vested interests within the NHS Industrial Complex, as instructed by High Priests like Owen Jones:

Ask a striking junior doctor why they’re taking this action, and you won’t simply hear an eloquent spiel about their contracts. It’s the very future of the NHS – which they have committed their lives to – which they fear is at stake. There are the government’s policies of marketisation and fragmentation – yes, accelerating what previous administrations did – stripping the “national” from NHS.

“Committed their lives to”? Heavens, you would think that these people had pledged themselves as members of the Swiss Guard, the Night’s Watch or the Order of the Phoenix, the way that Owen Jones talks about them, rather than simply signing up as employees of the fifth largest bureaucracy on the face of the planet.

But it is sneaky what Owen Jones does here, suggesting that people become doctors out of a desire to work in a large government bureaucracy rather than feeling the call of a vocation to heal. Other countries seem to manage to recruit and train doctors without danging the carrot of getting to work for a massive state-owned bureaucracy in front of them, but Jones would have us believe that we only have doctors and nurses because people are so dreadfully inspired by Aneurin Bevan’s rusting 1948 vision. Nonsense, of course, but very effective propaganda from the NHS Industrial Complex.

The NHS Industrial Complex is made up of many different actors, all with their own motivations. One has the ideological leftists like Owen Jones, whose entire worldview relies on supporting a monolithic state healthcare provider churning out a precisely equally dismal service to every postcode in the UK. Then one has the worker bees within the organisation itself, whose medical or bureaucratic expertise rarely qualifies them to pass judgment on the optimal healthcare system for a country of 65 million people. And then one has the vast supply chain serving the beast, which is motivated primarily by a desire to preserve and expand existing revenue streams and avoiding risky disruption.

How fortunate that this cast of villains and useful idiots is able to hide behind the junior doctors – most of whom are eminently decent people supporting a superficially worthy cause – as they press for the preservation of the status quo, the scuttling of reform and a wider pipeline direct from the bank account of every UK taxpayer direct to the fifth largest organisation in the world.

But perhaps now that we know that the NHS Industrial Complex’s most photogenic spokespeople are actually more than happy to upend the whole system, spit on Britain’s national religion and see the NHS fully privatised so long as the pay rise outweighs the public vilification, the junior doctors’ collective halo might tarnish a bit.

Still, there are always the nurses. Everyone trusts a good nurse.


NHS Logo - Cross - National Religion - Worship - Idolatry

Save Our NHS

Top Image: University of Liverpool Faculty of Health & Life Sciences / Wikimedia Commons

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The Junior Doctors’ Strike Is A Tawdry Pay Dispute, Not A Principled Defence Of The NHS

NHS Junior Doctors Contract Strike

This strike is about money, not patient safety or the future of the NHS

James Forsyth speaks sense on the naivety and arrogance behind the ongoing junior doctors’ strike:

This walk out, the first all-out strike since the NHS’s creation, isn’t over some issue of high principle. It’s about money. The main sticking point in their negotiations with the government is that Saturday shouldn’t be treated as a normal working day.

The BMA’s suggestion at the weekend that it was prepared to call off the walk out if the government didn’t impose the new contract, but instead pilot it for a while, suggests that even the doctors themselves fear they’ll lose public sympathy by going ahead with this strike.

Yes. The fact that the final sticking point in negotiations is around money reveals all of the previous lofty, high-minded concerns about public safety and “tired doctors making mistakes” to be the cynical campaign rhetoric that it is.

Forsyth hammers home the point on pay:

Under the government’s offer, those junior doctors who are on duty one Saturday in four will receive a premium pay rate of 30 per cent. This means they are, on average, getting paid more for working on Saturdays than nurses, midwives and paramedics. The proposed deal is also more generous than what firefighters and police officers get for doing their job on a Saturday. This is hardly grounds for a walkout that will inevitably put lives at risk.

Junior doctors are right that they are paid less than doctors in some other countries. But this is, in large part, because the state has heavily subsidised their education. By the time a doctor has finished their foundation training, the state has already spent a quarter of a million pounds on them.

Until doctors are prepared to pick up more of this tab themselves, they shouldn’t complain that some of those working in other health systems are paid more than them. Indeed, it would be sensible of the state to actually require medical students to commit to working in the NHS for a certain number of years before funding their training—something that it doesn’t currently do. Junior doctors should also remember that if they stay in medicine and become consultants, they will find themselves in the top two percent of earners in this country.

This blog is no fan of the current Conservative government and no great proponent of the latest NHS reforms. But for the sake of decency, this strike needs to be broken. And then we need to have a long, hard national conversation about why an advanced democracy like Britain is facing a national strike of any kind in the year 2016.

Hint: if we did not still have a monolithic nationalised health service – the fifth largest employer on the planet serving the 22nd largest country by population – we could never be in the ludicrous position of suffering a strike of all the junior doctors in the land. Doctors would not all share the same employer, patients would not all rely on the same medical service and we would all be spared this drama.

Something to mull over as the accusations and counter-accusations fly.


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Responding To The Junior Doctors’ Strike

An inspiring (if unattainable) example from across the Atlantic

How to respond to a national walkout by government employees who perform a critical job for a large organisation, and who cynically advance their demands for more money under the false banner of concern for public safety?

Ronald Reagan offers us one blueprint, from back in that dim and distant time when both Britain and America were blessed with leaders who (for their various faults and blind spots) were not afraid to lead, and to take bold and decisive action when necessary.

This is the speech Reagan gave in August 1981 when PATCO, the American air traffic controllers union, called an illegal strike (federal workers being prohibited from striking under the Taft-Hartley Act) demanding, among other things, a 32-hour work week:

This morning at 7 AM the union representing those who man America’s air traffic control facilities called a strike. This was the culmination of 7 months of negotiations between the Federal Aviation Administration and the union. At one point in these negotiations agreement was reached and signed by both sides, granting a $40 million increase in salaries and benefits. This is twice what other government employees can expect. It was granted in recognition of the difficulties inherent in the work these people perform. Now, however, the union demands are 17 times what had been agreed to – $681 million. This would impose a tax burden on their fellow citizens which is unacceptable.

I would like to thank the supervisors and controllers who are on the job today, helping to get the nation’s air system operating safely. In the New York area, for example, four supervisors were scheduled to report for work, and 17 additionally volunteered. At National Airport a traffic controller told a newsperson he had resigned from the union and reported to work because, “How can I ask my kids to obey the law if I don’t?” This is a great tribute to America.

Let me make one thing plain. I respect the right of workers in the private sector to strike. Indeed, as president of my own union, I led the first strike ever called by that union. I guess I’m maybe the first one to ever hold this office who is a lifetime member of an AFL – CIO union. But we cannot compare labor-management relations in the private sector with government. Government cannot close down the assembly line. It has to provide without interruption the protective services which are government’s reason for being.

It was in recognition of this that the Congress passed a law forbidding strikes by government employees against the public safety. Let me read the solemn oath taken by each of these employees, a sworn affidavit, when they accepted their jobs: “I am not participating in any strike against the Government of the United States or any agency thereof, and I will not so participate while an employee of the Government of the United States or any agency thereof.”

It is for this reason that I must tell those who fail to report for duty this morning they are in violation of the law, and if they do not report for work within 48 hours, they have forfeited their jobs and will be terminated.

Obviously such a feat could not be repeated by the British government in its dealings with striking NHS staff – though the case for banning strikes by national public sector workers becomes more compelling by the day.

But if repeating Reagan’s actions are not possible for political and logistical reasons (firing 11,000 air traffic controllers is much easier than firing 55,000 junior doctors, not to mention the fact that the junior doctors are operating within the current law), at least we might hope that the government will act in the spirit of Reagan. And in the spirit of Reagan, the government should refuse to give any further ground to striking public sector workers who are willing to cynically jeopardise public health in a dispute which now rests primarily on the question of Saturday payand is certainly nothing to do with patient safety or the continued existence of the NHS.

This blog firmly believes that the NHS model is broken and than a system conceived in the 1940s is barely adequate to the demands of the 2010s, and will be hopelessly inadequate to the demands of the 2040s. If we are to persist with a public option, then there is no reason why healthcare should continue to be provided by a monolithic government organisation, the fifth largest employer in the entire world (with all the baggage, internal politics and resistance to change which that stunning fact implies).

There is no good reason why we cannot look closely at the healthcare systems of countries such as France, Germany, Japan or Canada and redesign our system accordingly – if only we could rediscover our sense of national ambition and shed our increasingly unwarranted pride in the NHS. We could even still call the new healthcare system “the NHS” if our cult-like attachment to the brand really runs so deep.

The time is long overdue for Britain to have that national conversation, endlessly kicked down the road by politicians terrified of upsetting nervous voters and governments which have proved constitutionally incapable of daring mighty things. But first we need to overcome this peculiar, anachronistic industrial dispute – one which belongs more comfortably in 1976 than 2016 – and end the junior doctors’ strike, by imposing the current contract offered if necessary.

And in that effort, let the spirit of Ronald Reagan guide Jeremy Hunt.


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Jubilant Trade Unions Are Wildly Misreading Jeremy Corbyn’s Mandate

TUC Conference - Young Socialists - General Strike

Trade union activists may be delighted by Jeremy Corbyn’s triumph in the Labour leadership contest, but they should not mistake the scale of his victory for widespread demand for socialist and pro-union policies among the wider British public

Can you imagine a British general strike taking place in the year 2016, ninety years since the last, with workers from every industry downing tools (or leaving their public sector office desks, as it would be today) to bring the entire country grinding to a halt?

No, of course you can’t – no person with a single foothold in reality can take the prospect seriously, let alone countenance the circumstances whereby a general strike might now be justified. But Britain’s trade union leaders can – and now that Jeremy Corbyn has been installed as Labour leader, they fully intend to make it a reality.

The Daily Mail strikes a suitably alarmist tone:

It would be the first time that there had been a General Strike since 1926, when work was halted for nine days.

Unite, led by ‘Red Len’ McCluskey and one of Mr Corbyn’s biggest supporters, is calling for ‘a broad, militant and imaginative campaign’ against the Trade Union Reform Bill.

It even proposes breaking the law, saying the TUC should be open ‘to giving maximum possible political, financial and industrial support to those unions that find themselves outside the law’.

But on this occasion they are right to be alarmed. The Telegraph reports that Britain’s favourite union leader, Mark Serwotka, sees Jeremy Corbyn’s Labour leadership victory as only the start:

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SPS strike protest 0b


Did life as you know it come grinding to a halt during yesterday’s strike?

Probably not, unless you are a parent who had to make last-minute childcare arrangements because of the teachers walkout and school closures, or you were one of the zero reported cases of people whose houses burned down in the temporary absence of the fire brigade.

The failure of the strikers and the public sector unions to capture the public imagination and win their support is largely down to the fact that the majority of Brits generally accept the need for pay restraint and fiscal conservatism on the part of government, even if they also acknowledge that the clumsy imposition of “austerity” is causing unnecessary hardship and suffering for some of the people most reliant on a big-spending government.

As this blog argued yesterday, it is not enough for opponents of austerity to rail against the “bankers, toffs and Tory scum”, the usual bogeymen of the Left – not if they want to win the next general election. Voters rarely kick out incumbent governments when the economy is on a positive trajectory, and particularly not when the opposition struggles to articulate a convincing vision of how different life would be under their rule.

What, precisely, do the strikers and anti-Austerity demonstrators want? Is it simply a return to pre-austerity 2010 levels of government spending, as though Gordon Brown were still in office? Is it that plus inflation-busting public sector pay raises (at a time when many in the private sector cannot hope for the same)? Or is it something bigger, along the lines of the joyful hippie revolution called for by Russell Brand?

From observing and talking with some of those on strike and others supporting them, it was clear that they have no single answer, no solid idea to rally behind other than to point at the Conservative-led coalition government and say “down with this sort of thing!”

One cannot necessarily expect the grassroots and those on the cutting edge of austerity to be articulate creators of alternative government policy, but from the Labour leadership’s awkward dance around whether they supported the strikes or not, it is clear that they are also stumped for a workable, electorally viable alternative.

With the general election less than 10 months away, the opposition (both official and the activist base) looks and feels very much divided and conquered.

Here are some telling images from the strike which sum up the prevailing atmosphere, taken in London by Semi-Partisan Sam:

SPS strike protest 3 SPS strike protest 4 SPS strike protest 5 SPS strike protest 6 SPS strike protest 7 SPS strike protest 8 SPS strike protest 9