Britain's doctors may disrupt NHS services for a second day over changes to their pensions after Thursday's go-slow meant at least 26,000 patients across the UK could not have an operation or see a specialist as planned.
The British Medical Association (BMA) will next week discuss whether to risk alienating the public with another partial withdrawal of labour when it considers how to force the government to reopen negotiations and make some concessions to soothe the profession's anger.
The BMA insisted the day of industrial action by doctors – their first since 1975 – had successfully conveyed the depth of anger at changes that will force them to contribute more and work longer and had sent ministers "a strong message that a fairer approach must be found".
But health secretary Andrew Lansley gave no hint of making any concessions that might resolve the impasse and instead condemned doctors for taking "completely unjustified" action that had inconvenienced and distressed patients and even prejudiced their care.
The Department of Health (DH) said the action had produced only "minimal to moderate disruption to the NHS" in England. Only about 11,500 NHS doctors – just over 8% of the total – had taken part in the action and just 2,700 (9%) of planned operations and 18,750 outpatient appointments (9.4%) had had to be rescheduled. Three-quarters of GPs' surgeries offered a full range of normal services, it added.
BMA chief Dr Hamish Meldrum said those figures underestimated the action's impact and "should be treated with extreme caution. Our feedback from doctors co-ordinating the action on the ground indicates that in England up to a quarter of non-urgent cases have been postponed and around a third of GP practices have been taking some form of action."
He said the intention "has not been to maximise the impact on patients but to communicate the scale of doctors' anger and encourage the government back to the table". He will try to speak to Lansley as soon as possible to see if they can have "positive discussions" about pension changes to end the dispute.
The BMA's ruling council will decide next Thursday what the union should do next to pursue its case that the coalition's enforced changes to their pensions are unfair and unnecessary.
The large majority in favour of industrial action in last month's ballot of BMA members means it can call one or more further days of action if its council decides that is wise when it meets on the last day of the BMA's annual conference in Bournemouth, which starts on Monday.
The union confirmed that further industrial action is an option. But Meldrum strongly hinted in an interview with the Guardian that he would prefer to reopen negotiations without that happening.
"When I speak to Andrew Lansley we will discuss what happened and I hope discuss how we can reach some sort of resolution to this problem. I'm not pretending that something as difficult as this can be solved overnight. But I would hope that everybody is anxious to avoid another day like today because it's in nobody's interests to have a repeat of today", he said.
But Lansley's tough stance seems to leave little room for compromise.
Some doctors are unclear what they have achieved by their action, which saw GPs at many surgeries offering no routine appointments and only seeing urgent or emergency cases. Dr Kailash Chand, a BMA council member, said that it had been "not helpful", had diminished doctors' standing with the public and was unlikely to compel ministers to think again. "It was the wrong fight at the wrong time with the wrong tactics," he said. Doctors should instead withdraw from helping to implement the transition to GP-led commissioning in England, the central plank of the coalition's controversial NHS shake-up, Chand said.
Figures supplied by the NHS showed that 2,703 patients in England had their operation cancelled and another 18,717 were unable to have their scheduled hospital outpatient appointment. In Scotland 3,650 patients missed out too, the Scottish government said, and in Northern Ireland the figure was 897, NHS trusts there said.
Patients stayed away from GPs' surgeries, apart from those with urgent problems, who were seen speedily. Dr Caroline Snell, a GP in Gateshead, said: "I've never had an on-call [for emergency patients] as quiet as this before. Other doctors have also had lots of free appointments. The message appears to be out there that the surgery is closed. Some patients have been phoning us asking whether we are open. I'm not looking forward tomorrow. I expect we will be inundated.
"In the surgery we're not sure whether the industrial action will make a lot of difference. We just wanted to express our unhappiness. Government spin is making the public think they can't afford our pension and that we are overpaid."
Comments
21 June 2012 10:36PM
Doctors get high pensions, but they are doctors who spend their lives curing the sick. They deserve it. They also pay large amounts into those pensions pots.
I support the strikers for those reasons, but also because anyone challenging the Conservatives' dogmatic, ideologically-fuelled distaste for public servants, and their race to the bottom on wages and pensions, deserves our support in my view.
21 June 2012 10:50PM
The BMA is a useless union. They completeley miscalculated - the action undertaken meant the vast majority of doctors did the vast majority of their normal work. They even helped trusts to rearrange appointments and ops, and did all other emergency work. And all this to maintain public support. Public support that doesnt exist, if the media coverage is anything to go by. SO the action just weakened their position.
They should have aimed to maximise disruption, not minimise it. Thats how industrial action works. Complete withdrawal of labour, every hospital, every GP. The government would have re-entered negotioations in hours. Either that or a prolonged work to rule. The current action just seems like a bit of a non-action to me, perhaps a doc can say how different things were today?
21 June 2012 10:50PM
When can we have a very very long bankers strike please?
21 June 2012 10:59PM
Doctors are self employed but get a public pension with all the benefits of index linking, protection from falling annuities and the vagaries of the stock market. Funny arrangement, or strong professional union.
21 June 2012 11:02PM
Well done to those doctors who striked. I am sure many would have prefered to have withdrawn their services in protest at the NHS reforms and the transition to GP-led commissioning, however that would be deemed politically motivated and strike action on these grounds is illegal. Legally strikes can only be called on the grounds of working terms and conditions.
That said, the changes to doctors pensions are an attack on the NHS as they render it more possible to privatise huge swathes of the NHS, so defending pensions is in the same stroke defending the NHS as a health care service free at point of use to all. Doctors have a very valid case to strike on these terms. They deserve to be well renumerated. They are worth far more to our society than any self-serving politician or corrupt banker.
21 June 2012 11:07PM
Two letters to The Lancet this week:
"Of course the attack on [NHS] pensions is part of the government’s privatisation strategy. It makes it cheaper for private companies to take over services provided by the National Health Service".(1)
1. cutting NHS pay / pensions means it's cheaper for private companies to take over NHS work and staff. (2) Danny Alexander, Chief Secretary to the Treasury said: “The new pensions will be substantially more affordable to alternative providers”. (3)
2. Worse pay and NHS pensions makes the NHS less attractive for doctors and NHS staff, so they will want to go and work in the private sector. (1)
3. If lots of doctors are faced with a big pay cut, they may end up turning to private work to make up the difference. (1)
T Blair put their salaries up. They didn't ask for it.
1. "Defending the UK’s National Health Service".
Kambiz Boomla, Anna Livingstone.
The Lancet June 20, 2012
http://dx.doi.org/10.1016/S0140-6736(12)60996-9
http://download.thelancet.com/flatcontentassets/pdfs/S0140673612609969.pdf
2. "Defending the UK’s National Health Service"
The Lancet. June 20, 2012
http://dx.doi.org/10.1016/S0140-6736(12)60995-7
*Nicholas S Hopkinson, David J Nicholl, Kevin O’Kane, David Cohen, Jennifer Mindell, Allyson Pollock,
Andrew Cummin, Lesley Kay, Natalie Silvey, Sheldon Stone, James Robertson
http://download.thelancet.com/flatcontentassets/pdfs/S0140673612609957.pdf
3. (UK HM Treasury. Statement by the Chief Secretary to the Treasury, Rt Hon Danny Alexander MP on Public Service Pensions 2011.
http://www.hm-treasury.gov.uk/statement_cst_201211.htm (accessed June 12, 2012).
21 June 2012 11:12PM
Doctors aren't self employed. GPs are (mostly) self employed, but you may have noticed that not all doctors are GPs.
Not impressed by the BMA's handling of this though. A prolonged work to rule might be more effective.
21 June 2012 11:25PM
I am a doctor, I voted to strike - I was technically on strike today.
However, I was told to go to my usual place of work and undertake any urgent clinical work. As a doctor I will always prioritise my patients over any political situation, and I don't think I'm unusual in this.
Because of the nature of my job, all my work is urgent (I work in a crisis/emergency specialty).
I could have said I was participating in the strike, and lost a day's pay.
But I was doing my regular job. I would not have been paid for doing my regular day's work had I declared I was striking.
Perhaps this explains the 'poor' turnout - we were mostly working as usual as our union suggested.
I am still enraged - when I trained/qualified I worked 120 hours/week for pennies, with a promise of a pension at the end of it. We were paid less than anyone else in the hospital, we were exhausted. I know things have changed for later cohorts but in my case and for many of my colleagues we put up with hellish conditions - no sleep, no decent food, no showers between shifts - for many years. We were led to believe we could expect some recompense in terms of pension - that has been stolen from us.
21 June 2012 11:29PM
The problem is not how much public servants, including the doctors, get as a pension.
The issue is that this government is trying to renege on agreed contracts of employment. These public sector schemes were not invented by the public servants, they were devised by previous governments, both Labour and Conservative, and it is not the public servants fault that these governments were unable to do the maths!
On the contrary they were more than happy to take in the billions of contributions that these schemes generated for them. It is only now when they are having to pay back a little bit more to keep their side of the bargain that they are trying to change the rules.
Basically the government is untrustworthy scum and I hope the doctors and other public servants do whatever is necessary to make this government of duplicitous blackguards honour long standing agreements and not let them change the terms and conditions of these contracts of employment.
After all it was governments lack of control of the banksters that got the country in this mess not the doctors, so why should they pay, especially as the bank bosses are still paying themselves outrageous bonuses?
21 June 2012 11:31PM
'Well done to those drs that were on strike.' Why? They are very well paid and are now as greedy as the bankers
Let's hope hope you do not fall sick, have an accident etc while they are taking a paid rest day from their labours and perhaps get in another day on the golf courses.
You could be in pain and danger but never mind eh? the doc's on strike, bless. Price of their golf balls, fancy cars and holidays is really too much for the poor poppets aka shameful money grubbers to cope with.
Those of us outside the magic circle of public employees can only press our cold, hungry faces to the glass and watch our had earned money being foolishly thrown at public sector workers.
Ah well this is the Guardian not the sharpest knife in the box.
21 June 2012 11:32PM
Bless what a little trooper.
21 June 2012 11:37PM
Agree with Dr Chand's suggestion to withdraw from GP-led commissioning.Patients/profession will support such a decision as this would not hurt patients - will frustrate the government's plans to implement ideologically driven NHS reforms
21 June 2012 11:42PM
Let's have another strike.
After all, £5000 a month pension is not enough for anybody, is it?
More public sector disconnect from the realities of who is paying for these pensions, yea, all £5000 a month, every month, for life.
It has to be that dreadful government's fault doesn't it and stuff the taxpayers that have to pay for it all.
21 June 2012 11:46PM
I really rather like Dr Chand's idea. Go on strike from anything relating to the implementation of GP commissioning, but carry on actually being a doctor.
Another option, which apparently worked in Ireland, is to go on strike from signing death certificates. Not exactly kind on those wanting to bury their nearest and dearest, however...
21 June 2012 11:52PM
to get the public fully onside, strike over nhs privatisation.
22 June 2012 12:02AM
Cheese is delicious but I prefer a hearty wedge of Andrew Lansley's underpants, a sharp tug until the pips squeak........keep on tugging medical profession.....you know you like it.......
22 June 2012 12:50AM
They're not allowed to.
22 June 2012 1:40AM
Would you care to expand upon that comment? As it is, it sounds somewhat patronising.
22 June 2012 1:41AM
What about the patients who have to put up with no sleep, no decent food, no showers and are ill at the same time?
The hellish conditions are what's left after you pay doctors more than what they get almost anywhere else in the world (twice what they get paid in France) resulting in no money left for anything else.
On £100k a year once outside the hospital, doctors live extremely well compared to almost any other job.
22 June 2012 1:48AM
To expand on historydoctor's comment, my rough understanding of trade union law is that any strike that isn't over the group of worker's own pay and/or conditions is illegal. I think this law was introduced or widened under Thatcher to prevent one set of workers striking in solidarity with another. For example workers in one factory wouldn't be allowed to go on strike to support workers in a separate business that supplies materials to their factory.
Unions organising strikes in contravention to this rule are at risk of having their funds confiscated, and workers that participate in unofficial strikes are at risk of disciplinary action or potentially being sacked.
Of course it seems possible that the unpopularity of nhs privatisation may have encouraged more doctors to vote to strike over their pensions than would have done so otherwise.
22 June 2012 1:56AM
"http://www.guardian.co.uk/discussion/user/id/4327066" They are very well paid and are now as greedy as the bankers"
... don't think so actually, look at the payscales!
Before you complain too much try and put it in perspective - doctors are very well educated and comparable professions (law, accountancy, vets, dentists) do MUCH better financially.
At the end of the day would you like to get treated by a happy, well-paid, competent doctor, or a fed-up, underpaid, over-worked, burnt -out doctor who is beginning to question why they bothered getting three A's at A-level then 5 years in medical school, then a one-in-two or three on-call rotation for 3 years as a house officer (making under the minimum wage) with the promise of a decent salary and pension once they became consultants etc etc....?
There is a significant movement of well trained doctors out of the NHS and into private practice or overseas positions as they realise that their skills are appreciated more by other populations. Look at other health systems where doctors are paid a commercially viable wage (US, Bermuda, etc) and see if you want that to become a reality in the UK. For instance a consultant in the US will frequently earn over 6 times that of a comparably trained NHS consultant.
I think our NHS doctors do a great job despite the poor working conditions and should be fully supported.
22 June 2012 2:09AM
Nobody can guarantee you a good night's sleep, decent food isn't a human right (and indecent food isn't the end of the world), what is your experience of lack of access to a shower in hospital? And lastly, to point out the obvious, if you weren't ill you wouldn't be in hospital.
I noitice that you make no mention of the standard of care that you received from the doctors that you are so quick to criticise.
22 June 2012 2:36AM
I made the mistake of recommending this post before I read it.
Perhaps you should consider the post above of the doctor who though technically on strike and therefore losing a day's pay, nonetheless went into work and worked a normal day, which is probably why there were few marching.
So, if I can't get in no one else should be allowed to either, is that it? And did you train for 10 years to do your job and work 80 hour week, shifts of 40 hours without breaks and get paid a pittance for doing it? No, I didn't think so.
Good job you're in the private sector then. You must be a banker.
22 June 2012 2:38AM
I agree - these bloody MPs and top Civil Servants, and the rest. And they get it only after 15 years too!
Good job they're not bankers, isn't it? They get that much every day!
22 June 2012 2:43AM
Inconsiderate of them, what? How dare those doctors spend time actually making those people well so successfully, and under such appalling conditions? Do you think it would be any better if doctors were paid a pittance?
22 June 2012 2:50AM
When I think of the TAX AVOIDANCE and TAX EVASION from wealthy people within this government and bejond , right. left and centre, who have no morals or ethics, holding the GPs to ransom re there work moral ethics "do patients no harm" I am very angry.
I know where I would prefer decent pension to go to, not the few, who look after there own bank accounts and there paymasters......To the few who look after the many....GPs for me, without a doubt. Same goes for all health care workers.
Health care workers be it from cleaner to consultant or Mr must not because of there great moral ethics not have a voice, must be heard. Do not let this government with little or no moral stance play the same old card. There is no easy answer. Tories will not communicate with BMA, too busy playing public divide card.
Full praise for the GPs...fight your corner. Both private sector workers and public sector workers are the many who will require NHS service at some point, your service......Not the few, they have there own backs covered....Private health care.
There is no easy answer...... Voice must be heard, after all "Listening Government" only to what they want to hear. Too busy raiding public sector pensions to pay of financial meltdown....Not caused by average man or woman. Most have earned there pension, paid into it for years. It is pure ideology from this Tory government. RACE TO THE BOTTOM.
22 June 2012 2:50AM
When I think of the TAX AVOIDANCE and TAX EVASION from wealthy people within this government and bejond , right. left and centre, who have no morals or ethics, holding the GPs to ransom re there work moral ethics "do patients no harm" I am very angry.
I know where I would prefer decent pension to go to, not the few, who look after there own bank accounts and there paymasters......To the few who look after the many....GPs for me, without a doubt. Same goes for all health care workers.
Health care workers be it from cleaner to consultant or Mr must not because of there great moral ethics not have a voice, must be heard. Do not let this government with little or no moral stance play the same old card. There is no easy answer. Tories will not communicate with BMA, too busy playing public divide card.
Full praise for the GPs...fight your corner. Both private sector workers and public sector workers are the many who will require NHS service at some point, your service......Not the few, they have there own backs covered....Private health care.
There is no easy answer...... Voice must be heard, after all "Listening Government" only to what they want to hear. Too busy raiding public sector pensions to pay of financial meltdown....Not caused by average man or woman. Most have earned there pension, paid into it for years. It is pure ideology from this Tory government. RACE TO THE BOTTOM.
22 June 2012 3:14AM
Clicked "post comment" twice, hence two comments stating same comment. Can't take one out.....Guardian can.
Mind you! My comment may be seen as not "politically correct" by Guardian. However, do not care if politically correct or not. Might have two comments deleted.