![Senior doctors strike on a picket line](https://www.telegraph.co.uk/content/dam/news/2023/09/01/TELEMMGLPICT000346652678_16935683354460_trans_NvBQzQNjv4BqgsaO8O78rhmZrDxTlQBjdGLvJF5WfpqnBZShRL_tOZw.jpeg?imwidth=680)
![Senior doctors strike on a picket line](https://www.telegraph.co.uk/content/dam/news/2023/09/01/TELEMMGLPICT000346652678_16935683354460_trans_NvBQzQNjv4BqgsaO8O78rhmZrDxTlQBjdGLvJF5WfpqnBZShRL_tOZw.jpeg?imwidth=680)
The news that junior doctors and consultants are to join forces in strike action, timed to coincide with the Conservative Party’s annual conference, is a further escalation of disputes which have been going on for over a year.
The “junior doctors” – a misleading description of a group ranging widely in age, with total pay averaging around £50,000, exceptionally generous pensions, and excellent prospects for future promotion – are claiming an increase of 35 per cent. This is said to be necessary to compensate for the effects of inflation over the last fifteen years. The details of this comparison are obscure, but anyway, with flatlining productivity, rapid price increases and ever-increasing taxation, very few salary earners staying in the same job have kept pace with the cost of living. Are junior doctors really a special case? As for consultants, they are one of the best-paid groups of public sector employees in the country, earning well over £100,000 a year on average, again with a stonking pension, and with many opportunities for lucrative outside earnings.
But irrespective of the merits or demerits of these pay claims, which would considerably outstrip the settlements reached with nurses and other key medical staff, must we just accept that damaging strikes like these, already responsible for hundreds of thousands of cases of delayed treatment, should be allowed to continue? The BMA points out that the extra costs associated with covering for junior doctors so far have been in excess of £1 billion, which would have gone a long way to meeting their claim. This is a spurious argument, of course: while the extra payments were, we must hope, a one-off, any permanent pay increase would baked-in to next year’s spending, and would form part of the foundation on which all future claims would be erected.
Yes, think about the future. Earlier this year, NHS England, with the support of all political parties, launched a long-term workforce plan. This would see the NHS headcount rising from 1.5 million today to 2.3 million in 2036. This would cost on current projections the equivalent of 6 percentage points added to all income tax rates, and this could well be an understatement. In such a scenario, can we indefinitely accept that key medical staff should be allowed effectively to hold the taxpayer – not the evil Tory government, as the BMA might have us believe – to ransom whenever they feel they are not being paid enough?
Every strike is in essence a breach of contract. Since the 1906 Trade Disputes Act, unions have had immunity from being sued for contract breaches. This “right to strike” is considered sacrosanct, although the terms under which it can be exercised have changed several times over the years. But consider the context of 1906: virtually all strikes were in the private sector, arguments over the employee share of a surplus generated by productive activity paid for by customers who had a choice of suppliers. Workers had very few protections: no minimum wage laws, no unfair dismissal rules, precious little health and safety legislation, no paid holidays or limitations on working hours. And when they came out on strike they often had to lose weeks or months of pay and face the threat of penury.
For years now, the vast majority of strikes and days lost have been in the public sector, where those who ultimately pay for settlements have no alternative suppliers. This strike action is deliberately aimed at punishing ordinary people, in the hope this will lead them to turn on the government. It takes the form of repeated one- or two- day strikes, which minimize pay loss to strikers and increase uncertainty and damage to the public. In the USA such intermittent strikes don’t receive the protection given to unions in the National Labor Relations Act.
It’s 2023 rather than 1906: maybe we should rethink. We already restrict the right to strike: soldiers, the police and prison officers cannot walk out and leave us unprotected. In some countries, more groups are restricted: civil servants in Germany and Denmark, firefighters in Czechia, federal employees in the USA and teachers in many US states. In other jurisdictions, including Australia and some Canadian provinces, the government can impose compulsory arbitration in long-running disputes which damage the national interest.
If we are to face repeated action of the kind we will be suffering in the next few weeks, perhaps we should start to look at banning extended public sector strikes, starting in the health service where the damage is greatest.
Len Shackleton is professor of economics at the University of Buckingham
The BMA has left the Government little choice. Should it now ban NHS strikes?
Must we really accept that key medical staff can hold the taxpayer to ransom whenever they feel they are not being paid enough?