The doctors' strike and the bond of trust
Published in: Daily Mail
As if we all didn’t have enough on our plate at present, in three days time an estimated tens of thousands of GPs and hospital doctors are planning to walk out on strike.
The medical profession, as we all know, subscribes to the highest ideals of altruism. So what is the elevated cause for which the doctors believe they have no alternative but to down stethoscope and scalpel for the day on Thursday?
Money. Their money. To be more precise, changes the Government is proposing to make to their retirement pensions.
In other words, these doctors are planning to walk out in the not-so-elevated cause of lining their own pockets.
How very depressing. But when you start to look at the details of this dispute, irritation surely gives way to incredulity. For these most aggrieved public servants are hardly facing thankless penury.
Under the Government’s proposals, newly qualified doctors who work until the age of 68 — which will become the normal retirement age for all workers — will receive a pension of £68,000 a year.
Doctors now aged 40 will have to work two years longer to receive the same pension as they do now. Oh — and pensions will be calculated on the basis of average earnings rather than a final salary.
Yes, that’s really it. That’s all they are going on strike about. For the first time in 37 years. And it’s not as if their current pension arrangements are ungenerous — far from it.
Official figures show that more than 100 GPs and consultants have recently retired with pension pots worth more than £3.5 million each.
They will receive pensions of at least £78,000 a year for life. They also received a tax-free lump sum at retirement of at least £234,000.
One 60-year-old GP who recently retired received a £334,871 tax-free lump sum and is on £111,623 a year for life.
Of course, it may be said that these are at the most lucrative end of the scale and that most doctors are not in line for anything like such largesse.
But clearly, most of them still do very nicely indeed out of what, by public sector standards, is an extraordinarily generous pension deal, said in fact to be the most generous in the world.
A typical NHS doctor with an unbroken record of service, who retires now at 60, will receive a pension of more than £48,000 a year for life, with a tax–free lump sum of about £143,000 on top of that.
To put it in perspective, by contrast only 70 members of the Armed Forces’ pension scheme receive more than £67,000 a year, while the average private sector final salary pension is just £5,860 a year.
The British Medical Association, which has called the strike, has moreover long behaved more like a thuggish trade union than its ostensibly elevated public image might suggest.
Its leader, Dr Hamish Meldrum, whose own pension is estimated to be at least six times as much as the public sector average, behaves less like the Bridlington GP that he once was than militant union boss Len McCluskey on NHS- prescription steroids.
In any event, whatever genuine grievance the doctors may have with the Government, the fact remains that for doctors to go on strike in pursuit of their own self-interest just sticks in the craw.
The essence of this row is that doctors will be expected to contribute more to their pensions and retire later. Well boo-hoo.
Everyone is now having to pull in their horns. There is real and widespread hardship from rising unemployment and the cost of living. Many fear for their economic future.
For doctors to go on strike over reductions to their pensions, when they are among the best remunerated of public sector workers and with pension arrangements far more generous than those of millions of others, suggests quite remarkable arrogance and complacency.
More fundamentally, doctors have a professional obligation to put the interests of their patients first. Yet on Thursday they are intending to put these last, as GP appointments and non-urgent operations are cancelled.
The Department of Health has warned that this strike could cause a backlog of 1.25 million GP appointments — including 140,000 appointments for children.
Even assuming a certain amount of tactical shroud-waving by ministers, it is inevitable that patients will suffer.
Doctors taking part in this strike will refuse to carry out all but urgent or emergency care. Operations will thus be cancelled and appointments rescheduled. People will have to wait longer for treatment, which will inescapably exacerbate distress, discomfort or pain.
Doctors’ leaders say that no one will be put at risk. But in these circumstances, it is simply not possible to calibrate such risk. Delayed treatment or appointments can all too easily turn into an emergency. And even if it does not, sick people will still be forced to bear the brunt of this disruption.
This is totally unjustifiable.
The last time doctors went on strike was in the Seventies. At least that was in the cause of reducing the duty hours of junior doctors whose level of overwork was endangering patient safety.
It is hard to view this week’s action, however, other than as an outrageous display of selfishness and greed by professionals who appear to have forgotten their calling. Unfortunately, there have been increasing signs over many years now that too many doctors have lost sight of this ethical imperative.
The settlement reached a few years back between GPs and the Government hugely boosted doctors’ earnings — but at the expense of patients, by allowing GPs to opt out of out-of-hours care.
That particular reduction in service has caused tremendous public distress. People not only often find that locums provide unsatisfactory care, but feel the arrangement reflects a nine-to-five mentality which undermines the ethos of public service to which doctors once subscribed.
This is sadly part of a more general trend towards a culture of self-interest in which the old understanding of public service appears to be dying out. Accordingly, doctors are increasingly treating the practice of medicine more as a job than a calling.
One of the key characteristics of a profession is that it involves a bond of trust with the public, which believes that the professional will put the interests of patient, pupil or client before their own or anyone else’s.
If doctors walk out, that destroys this bond of trust. The damage such a strike threatens to do therefore goes far beyond even the likely harm to patients’ physical well-being. It also endangers the core relationship between the medical profession and the public.
This would be a most regrettable development. Doctors are almost the last redoubt of trust and respect in a culture of profound and corrosive cynicism about most figures of authority.
While teachers, lawyers, police officers, politicians and others have all become tarnished by public disillusionment, doctors have retained much of their mystique. Indeed, in a era when so many have turned away from organised religion, people tend to invest doctors with the role of confessor or guide through life.
What a tragedy it would be if, through this deeply unjustifiable strike, the public became as disillusioned and cynical about the medical profession as it is about the rest of Britain’s all-too self-serving public servants.
The doctors’ Hippocratic Oath says ‘do no harm’. This strike, however, will cause patients harm. Dr Meldrum and the BMA should step back from the nation’s medicine cabinet which they are so carelessly about to smash.