Thursday, 7 June 2012

A phoney war

From the distance that holiday provides you, it is possible to reflect on events close to home with a degree of detachment that would otherwise be very difficult. Thus, it is with the benefit of distance that it has become possible to make some sense of what the decision by the BMA members to vote for strike actually means. And doctors don't come out of this terribly well unfortunately.

 The problem is one of perception. The prospect of paying more and working longer for a smaller pension is never going to be a good one. The sense of injustice within the medical profession is no doubt heightened by a couple of other factors. Firstly, many within the profession believed that pensions had been renegotiated for the next generation 5 years ago, and that for the government to renege on the agreement made then is unfair. Secondly, for many, the prospect of a good pension is one of the factors on the plus side when considering the pros and cons of going into the medical profession in the first place, and maintaining one's allegiance to the NHS in the long term. And all of those arguments have merit. But probably not enough.

 In electing to strike over this issue, admittedly, only on the provision of non-urgent care, the medical profession is making a public appeal for support. And this is the problem. Whatever the realities of life are for a lot of doctors, the public perception of the profession is that its members are comfortable and fortunate. And doctors may well find this impression difficult to argue against: it is after all, a job that comes with a decent wage, and when doctors consider the things that they are currently struggling to afford, I suspect that they will be things that many other people would consider to be more towards the finer side of life, than the essential side.

 Without public support, in striking against the pensions reforms, particularly when doctors failed to strike against the broader health reforms, the risk is that the profession portrays itself as rather spoiled and petulant. And this would be a shame. The profession is still awash with genuinely well-meaning men and women, who are doing their best to serve their patients. But perhaps, on this occasion there has been a disconnect between the way that doctors think that their patients feel about them, and the way that their patients actually feel about them.

 And perhaps it also belies another misunderstanding by doctors: the possibility exists, and it is something that I have written about before, that NHS pensions, post-reform, become a thing of the past: as services become increasingly tendered out to non-NHS organisations, the increasing likelihood becomes that all doctors end up with a collection of different pension funds, with slightly varied terms and conditions, that represent the different organisations that they have worked for over the course of their careers.

 And if this is true, then any battle fought over the terms and conditions of the NHS pension, when the broader war about the provision of NHS pensions for all healthcare employees has been lost, is a part of a phoney war.

 And a phoney war that the public doesn't support. Make of that what you will.

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