Strike Disrupts Medical Care in England ; First Walkout by Doctors in 4 Decades Highlights Strains on Health Service

By Castle, Stephen | International New York Times, January 13, 2016 | Go to article overview

Strike Disrupts Medical Care in England ; First Walkout by Doctors in 4 Decades Highlights Strains on Health Service


Castle, Stephen, International New York Times


The first strike by doctors in the country in four decades heightened tensions over the stewardship of a health system that has come under growing strain.

The first strike by doctors in England in four decades disrupted care for thousands of patients on Tuesday, heightening tensions over the stewardship of a health system that has come under growing strain.

Tens of thousands of junior doctors, a term that covers medical professionals with as much as a decade of experience, were believed to have refused to work, providing only emergency coverage because of a dispute over pay and working conditions, notably weekend shifts.

The strike led to the cancellation of about 4,000 nonurgent operations, such as routine procedures for knee and hip replacements, and Prime Minister David Cameron warned that the strike would create "real difficulties for patients, and potentially worse."

The popularity of the program means that the dispute carries risks for the government. The National Health Service, which is financed by taxes and payroll deductions, delivers most care free. There has been no similar industrial action since 1975.

Mr. Cameron's Conservative Party has always found it hard to put in effect changes to the health service, which was created by the Labour Party in the 1940s and is now creaking under the strain of an aging population and tightened budgets.

In his memoirs, Nigel Lawson, a chancellor of the Exchequer under Margaret Thatcher, wrote that health practitioners regarded themselves as "a priesthood," making the sector "extraordinarily difficult to reform." The National Health Service "is the closest thing the English have to a religion," he wrote.

Weekend shifts are at the heart of the current dispute. A new contract would increase basic pay but would reduce the number of hours for which junior doctors receive added compensation for work on the weekends.

The government argues that this would improve treatment on weekends by creating a genuine seven-day service.

The doctors counter that their stand against excessive working, and the strain it puts on them, makes them the guardians of safety in hospitals.

The doctors are officially required to work a 48-hour week, but that is calculated over a 26-week period, and they can end up working long stretches, particularly over weekends.

To an extent, the dispute has crystallized a broader set of worries and frustrations felt by many doctors working in a system in which demand for health care sometimes seems infinite, but for which resources are definitely not.

When junior doctors were asked to authorize a strike last year, 98 percent voted in favor. A threatened strike in December was postponed at the last minute.

Some opinion surveys have suggested that public support lies with the medical professionals, at least in the initial phase of the walkout. The doctors are planning two more protests in the coming weeks: a 48-hour strike that would also affect nonurgent care, and another day's walkout in which they would withdraw all treatment.

Plans for the new contract have been under discussion for several years, but the government has indicated that it would impose the new terms in the absence of an agreement. …

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