The tube strikes make chumps of us all

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Tube strikes? This is just normal London

Last Thursday my newsfeed was bombarded with people in London making complaints. The lifeblood of the capital, the London Underground was once again in lockdown due to the workers going on strike. As a member of the medical profession, a curious table began spreading, detailing how tube drivers started with a better pay packet than I would be receiving come August. London was in uproar. Twitter was swarming with so many threats of terrorism that London may as well have been declared a new Islamic state. I doubt the police managed to arrest all these terrorists.

For many people, this was simply an indicator of how greedy tube drivers are. With significantly less training, and a much better pay deal than doctors, these people had decided to hold London to ransom just because they wanted an extra dollop of cash. The reality nonetheless is that simply for one day, Londoners were slightly inconvenienced. I have yet to see a newspaper article about tube drivers being greedy cheats since.

Looking at the ballots cast for strike action, we see that 81% of its members voted with 97.6% in favour. Not only is this considerably stronger than any the government’s mandate to rule, it also shows almost complete agreement. Unless you want to take this as evidence that 80% of tube drivers must be greedy scoundrels, there must be some reason why this vote to strike is so overwhelmingly strong. Indeed, the dispute that most newspapers are ignoring is that management has unilaterally enforced additional weekend and night shifts to all drivers with no additional remuneration of any sort.

Now, given the option of having unsociable hours on me without any choice whatsoever, would I want to do something about that? Yes I would, as I’m sure most of us would given the circumstances. Londoners may find one day slightly annoying but these drivers would need to deal with poor work conditions for the rest of their lives if they had simply caved in. But some of you might say that tube drivers are still overpaid and just hitting parity with the rest of us, they don’t deserve the pay they get. But I would say the opposite. These people are what allows the capital to work. London is city with centuries of history; modern road planning was not part of it. These people deserve to be treated with respect and good pay. The question instead should be why the rest of us put up with subpar pay and working conditions.

One reason may be due to the fact that tube drivers are organised into unions that allow collective bargaining power. This prevents management playing off people against each other as their demands are given together. They also have access to the powerful tool that is gripping London: a strike. Unions are only one half of the negotiating team though, the second half is management. And management interests rarely coincide with worker interests.

The thing is that doctors do have a union: the BMA. But whilst it has succeeded occasionally such as the negotiations for GP pay with the Labour government after taking out of hours care outside of GP hands, other areas remain lacklustre. For example, the whole host of changes striking at the NHS with stealth privatisation, fragmented care and increasing levels of bureaucracy make conditions worse and worse for doctors. And whilst a vote of no confidence can be passed on opinions towards the health secretary, very little has come out of this other than a public display that we are not happy. Indeed, several Royal colleges have also stated their displeasure, again on the deaf ears of the government.

The reality is that without any actual ability to threaten the government with non-compliance in healthcare, very little can be done. Some might say, what can we do? The idea of doctors going on strike to many is unethical. Many of us take pride in the care of our patients and the thought of doing any less than our utter best is an anathema to the careers we chose. But this is fundamentally what is being taken for granted by managers. They know full well that most doctors would not dare jeopardise care and so relish in taking abusive steps that no other professions would deal with.

But on the other hand, we must at some point realise that healthcare is already under threat to the point that we cannot simply let things slide anymore. For example, one issue in the Mid-Staffordshire enquiry was that nursing staff levels were below adequate. The proposal to ensure minimum staff numbers was quietly ignored by the government thus ensuring another disaster is just a matter of time.
More directly related to doctors however, was the fact that management was effectively able to coerce doctors into silence via threats. The basic job of ensuring care for patients could not be fulfilled. Indeed, it is often these whistleblowers themselves that end up being shunned by our profession. It should not be.

Sometimes, it takes the view of a long term strategy to ensure that the best outcomes are reached. If it takes conflict with management and the government to ensure the best care of patients in the long term, it is not a challenge we should shirk away from. Local groups have formed and managed to prevent the closure of Lewisham A&E on spurious financial reasons. But this was one battle. The medical profession needs to start standing up for what it believes in and make our callous politicians realise we’re not just going to lightly sit down and swallow their ineffectual headline grabbing initiatives. We need to become organised in order to stand as one effective body against the abuses we can see healthcare being put through. Our profession has already voted through our displeasure, it’s time to show we will do something about it.

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