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At the heart of general practice since 1960

A pussy-footed sort of protest

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So, tomorrow, we’re all on strike. That’s the public perception. That’s what everybody thinks, if they think about it at all, which most people won’t. There may be about a million interactions between the public and primary care on any given weekday, which sounds a lot. But it also means that there are another 59 million interactions across the UK that don’t happen.

It’s not a strike, of course, it’s industrial action (although the press and our political leaders seem keen to promote it as a strike). But the more you chase this abstract concept, the more elusive it seems. What exactly does industrial action mean? When I heard the result of the BMA ballot, I was immediately online looking for one of those braziers that you apparently have to stand around if you want anyone to take you seriously as a picket line. But donkey jacket sales remain resolutely flat, and the offer of police overtime is not pulling in many punters.

Here in the northeast, the Metro train drivers have chosen to go on strike on the two days of the two big concerts at Sunderland’s Stadium of Light. The Coldplay gig has already been disrupted, and at the time of writing, another strike is planned for tomorrow. Want to see Bruce Springsteen? Don’t go by the Metro. The drivers want you to feel the pain.

We GPs, on the other hand, seem to want to have the most pussy-footed and deferential  industrial action in the entire history of proletarian protest. What is the point of hoisting a placard if our main stated aim is not to inconvenience anybody, to the point where they’d not notice that we were doing anything at all? And why, if we’re being pragmatic, should we refuse to do any work when we are perfectly well aware that nobody else is ever going to do it for us and we’ll just have twice as much to do the next day?

Take my own practice. I’m not a member of the BMA for ideological reasons – I’ve resigned twice on points of principle, and it would look odd if I joined again for a third time – but I’m the only one who plans to take any action on the day. So I won’t see any booked patients, but I will see ‘urgent extras’, and as it is our patients who define the word ‘urgent’, it is a given that I’ll see the same number of patients that I usually do. My last patient today, for example, insisted on seeing me this afternoon even if it did mean her and me staying back half an hour after everyone else had left the building. The psoriasis on her scalp remained, I am assured, even after the 10 years since the diagnosis, very itchy.

But what’s the point? I’m not actually paid by anyone, as we are self-employed and take profits from a company, so nobody can deduct anything from my salary. If we partners persuaded our salaried colleagues to take action for the day but still be on the premises for emergencies, we could technically dock their pay and be better off ourselves. (I’ll personally come round and beat up any GP who does that, by the way.) And our registrars and F2 trainees, our colleagues most vulnerable to this detestable and cynical manipulation of our previously-agreed pension arrangements, are paid by authorities over which we have no control.

We seem to be desperate for our patients to love us. I don’t believe we need to bother about that. I’ve had conversations about medical pensions with three intellectually literate patients of mine, all of whom agreed that we have been royally screwed. Nobody else expressed an interest, despite my lapel badge.

I don’t intend to die in the saddle at the age of 68. But a single day of propping up a placard outside the practice is no way of ensuring this. We have to go further, or we have to capitulate. It’s up to us.

Dr Phil Peverley is a GP in Sunderland

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