The BMA is facing growing clamour for visible industrial action, but Dr Andrew Mimnagh argues that GP leaders are right to be putting patients first.
I am a doctor, and so the health of my patient is my first consideration (Declaration of Geneva 1948). We all acknowledge this.
We then automatically skip to how we address the inept dealings with our profession, by a succession of political parties, to the detriment of ourselves, our family life and latterly our financial stability in retirement.
But first we have to go back a step. The stated precept about putting patients first underlies the enormous trust and respect the general public have for our profession.
Doctors are the most trusted and respected profession (Ben Page, Ipsos Mori). Perhaps this is because we display a fundamental weakness in our character. I observe my friends and colleagues in local practices deliver over and above the contracted time, demonstrating a selfless care to patients that never ceases to amaze me.
This has now become taken as the norm, and medical staff are approached by every level of NHS management to deliver even more with no extra, and sometimes less, financial resource. They call it QIPP – perhaps because it is a sick joke?
So can we realistically withdraw our labour without patients suffering? The answer is no. If all doctors stop working, people die. If we maintain emergency cover, then we have individual doctors working during a strike. The debate then is over what grade of response we take, and so the BMA policy is fundamentally correct, as it is based on a graded response.
- Let us be clear what the profession's nuclear option is: all-out strike.
- Let us be clear it is the last resort.
- Let us be clear it is the end of the NHS.
Current circumstances require us to constrain our other most notable professional characteristics – our ego and self-reliance – and be mature enough to let our leaders lead.
A debt of honour
However, metaphorically, we are fighting on the wrong field of battle. Placing yourself at a disadvantage for the greater good underpins the military covenant. Society's moral duty to preferentially treat our armed forces' injuries is to become enshrined in law to protect it.
There is a similar moral contention, under which medical professionals should not be put in a position forcing them to compromise their core values for their own self-protection.
I suggest there is a debt of honour owed by the parties of power to the health profession.
I need not trouble you with the full history of NHS pay rises – hardly ever on time, hardly ever implemented in full and frequently deliberately ignored.
Let us lobby our patients now to accept that the handling of our profession by politicians has been immoral.
Yes, we are the tallest poppies in the public field and, yes, other vested interests would wish to supplant our position. But let us show this for what it is: jealousy and hunger for our status without the ability, commitment and hard work to achieve it.
We do not deliberately fail patients, but we are human and make mistakes. This is at odds with the organised campaign of denigration and diminishment of the medical profession that is currently being propagated. By all means let us lobby the BMA, so the weight of our feeling is made known to politicians.
However, let us throw our support behind the BMA's graded strategy and place our efforts into putting the parties of power under scrutiny as to their true intentions.
I go on strike the day the NHS dies, but on that day it needs to be clear to the public that it was the politicians, not the doctors, who killed it.
Dr Andrew Mimnagh is a GP in Waterloo, Merseyside
