I became chair of BMA Council at what could reasonably be described as an interesting time, with the medical profession having just entered uncharted territory. The 21 June was an historic day – the first industrial action by UK doctors for four decades.
Whatever happens next, we should not lose sight of its significance and we should remain proud of what we achieved as a profession – acting in unity and sending a strong and clear message of how let down we felt by the attack on our pensions, while ensuring that we put the safety of our patients first.
There is no question that the action, and our subsequent decision not to ballot on a possible escalation into a full strike at this stage has again emphasised the range of opposing views on industrial action among GPs and hospital doctors. Since the decision by BMA Council to suspend industrial action and to focus instead on discussion and campaigning, my postbag has been full of emails and letters from GPs – some of them passionately condemning the decision, with others warmly welcoming it.
Before expanding on that decision, however, I want to address one of the most common questions from GPs – namely why we ruled out a boycott of commissioning as a form of action against the pensions changes.
First of all, I want to assure you that there was no possible form of action we did not consider. Many were ruled out for legal or ethical reasons, because they would be too complex or because insufficient numbers of doctors would have been able to participate.In the case of boycotting commissioning, there are a number of factors that helped us decide against pursuing that option.
The strength of the action on 21 June owed much to the fact that it was simple and that most doctors – in every part of the UK and every part of the profession – could participate. Advising GPs to withdraw from CCGs would be confined to general practice in one part of the UK, and not all GPs would have the same opportunities to take part in a way that would have meaningful impact.
But more importantly, there are major question marks about how effective it would have been as a form of action. There is a strong argument that it would not have influenced the Government and would even have proved counterproductive, creating opportunities for the private sector to become more involved.
After carefully considering the impact of the action on 21 June, the BMA also took the view that a repeat of the ‘urgent and emergency care' model would probably not have the same level impact, as employers would be wiser about how to manage such action. That left council with two realistic options – ballot members on an escalation into a strike (with doctors withdrawing their labour and not being at their place of work), or suspend plans for further industrial action and focus instead on making the most of the opportunities available to seek improvements to the pensions changes through discussion.
Ultimately, council – after a lengthy debate and having considered the scale of the action on 21 June, its impact on public opinion, the views of the wider membership, the chances of the Government agreeing to a serious rethink of its plans and the likely effect on patients of strike action – decided to suspend plans for further industrial action.
So what now?
I would like to emphasise that this decision does not mean we have definitely ruled out future industrial action – on this issue or any other. It means that, for now at least, we are engaging with the talks on offer about the age of retirement and contribution increases in 2013 and 2014.
We will also be working with other unions to campaign for a fairer retirement age for frontline staff over the longer term, especially as the main changes do not come into effect until 2015.
I'm not expecting every GP to agree with this decision. But I hope they can understand that as a profession, we were faced with an extremely difficult situation, and an intransigent Government – which was dead set on pushing through these changes – has at every turn refused any serious negotiation.
Throughout this process, we have sought to listen to and voice the views of our members and to work to get the best possible outcome for them. That hasn't changed. But for now, we will be working to achieve those aims through discussion and campaigning rather than industrial action.
Dr Mark Porter is a consultant anaesthetist at University Hospitals Coventry and Warwickshire NHS Trust andchair of the BMA