LONDON — Hospital doctors in England staged their first strike in four decades Tuesday, disrupting treatment for thousands of patients in the National Health Service and escalating political tensions over a publicly funded health care system so revered that it was once likened to a national religion, NY Times reports. Operations were postponed and appointments canceled in a bitter dispute over pay and working hours between employers and junior doctors, a term that covers medical professionals with as much as a decade of experience.
With the junior doctors offering only emergency care, about 3,500 operations had been affected by Tuesday afternoon, including routine procedures for knee and hip replacements — prompting a warning from Prime Minister David Cameron that the labor action would create “real difficulties for patients, and potentially worse.”
Yet the dispute over the health system carries risks for the government. The National Health Service, which is funded by taxes and payroll deductions but has faced years of financial strain, delivers most treatment without charge. Despite regular funding crises, there has been no similar strike since 1975.
Cameron’s Conservative Party has always found it hard to make 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 Prime Minister Margaret Thatcher, wrote that health practitioners regarded themselves as “a priesthood,” making the sector “extraordinarily difficult to reform.”
The National Health Service, he wrote, “is the closest thing the English have to a religion.” It is also a significant presence in national life, employing 1.6 million people which, it says, puts it in the top five of the world’s largest workforces, alongside the U.S. Defense Department, McDonald’s, Wal-Mart and the Chinese People’s Liberation Army.
Weekend shifts are at the heart of the current dispute. A proposed new contract would increase basic pay but would reduce the number of hours for which junior doctors receive added compensation for work, particularly on Saturdays.
The government argues that this would improve treatment by creating a genuine seven-day service, and the health secretary, Jeremy Hunt, on Tuesday highlighted the elevated mortality rates recorded for some medical conditions on weekends, when hospitals have fewer staff.
Speaking to the BBC, Hunt compared the situation of a hospital doctor to that of an airline pilot’s being told, “‘I’m sorry, but as it’s Sunday you don’t have a co-pilot, but off you go to New York.’” The doctors counter that their stand against excessive working, and the strain it puts on them, makes them the guardians of safety in hospitals.
Officially, junior doctors are 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.
The government insists that doctors would not be worse off under the new contract, but that is disputed by the British Medical Association, which represents more than 37,000 of the country’s 55,000 junior doctors and which describes the proposed conditions as “unsafe and unfair.”
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.
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.
Several opposition politicians sided with the strikers Tuesday. Justin Madders, who speaks for the Labour Party on health issues, said that junior doctors had been left with “no choice but to take this action,” while the shadow chancellor, John McDonnell, visited a London hospital picket line.
Like other aspects of the dispute, the scale of the strike in England was contested Tuesday. The British Medical Association said that “tens of thousands of junior doctors” were striking, but NHS England, which leads the health service, said that 39 percent of junior doctors, out of a possible 26,000, had reported for duty on the day shift. The current action is scheduled to end Wednesday morning.
Johann Malawana, who leads the medical association’s junior doctors’ committee, said that his members felt that they had no alternative but to strike, and appealed to ministers to address “concerns around safe working patterns and ensure the contract recognizes the long, intense and unsocial hours which junior doctors do.”
Anne Rainsberry, the national incident director for NHS England, apologized to all patients affected. “It’s a tough day,” she said, “but the NHS is pulling out all the stops, with senior doctors and nurses often stepping in to provide cover.”