KEY POINTS:
There is a depressing familiarity about the junior doctors going on strike. It seems the prospect looms whenever their pay and conditions come up for renegotiation. Every time, we are told of the impossibly long hours they work and the inadequate financial reward. Every time, we are led to believe that all will be well in their world if they receive a generous settlement. Every time, it does not work out that way, and the public has every reason to feel gravely disappointed.
The responsibilities and strains imposed on doctors as they find their professional feet have long been an issue. The difference over the past few years has been that junior doctors, like other health workers, have set to one side ethical qualms about their entitlement to strike. They are ready to use the sick as bargaining chips as they flex their muscle. The result is substantial upheaval. At the moment, it appears that a two-day strike by the junior doctors will lead to an estimated 8000 people having their scheduled elective surgery or an outpatient visit postponed. Some will suffer greatly. There will also be a financial cost as senior doctors fill in, for which they will be paid $300 to $500 an hour on top of their normal pay. That is money intended originally for health services.
There are two particularly unsatisfactory aspects to this stand-off. The first is that even if the junior doctors' pay claims were met in full, many would still go overseas. It is wrong for the doctors to suggest otherwise. New Zealand, quite simply, cannot compete with Australia, which is recruiting vigorously to overcome a shortage of doctors. Secondly, negotiations between the district health boards and the Resident Doctors Association have proceeded in a way that is untenable, given the impact on the sick. A spokesman for the health boards said that, most recently, an offer to meet the junior doctors' union again was refused unless the boards increased their offer. The boards have refused to do this because it would lift the pay increase to junior doctors out of line with settlements with other workers.
This posturing might be acceptable if hospitals were in the business of producing widgets. They are not, and sick people are unable to switch to another supplier. At the moment, they must watch as entrenched positions are slowly unwound, compromises are fashioned, and disputes meander towards a settlement. The very inevitability of the process adds to the level of public disenchantment. In effect, thousands of patients will be put to one side for no significant purpose.
In 2006, when the country last endured a junior doctors' strike, the Medical Council, discerning the public mood, offered a solution. It said such disputes should be subject to compulsory independent arbitration. The council concluded, quite accurately, that health sector groups' propensity for striking had upset any attempted balance between the right to take such action and the requirement to ensure the continued operation of life-preserving services.
The removal of the fundamental freedom to withdraw labour can never be done lightly. But there are several justifications. The most fundamental is the recognition that healthcare, like policing, is an essential service. It would also be a reasonable consequence of the pointlessness of much of the industrial action. Finally, it would be an acknowledgment of the harm to the public of delayed or interrupted treatment. Compulsory arbitration would accelerate negotiations, while making little difference to the final outcome. There would be no losers. Most of all, it would put an end to what has become a tedious spectacle. It is an overdue prescription.
