Anyone who has either a member of the NHS or a medical student as a Facebook friend is likely to have learnt two things yesterday: the imposition of a new contract on NHS junior doctors and just how deeply unpopular- indeed reviled- that contract is. A little digging and listening to British Medical Association representatives also reveals that this whole struggle between the BMA and the government is to do with much more than just junior doctor contracts. It is also informed by underinvestment in the NHS and the privatisation of NHS services, both of which are the result of (broadly ideological) austerity.
None of us can predict the future and foresee whether the imposition of a contract over which the BMA (who have first-hand experience of practicing in the NHS) has already vowed to fight the government (who almost wholly don’t) will become emblematic of this Conservative administration or fade away from public memory as it is snowed under by the next extreme and damaging policies invariably around the corner. For the most part, however , I’m inclined to think that it will have a lasting impact, and has been a very strange fight for the government to pick.
Barely anyone viscerally cares about vulnerable welfare claimants, struggling immigrants or low-paid public sector workers who are all too easily coloured as the people ‘proper businesses’ didn’t want to employ. It has been easy for the government to cut away at their livelihoods and for people to engage in very dubious moral gymnastics and cognitive dissonance to defend such action. After all, people , especially voters, who are far more likely to hail from wealthier backgrounds, come into meaningful contact with those actually affected by the Bedroom Tax or the increased income threshold for migrant spouses.
However, we all come into contact with doctors. We all get sick, and most of us are likely to have required/require an operation or have been/be present at the delivery of a child. The quote from Nigel Lawson that the NHS is “the closest thing that the English come to a national religion” is well-known, and even Katie Hopkins in her bizarrely obfuscatory and wildly inaccurate column on the doctors’ strike acknowledged the personal debt she has to the NHS. Nearly all of us owe a huge amount to the whole NHS, including the junior doctors who work tirelessly and endlessly (far more than the apparent saviours of our economy, the bankers). Attacking the lynchpins of our hospitals with a contract that will stretch them to the limit, not to mention lower their morale, is hardly likely to curry favour with the public. Just wait until the first deaths as a result of exhaustion occur.
Secondly, doctors are the people that especially the middle-classes, the bastion of democratic expression, meet on a regular social basis. They are there, down the your suburban street, at the tennis club or at the craft ale stand at the village fete. They are seen as one of the prime traditional ‘community actors’, respectable and educated, motivated and intelligent. People respect the opinions of doctors, and the ones to whom doctors are disproportionately likely to be offering their private opinions are fellow educated, middle-class, classically Tory-voting friends.
You don’t bite the hand that feeds you, and the government strategically should know better than to attack uniformly well-respected members of communities up and down the country. It seems more than likely that, if attitudes such as those which the government is exhibiting continue until 2020, we will see the junior doctor, the young professional with an intense university education and secure career prospects, putting in a vote for parties who are the Tories worst nightmare.