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Junior doctors’ industrial action

Royal College of Physicians president Professor Jane Dacre's special bulletin on junior doctors' industrial action.

The result of last week’s British Medical Association (BMA) ballot in overwhelming support of industrial action clearly demonstrates how bad morale has become. I am sad that things have reached this stage. It is worrying for patients, the public, the NHS and the medical profession.

Every vote was a carefully considered personal decision, made by a professional whose daily business is about evaluating evidence, acting ethically and making sophisticated judgements. This makes the current situation all the more potent and stark.

The need for our trainees to feel valued, supported and motivated, and to be heard, is evident – as is the fact that they are a long way from this position. These are all essential components of the transformation agenda.

It is very unfortunate that the profession has reached this stage. It is clear to me from meetings with members, fellows and trainees (including the RCP’s own Trainees Committee) across the country that:

  • patient care is vulnerable in the longer term to the degradation of morale and motivation of healthcare professionals and, in the short term, to strike action
  • our trainees must feel valued, supported and motivated to deliver high-quality care
  • no progress or solution will be reached without negotiation
  • confidence in the profession, and ultimately in employers and the government, is placed at serious risk by continued failure to resolve these issues.

I still hope that we will not reach the stage of industrial action, and I urge both the BMA and the government to be transparent and leave no stone unturned in seeking to avoid a strike. This can only be done by working together, whether through direct negotiations or through an intermediary, to develop a long-term solution that supports doctors to deliver high-quality care.

While the result of the ballot was clear, from speaking to a range of individual members and fellows it is apparent that, as a profession, we have mixed views on industrial action – whether or not, and how, to take it. It is clear that this is a personal matter which every individual must consider very seriously, within an ethical framework that we are all familiar with and trained in. No matter what happens over the coming weeks, I expect us to rely on our professional values, to ensure that we put patients first, and also to demonstrate respect for each other.

The RCP will follow the situation closely and will ensure that its own activities and services reflect the needs of patients, members and fellows on strike days (if they take place). We will cancel and reschedule activities and events so that there is no obstacle to physicians’ availability to provide care on strike days. We also expect our fellows to continue to support, mentor and guide juniors through this difficult time.

The result of the ballot is very worrying for us all, and over the coming weeks we will face a range of challenges. Please refer to the General Medical Council and BMA guidance, speak to your trust and – most importantly – speak to each other and have confidence in your underlying professional and core vocational values, your experience and your training.

As clinicians we have a duty to our patients, but as a profession we can only do this well when we work together in the best interests of those patients. Even in these difficult days, remember what made us become doctors in the first place.