KEY POINTS:
Once, health workers thought long and hard about whether they were ethically entitled to strike. They worried about conflicting obligations and, at a practical level, the use of sick people as bargaining chips. Not any more, it seems. This year, junior doctors, radiographers, radiation therapists and now medical laboratory workers have walked off the job, seeking better pay or conditions. In so doing, they have attracted the antagonism of the public - and all for industrial action that serves no real purpose.
The popular reaction is understandable. A quick glance at the consequences of the laboratory workers' strike confirms as much. It has led to elective surgery being postponed for more than 1000 patients. Some cancer patients will have a long wait for rescheduled surgery, knowing all the while that the disease could be an increasingly malignant presence. Many people are being put at risk because they are being admitted to hospital without the usual tests. Faced with imprecise diagnoses, doctors have little option but to prescribe more antibiotics or other drugs than usual.
These strikes are unusual not only because of the repercussions in terms of potential mortality and morbidity, but because the third party is not the consumer of a product who can switch to another supplier. The only recourse is to apply pressure for the settlement of a strike or, in the case of frequent industrial action, a mechanism that prevents its recurrence.
The prevention state has been reached. A system that tries to balance the right to strike with a requirement to ensure life-preserving services is now seen as being out of kilter. Early last month, as radiographers prepared to walk out, a Canterbury District Health Board member called for health workers' strikes to be outlawed. Alister James said healthcare should be deemed an essential service, putting workers on the same footing as the police, who are forbidden to strike. His call was echoed this week by the Medical Council chairman, Professor John Campbell, who suggested that compulsory arbitration needed to be considered.
This will not sit well with a Labour-led Government, which doubtless would cite the fundamental freedom to withdraw labour. But it needs to acknowledge the frequency of health-worker strikes and the increasing level of public discontent as stressed patients find themselves at greater risk. It should also ponder the essential pointlessness of this industrial posturing. While people suffer and hospital resources become misaligned, striking workers go through a process that leads inevitably to mediation and, finally, settlement. There is no evidence the junior doctors gained any benefit from their five-day strike, forerunner to meandering negotiations that finally ended late last month.
One answer might be to set up an independent body that would determine what levels of services health workers should maintain during a strike. These would vary, depending on the duration and location of the action and who was involved. The body's task would be to ensure no patient was placed at greater risk because of interrupted medical attention.
But there is more appeal in a direct approach that recognises healthcare as an essential service. Disputes should be subject to compulsory independent arbitration. The Medical Council has read the public mood accurately in suggesting this solution. In practice, it would make little difference to the outcome of disputes. The effect would be to accelerate the negotiating process. Health workers' interests would not suffer, and neither would the welfare of long-suffering patients.
