John Roughan: Junior doctors' strike has smell of needless theatre

A friend diagnosed with prostate cancer a couple of months ago was to have his operation this week. I can only imagine what a wait for cancer surgery would be like. Life would be suspended, I think.

Terror would grip at times. Every ordinary thought of the future would bring the shadow back to mind. You'd count the days towards your date in the blessed theatre.

I can imagine that. I can also imagine the thump you would take if there was just another week to wait and the operation was postponed for some incomprehensible administrative quirk.

But I can't imagine having to deal with an indefinite delay at the hands of Deborah Powell's Resident Doctors' Association. This delay is deliberate, calculated, and cruel to those cases the union does not think urgent. Worse, it smells like needless industrial theatre.

It smells that way because Dr Powell has been complaining for as long as I can remember that resident hospital doctors work to punishing rosters and their frequent exhaustion is a danger to patients.

We heard it in 2004, 2003, 2001 and 2000. I haven't checked the previous millennium.

We hear it every time the junior doctors' contract is to be renegotiated and I don't doubt that it is true, though the young medics are in transition to some mitigating career comforts.

Every time the union threatens a strike, we give the doctors our sympathy and public hospitals duly put off all the operations they can for the duration of the dispute.

And every time when the dust settles we suppose the problem has been fixed, but it turns out they settled for a pay rise.

If the safety of patients is at risk from the doctors' rosters, a pay rise is no solution. Those who raise this alarm, then settle for money, discredit themselves.

Dr Powell, a bargaining agent for several unions in the public health service, has been running the junior doctors' negotiations for many years now, much longer than you might expect a consultant to survive if a genuine problem remains uncured.

When that happens, it is reasonable to wonder whether the union wants it resolved. This smells like one of those issues that is more valuable if left to fester, for the public support they can summon when contract negotiations are pending and the pressure that public sympathy can put on the other side.

This sort of theatre is not as common now as it was 20 or more years ago. The two big state services, health and education, are a kind of Jurassic Park of industrial bargaining, the only significant sectors of the economy that were not re-organised along competitive lines in the late-20th century.

Competition has changed the wage negotiating game. Back when trade licensing limited the number of suppliers in every market, incumbents could readily pay a wage rise by boosting the price of the product. Industrial bargaining in that set-up was a circus.

If you look back at newspapers of that time you will notice that strikes and direct action of some kind were on the front page almost daily. Union disputes were a stock item in the news diet, much more than they are today.

You would gain the impression that industrial negotiations were extremely important in those days and they were, for the public, given the ever-present possibility that services could be disrupted, and for the Government, since wage-driven price rises caused national inflation.

But wage bargaining was not very important to companies at that time. They could leave it to organisations representing all employers in the same sector and, as long as any change in pay or other terms of employment would affect them all, none had a reason to worry about it.

Their negotiating was done by a small profession of full-time advocates who had about as much to do with the industries they represented as the average union official had to do with its workers, whose membership of the industry's sole designated union was compulsory then.

Employer and union advocates came to know each other better than they knew their clients. Together they formed a world of their own, a world of ritual animosity across the bargaining table, when industry or worker delegates were watching, but otherwise they were clubby in their shared experiences and mutual regard.

News reporters assigned to industrial relations soon realised that much of what made for ominous front page copy was likely to be mere ritual.

Often you were left with the distinct impression that strikes and suspensions, or the threat of them, were of strategic benefit to the agents of both sides. A strike could make it easier for the employers' agent to get concessions from his clients while a suspension could help a union to sell a softer settlement to its members.

The clock stopped on that game in 1984. As industries were exposed to competition, every company had to watch its costs and unions had to be more realistic.

Witness the alternative business plan commissioned by the union representing aircraft engineers when Air New Zealand decided to reduce that side of its operations last year.

But in sheltered social services you can still see dinosaurs doing what they do. Dr Powell is spurning proposals from district health boards to try once more to work out sensible rosters.

She argues that a pay rise can stop the loss of one in four medical graduates to other countries, though it has never worked that trick before. She would say it was simply not sufficient. It never would be. That's the beauty of it from a bargaining point of view.

Not all junior doctors approve of the union's tactics. Their tough, two-year hospital stint can be seen as a public service, a gesture, if you like, to taxpayers who financed two-thirds of their medical degree.

It's an ordeal that will be a comfort to recall in those quiet times in carpeted consulting rooms when the insured patients have been seen, the week's surgery has been done, the waiting list is the Government's problem and the rewards of a specialist practice might seem guiltily good.