News

Long march to shorter hours

When junior doctors took industrial action against the imposition of a new contract in 1975 nobody expected it, least of all the doctors. Both the weighty but inert British Medical Association and the minute but hyperactive Medical Practitioners Union were taken by surprise by the anger of the hospital doctors, and their ready ability to organise and act, prompted only by telephone calls and the nightly TV news bulletins.

The MPU quickly galvanised its small hospital doctor membership into action and played a leading role, for a while. The BMA was slower but, once moving, carried all before it, re-establishing its dominance over subsequent negotiations.

The BMA invested resources in promoting the juniors’ case as far as its commitment to consultants’ interests allowed. The MPU organised within the representative bodies of juniors, the Hospital Junior Staffs Committees, and quickly formed the power-house for change, agitating for reduced hours of work at every opportunity.

The result was a plan to phase reduction in hours over five years, but without increasing the numbers of doctors. Shift systems and ‘cross cover’ (greater workload and responsibility at nights and weekends) were promoted as solutions, and local task forces were charged with working out the details.

At this point the campaign faltered. The mutual dependence of BMA and MPU had taken the whole issue into the sphere of committee politics. Whenever MPU activists sought to mobilise juniors they had only limited success, and then only where charismatic local doctors’ leaders worked. The unprecedented action of 1975 could not be replayed, and negotiators found themselves with little room for manoeuvre between an obdurate government, reluctant consultants and a discontented but inactive membership. The phased reduction in hours became elongated, overtime rates intended as punitive were bargained down and the juniors’ leadership found itself isolated from the grass roots.

Hardly surprisingly, the leadership in which MPU members were so prominent was overturned at a recent juniors conference. A new guard has been formed to replace the veterans of the long march, though with the MPU still well represented. There is manifest BMA anxiety at the new militancy, and the government is too far embroiled in the hours issue to pull back now. There are signs that the period of protracted negotiation for safe and humane hours of work in hospital medicine may be coming to an end.