As the BMA ballots its members on strike action, the workings of the government’s spin machine need to come in for an examination
When you think of selfish, over-privileged scumbags being paid far too much for a job that adds no value whatsoever to society, what springs to mind? Is it bankers, corporate lawyers, politicians; or is it NHS doctors?
Doctor, My head is spinning
As the Tory government squares up for a confrontation with the BMA over changes to the contracts of all doctors below consultant grade, the spin machine is in overdrive trying to persuade us that the NHS is staffed with grasping, entitled and overpaid good-for-nothings milking the public purse.
The row has been rumbling now for the better part of a year, with the government shifting its position on a regular basis as each of its arguments have been knocked down or shown to have little traction with the public. The claims made to win headlines and then dropped as soon as they’ve been proven false or otherwise lost their utility include:
- That this is not a pay cut. It is merely a change that requires NHS doctors to work more hours on the same salaries.
- That this is a pay cut, but only for a minority of doctors.
- That they have no idea whether or not this is a pay cut.
- That 10pm on a Saturday does not constitute anti-social hours, to which Private Eye responded with this gem
In addition, the government has been running a parallel campaign that claims to be pushing for a “truly 7 day NHS” and conflating the issue with that of doctors’ pay. This has lead to people putting their lives at risk by not in to hospital for emergency treatment on weekends because the government’s line has made them think there will be no staff there. So pronounced is this phenomenon that doctors have dubbed it #thehunteffect.
The idealised form of the government’s argument can be found in this remarkable piece of propaganda in Rupert Murdoch’s Sun Newspaper.
Now, painting the government as reasonable and doctors as unionised fat cats looking to keep their cream is a hard sell so it is worth looking at the Sun article in detail because it brings together all the techniques used by the government’s (publicly funded) spin merchants in one neat package. It is also very likely, based on my experience in the ugly world of spin, that it was directly briefed to the journalist by a Special Advisor in Jeremy Hunt’s Office.
The first technique is decontextualisation: the 11 per cent pay offer the article was referred to was not made at the negotiating table it was made through the media on the day that ballot papers went out from the BMA. As the doctors’ representative Johann Malawana observed, it was “megaphone diplomacy” not intended as an actual offer but designed to undermine the doctors position as a pure public relations exercise. The same goes for the claim that doctors have “shut the door” on negotiations. It is true that they have refused to negotiate given that the government is willing to discuss only one of the 22 points they have issues with, but putting forward an unacceptable offer and demanding that 90 per cent of it is acceded to without question before “negotiations” begin is not negotiation at all it is a cynical manipulation of public perception.
The second technique is the conflation of issues: The claim is made that keeping doctors’ pay at present levels stops the NHS from providing adequate staffing over the weekend. This just isn’t true. It is the case that non-urgent surgeries only take place on weekdays, but emergency care is available 24/7. While this particular article stops just shy of making the claim that there is no 7-day NHS, the claim has been given currency by articles in other newspapers and it taps into that latent understanding.
The third technique is comparing two different things as if they were alike: “Junior Doctors… are well paid compared to other public sector workers.” Yes, they are, compared to cleaners, traffic wardens and even nurses. This is because they are more highly trained and skilled. The idea that someone who is more skilled should be paid more is one that should be relatively easy to fathom.
The fourth is an appeal to prejudice and envy: By accusing the doctors of acting in “typical trade union style” they have been placed in a discourse that harks back to the winter of discontent, rubbish piling up on the streets and general strikes. The bad old days, in other words. The appeal to envy is straightforward enough to dissect – doctors have an overtime gravy train. The typical Sun reader does not. That is unfair and so the gravy train must be taken away.
And the final, most pernicious technique is dereliction of duty: This is summed up in the last line condemning the BMA because “it puts its members financial interests ahead of the public’s needs.”
It is worth bearing in mind that the row is not about new contracts for people just qualifying as doctors, but existing agreements. If your boss came to you one day and told you that your contract was being unilaterally altered to make you work longer and less sociable hours for less money, you would feel entitled to withdraw your labour because that was not what you signed up for. If your boss then said “you can’t strike because your skills are too important” you would wonder why they weren’t paying you what those skills are worth in the first place.
What is disgusting about this is that every NHS doctor is already taking a hit because they are working for the NHS at much less than the market rate for their skills, generally because they feel a sense of duty towards their fellow human beings. Hunt appears happy to use doctors’ consciences against them while appearing blissfully unencumbered by the Department for Health’s own duty of care towards its employees, leaving both the government and the Sun in the incongruous position of supporting the anti-capitalist stance of paying people less than the market rate for their wages.
[Addendum: It has been pointed out to me since this article went live that junior doctors can’t choose their overtime as the Sun article asserts so we can add “bare-faced lies” to the techniques listed.]
Politician, Heal Thyself
The interesting thing about the whole row is quite apart from the government’s position being cynical and constantly shifting, it is terrible politics and terrible economics. It also cuts to the heart of wider debates on how our society judges value.
Now it might be the case that doctors are on a publically funded gravy train and are destroying the NHS with their greed (it isn’t) but even if it were, I personally would rather than the person reattaching my arm after it has been severed by falling machinery or saving my child from meningitis wasn’t simultaneously worried about their mortgage or how they will pay for their daughter’s school uniform.
After all, the same government that claims to be on your side against grasping, greedy doctors has cut the 50p tax rate, wants to sell the public stake in RBS at a discount, is giving a free ride to millionaires through changes to inheritance tax and put forward a bill to cut tax credits that was so egregious that even the House of Lords – hardly a bastion of left-wing agitation- could not stomach it.
The people who have benefitted from these policies are sometimes called “wealth creators” in the hope this will distract from the fact that so much of the wealth they create either ends up in their own pockets or in political donations. Doctors, by contrast, do not create wealth, they merely help our workforce to be healthier and happier (not to mention more productive) for longer. A form of value those in power seem unable to process. In fact, for a government that prides itself on being stuffed full of business-minded, results-oriented people the Tory stance also betrays a lack of understanding of the basic rules of labour flow and the relationship between pay and conditions and the retention of skilled workers.
Unlike tube drivers or steel workers, Doctors do not fit easily into the bracket of bolshie militants. Many of them will be Tory voters or the children of Tory voters and all of them are articulate professionals both able to make their case and to access the media to ensure that their arguments are heard by the public. Moreover, most unionised workers have very limited options if things don’t go their way. A London tube driver can’t just up sticks and go to work for the New York Subway, a Redcar steel worker can’t just head off to China if the local works is shut down, but a medical professional with the best training in the world who is already working at 1/3 of the market rate can and will move to other countries if the combination of horrible hours, low pay and unrelenting insults to their value and professionalism continue.
But then, Hunt has already stated that his long term aim is to privatise the NHS so maybe running it down by making conditions untenable for the junior doctors who are its backbone is exactly what he’s trying to achieve.
Doctors have yet to make the decision on whether they will strike. But their considerations should not include the ridiculous notion that the removal of their labour is unethical because the job they do is so important. If their work is so vital, they should be paid a fair amount for it. Unlike bankers who continue to get bonuses when the institutions they work for are part owned by the public, doctors add value and make daily sacrifices to look after the health of the nation. The government’s attempt to paint them as selfish for doing so is deeply destructive and morally bankrupt.