BMA strike ballot – how should Christian doctors respond?

Today the BMA has begun to ballot members on whether to take industrial action over government pension plans. The ballot runs from 15 to 29 May on two questions – firstly whether doctors are prepared to strike, and secondly whether they are prepared to take action short of a full strike. However, the BMA has made it clear that an all-out strike is not being proposed. This is only the second such BMA ballot in the last half century. The scope of the action is likely to be limited to cancelling clinics and GP surgeries, and providing emergency cover and walk in/emergency appointment services only on the day of action.

Opinion seems to be divided amongst BMA members about whether such action is either necessary or likely to be effective in changing the Government’s proposals. Under the proposals, doctors will see their final salary pension scheme replaced with a career average one, the retirement age would also rise to 68 and contributions for the highest earning doctors could reach 14.5 per cent by 2014.

Many point out that even with these proposed changes, many doctors will not see a drastic reduction in their pensions, although for many working part time the reduction in the size of pension and the increase in contributions may be proportionally more considerable, and the rise in retirement age will affect many seeking early retirement. Others feel that, even if there were a vote in favour of industrial action (as recent polls suggest is likely), few would actually take action in practice, especially if the turnout was low (although it is hard to know how widespread this feeling is).

However, the Government is adamant that there is no better deal on the table. The BMA, meanwhile, are adamant that the current proposals are unacceptable. A deadlock has been reached, and this vote will be key in determining whether there is any mandate to put further pressure on the Government to make a better offer.

Many CMF members will be weighing up over the next couple of weeks how or whether they should vote. So let’s look once again at some of the issues around how and if Christians in the medical profession should get involved in industrial action.

To start with we need to ask the following questions (borrowing somewhat from Augustine’s ‘Just War’ theology) before going any further:

1: Is the cause just?

2: Have all other reasonable measures been exhausted?

3: Will the industrial action be of finite scope and duration (ie. will there be a clear set of boundaries

and an end point)?

4: Will it adversely affect patients and vulnerable people?

5: Will the likely outcome of the action be more beneficial than the likely outcome of not taking action (not least, is there a reasonable chance of success)?

To stand up for a just cause is always an obligation for Christians (eg. Isaiah 1:17) – although that is usually fighting a cause for the sake of those with less voice, power or privilege than ourselves. Nonetheless, if we, or our colleagues are likely to be facing significant hardships in retirement because of these new pension arrangements, then we must consider how we can act to change the situation.

But as we have blogged previously, it is hard to know if this dispute fulfils any of the above criteria – for doctors at least. Whilst it initially looked as though that those on lower salaries, such as ancillary staff and care assistants, would be disproportionally affected by these changes, it seems that the new proposals no longer affect those on the lowest incomes.

The Government remains intransigent, however, as do the unions, so it seems that all other options have been exhausted. It therefore looks unlikely that any action will have any effect on the Government, especially the modest action being proposed by the BMA (which looks unlikely to cause major problems for most patients). Whether the likely outcome of the action will leave the situation any better than before remains open to question.

Once again, I would lay out the following biblical framework for thinking through the way we approach this dispute:

Firstly, industrial relations:

Col 3:22 ‘Slaves obey your earthly masters in everything’

1 Peter 2:18 ‘Slaves, submit yourselves to your masters with all respect, not only to those who are good and considerate, but also to those who are harsh.’

1 Timothy 6:1 ‘Let all who are under a yoke as slaves regard their own masters as worthy of all honour, so that the name of God and the teachings may not be reviled’.

Philippians 2:14-16 also encourages us to not be grumblers and moaners in the workplace, but to be a positive influence.

It is clear that Paul and Peter, in writing these messages were urging slaves not just to do their jobs, but to be exemplary, going over and above the call of duty, and to have a positive attitude and spirit in so doing. While this is referring to the institution of slavery, the principles apply equally to modern employment.

Secondly, motivation:

Col 3:23-24 ‘Whatever you do, work heartily as for the Lord and not for men. Knowing that from the Lord you will receive an inheritance as your reward. You are serving the Lord Christ’.

Matt 25:40 ‘The King will reply “I tell you the truth, whatever you did for the least of these brothers of mine, you did for me”

We serve God when we serve our employers (and more importantly, our patients) well. But we are also enjoined throughout the Bible to have a concern for justice and to stand up for those who are disadvantaged or poorly treated: Isaiah 1:17 ‘Learn to do good, seek justice, correct oppression, bring justice to the fatherless, plead the widow’s cause’.

We are also called to make peace where there is conflict – Matt 5:9 ‘Blessed are the peacemakers’ – and to act with good conscience, putting others needs ahead of our own – Philippians 2:3-4 ‘Do nothing from rivalry or conceit, but in humility count others more significant than ourselves. Let each of you look not only to his own interests but also to the interest of others.’

Thirdly, our attitude to authority

In Romans 13, Paul urges the early church to see the governing authorities as instituted by God for the sake of all people, and therefore to act in obedience to them. Clearly Paul is not saying that we must go along with everything that government says and does, especially when it is clearly wrong or unjust – there are examples throughout scripture and the history of the church of God’s people challenging the authorities when they went against God’s way, and standing up for justice and righteousness in an unjust society. However we must be clear that we should not be challenging the Government unless it is failing to act in the interests of what is right and just.

So, in Christian workplace ethics, obedience and service are vital, putting the interests of others first, standing up for what is right, but seeking to honour our employers, and in so doing honour God. We serve God ultimately through serving the needs of our patients in obedience to our employers.

I would suggest that after thinking through these questions and the theological principles, there is one last question to ask when making a decision on how to vote, namely will I be honouring God in taking or not taking industrial action in this instance?

Finally, I would urge all CMF members in the BMA to vote in this ballot after weighing up these issues. To not vote is to tacitly accept the decision finally reached by the majority, but only those who actually vote can shape that final decision.

History, in the end, is only made by those who actually turn up!

Posted by Steve Fouch

CMF Head of Allied Professions Ministries