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The Traitment of Junior Doctors

Stephen White

It occurred to
me, that the most prominent current industrial dispute in England, between the Government and the Junior Doctors, might be an excellent vehicle to analyse how Millennials (defined typically as born after 1983) negotiate, and whether Millennial traits have impacted on the negotiations.

For non-UK readers; ‘junior doctors’ includes doctors from the time they leave medical school to the time when they are appointed as ‘Consultants’, typically about 10 years later. There are about 55,000 of them, a very important component of the medical provision in England (the dispute does not affect doctors in Scotland or Wales). The dispute dates back to 2012, when the employers announced that they wanted to update the terms of employing junior doctors. Negotiations have been on and off since then, but on Monday they broke down and the doctor’s union (the BMA) announced strikes for later this month.

There are some definitional problems. Although most junior doctors would fall into the age range occupied by Millennials, many wouldn’t – they are technically too old and would instead be defined as Generation X. This is reflected in the Junior Doctors Committee of the BMA – for example its Chair is Johann Malawana (born 1980). However, both the JDC member whose portfolio includes negotiation (Aaron Borbora) and their current media darling Yannis Gourtsoyannis both qualify as Millennials. Secondly, the JDA will be getting advice and maybe negotiating instruction from other older BMA officials, including Mark Porter (born 1962) who is Chairman of the BMA Council. 

First the issues: Millennial profiles all cite social awareness and responsibility as a major trait, so we might expect that issues of patient safety and medical integrity would be the drivers of the negotiation from the junior doctors’ standpoint. In fact, although these issue are widely used in their PR, the main motivation is money. The deal on offer from the employers offers a large (11%) increase in basic pay in return for reductions in payments for working at night and during the weekend. The union believe that this will financially disadvantage a significant number of junior doctors. The employers claim that only 1% of junior doctors will be worse off under the new terms; this is true but only because there will be temporary payments to existing junior doctors to maintain their income, and future new junior doctors won’t get these payments. Another important issue for the junior doctors is the removal of guaranteed pay increases linked to years of service. Instead the employers offer is that increases should be linked to training targets, presumably curbing increases to those who don’t do the training or who fail their exams. 

Secondly the methodology: Millennials are defined by their attachment to and dependence on technology for communication. They are the ‘connected’ generation. So their ability to muster their members and use the power of Facebook/Twitter etc is to be expected. It is no coincidence that when they balloted their members in November 2015 to approve potential strike action, as required to do by UK law, three quarters of their members voted, and 99% of those who did approved full strike action. It is because they were being informed and involved and kept ‘on message’ by the social media adeptness of their leaders, much better than the employers (led by Danny Mortimer born 1972 under the direction of Health Minister Jeremy Hunt born 1966) were able to do This has given the BMA a powerful mandate in the negotiations. There are parallels with the situation of Jeremy Corbyn, newly elected leader of the Labour Party, who has been able to initiate substantive policy changes despite opposition from Labour MPs because of the strength of the mandate he has from new party members, many of them Millennials, who supported his election campaign. And in the same way, Millennials admire authenticity and abhor fakery – that’s why they like Jeremy Corbyn, and that’s why their attitude to Jeremy Hunt is so negative.

Finally the outcome: Of course we don’t know what that will be, except that we know that all industrial disputes are eventually resolved. But we do know that another Millennial trait is pragmatism underpinned by a value system, so I expect to see a deal sooner rather than later, but definitely one which meets the priority aspiration of the union (= more money!!)

My conclusion is that either older-school employers will have to wise up to these and other Millennial traits in their own negotiating behaviour or find themselves at a disadvantage which will lead to poorer deals or more industrial unrest.

Stephen White

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