The junior doctors are without doubt the very backbone of the NHS. They span from the newly graduated medical students to the most senior postgraduate trainees who are about to embark on a definitive post as a hospital consultant or a general practitioner. In England alone they amount to some 54,000 bright, articulate and highly motivated individuals who have chosen a career of care and compassion and they remain a national treasure held in high regard by the sentient public. Alas, the ‘sentient public’ does not include the majority of career politicians, nor the privileged elite who would not be seen dead in an NHS facility and the mindless media who do not care anyway. Am I subtly introducing some evidence of bias here? Surely not. Of course, not all junior doctors are angels and some will progress to be clones of a latter day Sir Lancelot Spratt, but for those who take the time and effort to listen to the debate about the issues you will realise that current conflict between the junior doctors and Her Majesty’s Government is NOT a minor issue. Indeed, it is a mighty battle of good against evil.

The Evil is in successive governments who have used lies and spin to emasculate the medical workforce and burden the NHS with crushing financial commitments, from which no-one benefits apart from business people and shareholders who see the NHS as a cash cow. For those who do not understand why an increase in funding has failed to provide a proportionate increase in services it is important to understand the basics of PFI ( Another white elephant that actually had the support of the BMA for some time was the notion of having a consultant-led service. Perhaps this could have happened at one time when North Sea Oil revenues were rolling in and there was a massive increase in NHS funding, but so much of this has been wasted on management structures that are unproductive and IT aspirations that are criminally fraudulent.

Now the junior doctors are taking on the Government juggernaut in the same way in which the few, the mighty few, took on the Luftwaffe in the Battle of Britain. The analogy is not extreme and the consequences of inaction are potentially dire. Dr Rachel Clarke so poignantly and eloquently stated in her appearance on the recent Newsnight program that of course no doctor in the UK wants to go on strike.  However, until and unless the Government and in particular the Secretary of State for Health, Jeremy Hunt accept that the proposal of running a seven-day NHS with five days of funding and resources is fundamentally unsafe and unsound, the lesser harm of a strike is far overweighed by the devastating harm of allowing the government to pursue its dishonest and dangerous policies.

Going back to the PFI issue, it is a salutary reminder of those who use short-term benefits to hide long-term liabilities; major proponents were the World Bank, the IMF and the CBI! The same elitist groups who favoured ‘remain’ in the recent Brexit referendum.

The junior doctors, as a group, must fight for their principles and in doing so must make sure that their principles are right. I hear on the radio and read in the newspapers the comments from the ignorant troublemakers who like to quote the Hippocratic Oath and make the oft repeated error that it contains the phrase “Primum non nocere”. Quelle ignorance! Do they not know the difference between Ionic Greek and Latin! But seriously, do no harm does not mean do nothing. The junior doctors must strike, to save the National Health Service.

Evil exists. And the capacity for evil to exist and flourish when power is abused is precisely why we have professional ethics. The professions do have power in terms of exclusive knowledge or skills, and that is why professions need to be regulated. So I briefly return to my ongoing exploration of the lack of regulation of the medical and legal professions in Hong Kong. We have looked at the gross failure of duty of care that has led to a young girl’s brain being destroyed through lack of oxygen. We have looked at how two medical experts provided false and misleading reports aimed to exculpate the perpetrators of this death and now we look at the legal architects of this immoral crime. I will focus on this in the next blog, but as I have indicated elsewhere I am interested more about why people do what they do than what they actually do. This inevitably leads to some speculation and we have to be careful when we speculate. This is moving out of the realm of verified fact. But I think the legal profession can be “hoisted by their own petard” in this situation: where verifiable facts are not available I shall consider the probabilities and perhaps leave you, the reader, to weigh up the balance. The legal ‘balance of probabilities’ is a phrase much loved by those who pursue law at the expense of justice.

Andrew Burd (Prof)

The Chinese University of Hong Kong.

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