UK Government Uses Psychology To Destroy Medical Profession

The physicians strike, professional solidarity and the future for medicine

Posted Jan 13, 2016

BBC News and other media are reporting that NHS England claims about 10,000 junior doctors had reported for duty, out of 26,000 scheduled to work the day shift on Tuesday, despite the physicians' strike.

Doubtless the figures are going to be disputed—BBC News says it appears many of those had agreed in advance to come in to make sure emergency cover was provided.

Raj Persaud
Source: Raj Persaud

While the day-long strike of UK junior doctors is now over, bar the shouting, at first glance these numbers suggest a pattern which may have profound implications not just for the prospects of the dispute, but even the future of the UK National Health Service and the profession.

One possible interpretation of this preliminary data is that vast numbers of colleagues seem to have deserted from solidarity with the strikers. Perhaps those on the cusp of more senior appointments wobbled at the last moment when faced with career implications.

The previous overwhelming ballot percentages in massive favor of a strike suggested almost complete unanimity within the profession, so the actual turnout on the day appears surprising.

The latest research into strikes and solidarity, warns these disputes could corrode relationships between colleagues with effects that could endure long after this dispute is over.

A study published in 2014 entitled, "The dark side of solidarity: social norms and social relations in the aftermath of strikes," points to strikes having profound effects long after settlement. Data drawn from the 2009 European Company Survey of approximately 6,000 companies, show that firms experiencing a strike later report lower labour productivity afterwards. This effect stands even up to 12 months after the strike.

This new study by Kirsten Thommes, Agnes Akkerman, René Torenvlied and Marieke Born, report that a strike, as a psychological stress, may also have negative effects on the occupational health and job satisfaction of employees. Previous research had established that strikes impacted occupational health even six months after settlement of the industrial action itself.

Raj Persaud
Source: Raj Persaud

Overt hostilities can persist after dispute settlement between the former strikers and non-strikers. The lack of solidarity in those who crossed picket lines induces sentiments of betrayal in strikers. Strong emotions surface in the form of terms such as "blacklegs" or "scabs."

The problem, these authors point out, is that such sentiments split teams, organizations and sometimes whole communities.

The success of a strike will turn on the critical number of participating strikers. Non-strikers do not experience an income loss and other career implications during the strike, but do profit from the collective benefits yielded by the strike. The fear that there will be many free riding colleagues may be psychologically crucial, dissolving all enthusiasm for continuing with the protest.

It follows there is a strong psychological drive in strikers for controlling the behavior of colleagues during a dispute, ensuring a maximum turn-out. 

The authors of this new study, argue that, crucially, during a strike, employees are able to observe their colleagues’ behavior in an exceptional situation. For example, the extent to which a doctor lives up to the solidarity norm is revealed uniquely during this physicians’ strike. A medical colleague, who chooses to be a free rider while others strike for the collective good, will signal that his or her solidarity is weaker.

This new study, found that the expected proportion of strikers directly affects the anticipated worsening of social relations after a strike. The higher the respondents’ expected proportion of strikers, the less they expect a worsening of social relations between colleagues.

If the turnout of UK doctors for the strike is viewed as surprisingly low, then this research is predicting a significant worsening of relationships within the profession as a direct result.

The researchers in this investigation, from RWTH University Aachen in Germany, and VU University Amsterdam, University of Twente, Radboud University Nijmegen, all universities in the Netherlands, found that if more colleagues are expected to withdraw labour, the less necessary are punishment strategies to induce colleagues to participate in the strike.

Raj Persaud
Source: Raj Persaud

Again this has implications for how those physicians who went on strike are going to treat colleagues who did not. In the run up to next day of industrial action, will they endeavor to induce more to partake?

Perhaps particularly pertinent to this unique recent UK Doctors strike was another key finding of this study; that employees without any experience with strikes fear more a worsening of social relations between colleagues after a strike.

Unfamiliarity with the phenomena of striking may induce a negative perception of its consequences. This may have profound implications for the appetite of physician strikers to persist into further industrial action. Yet there is already more planned to come shortly in the UK.

The authors of this study, published in the Industrial Relations Journal, argue their results suggest that attempts by bosses to prevent the participation of workers may have strong and counterproductive effects in the long run, well after a strike is settled.

From the perspective of management, it might be better to endure a brief strike and negotiate reasonable terms, than to create a destructive split between employees by delaying agreements and hardening the fault line between striker and non-striker.

This investigation contends that these long-term, destructive effects are well documented in other studies: a lack of cooperation, motivation and socially detrimental behavior (such as harassment and bullying) degrade later productivity.

The paper concludes that such hidden costs of conflict need to be taken into account when management decides about risking a strike.

If the British Government is resolved on breaking the profession of medicine in the UK, then sowing the seeds of discord among doctors, may be precisely the hidden agenda behind this dispute.

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