By Robert Campbell

As the Government and the BMA wrangle with the NHS, the latest decision by junior doctors to continue with strike action continues to hit the headlines. There are always two sides to every argument but it seems that public sympathy in many households, including mine, is fading rapidly, as the protagonists appear to be losing the moral high ground.

Duty, devotion, vocation?

You have to ask yourself why individuals choose the medical profession. Years ago training to be a doctor was considered to be a ‘calling’ and it was understood that sacrifices would have to be made, initially. The idea of a caring vocation now seems to be in the distant past although doctors still do devote their working lives to caring for patients and have a right to expect decent pay and good working conditions.

A great deal of time and money is spent training doctors, and in their early careers the rewards may not be obvious with the effort needed from them; often beyond the call of duty. However, night and weekend working are no longer desirable and doctors want the freedom to work limited hours but still earn well. Should they expect a high salary early on, a generous pension, the right to a family life and a good work/life balance? I certainly don’t have an answer to this conundrum.

Some doctors expect that they can decamp abroad whenever they want in search of higher pay and better perks, but UK taxpayers’ investment shouldn’t allow them to go abroad just when they want to.

Stalwart of their profession or a grinch with a meal ticket?

You will all know and meet those doctors who are devoted to their work and their patients. They are polite and supportive of their staff, not picky or bullying. For them, the money is secondary. They rarely complain and are very popular. They spend time with their patients, even visit when they don’t have to, they diagnose illness and refer you promptly, but now and again, like all of us, they have grumpy off days.

I have to say that in recent years my family and I have had outstanding treatment and care from devoted and caring doctors who were prepared to spend time answering questions and giving full explanations. This standard of care does not fit into a 9 to 5 slot.

Then there are those who you end up battling with as the words “what do you expect me to do” spout forth. Spending time with patients is a nightmare for them. They see the job as a meal ticket. They plan their working days with the catchphrase, “I can’t deal with that today” and grumble if asked to do more – they just want to be off. These people are life’s time managers.

Taxpayers’ revolt?

Taxpayers’ money isn’t a bottomless pit. In my view the reason that past attempts to rein in NHS spending haven’t worked is down to the arrogance of Finance Managers and the failure of GP fund-holders to control spending.

The solution lies in positive rationing. No longer should the NHS fund maternity care for recently-arrived overseas visitors, or for cosmetic procedures on religious grounds, or IVF, whilst denying cataract operations. It may be controversial but not all medical treatment can be free for all. Free at the point of delivery should only apply to what can be afforded.

Junior doctors’ demands and the excessive salaries of NHS Trust Chief Executives have to be met – how are these to be paid? Rationing or patient charges?