Ahead of next month’s planned industrial action by British doctors, the British Medical Journal has published research that suggests patient fatalities are unlikely to increase due to the strike. A study by Harvard Medical School and Brigham and Women’s Hospital shows that in high-income countries, “patients do not come to serious harm during industrial action provided that provisions are made for emergency care.”
Countering concerns that patients may be put at risk by the walkout, the BMJ article reports that during previous doctor strikes, death rates remained the same, or decreased in developed countries. This is, however, contingent to strikes being organised in a way that ensures patient safety is not compromised. The research rejects claims by Health Secretary Jeremy Hunt that the strike will inevitably expose patients to serious harm.
However looking at data from previous strikes, the researchers found no evidence to support claims that industrial action harms patients. One of the studies examined the consequences of a strike by physicians in California in 1976. During that action, care for all but emergency cases was withheld for five weeks, during which the mortality rate fell. A second analysis of deaths following a strike by 73 percent of doctors in Jerusalem in 1983 found no increase in mortality. Similarly in Croatia in 2003, doctors went on strike for four weeks with no spike in patient deaths.
The Journal article notes that the continued provision of emergency care likely ensures no change in death rates during industrial action. In the cases where mortality rates dropped, the article speculates this could have been due to non-urgent surgery being cancelled, or that doctors tend to be better rested during strike periods.
However, the article cautions that industrial action could still cause harm or inconvenience to patients. “Some doctors will always feel that industrial action is fundamentally inconsistent with their professional obligations because of its inevitable impact on patients,” it states. “However, in balancing their competing priorities, doctors in high income countries can be reassured by the consistent evidence that patients do not come to serious harm during industrial action provided that provisions are made for emergency care.”