15/02/2016 09:12 GMT | Updated 13/02/2017 05:12 GMT

High Stakes Poker - 'All In'

The government has gone 'all in' and is imposing a new contract upon the junior doctors. Despite 98% of doctors saying no to the contract, two rounds of industrial action and multiple protests the government has declined to pay heed and unilaterally enforced their vision. The doctor's trade union, the BMA, must have known this was in the offing as it has long been muted. Thus, an emergency escape plan for the 'nuclear option' of imposition will have been drawn up in advance. The possible avenues available are explored below.

The first natural and knee-jerk reaction would be for relentless industrial action in protest. Fighting fire with fire would certainly sate the outpour of pent up anger and exasperation of the 53,000 strong workforce. However, continued striking would dent the pockets of the middle-aged doctors who have families and steep debt to think of. Aside from financial implications, the public support could also wane when it has an increasing impact upon their healthcare, even with the avid cover of consultants.

Interestingly, the legal action route has already started. Part of a disagreement between an employer (government) and employee (BMA by proxy) in varying a contract of employment is involving a mediator - in this case Acas. Doctors, by law, could say that they're working any new terms under protest (treating the change as a breach of contract) or are able to take their case to an employment tribunal. The other two legal options, resign and claim constructive dismissal or have a right to refuse to work under the new conditions, are discussed in the next paragraph. The government has moved to block the likeliest of these, working under protest, by staggering when the doctors take up the contract. This option will therefore be logistically complicated for the trade union to organise and involve uncertainty to the individual doctors. The second process of taking 53,000 cases to an employment tribunal will be extortionately expensive for both sides, but could be highly effective if successful.

The incredibly high stakes option would be mass resignation. This essentially flaunts the power and backing of the trade union by its members. The government would effectively be held to ransom and unless they concede to demands hospitals nationwide would stutter to a halt with only emergency care possible. The historic cat herding nature of medical professionals will be a stumbling block, and concern over training numbers and progression will be at the forefront. However, the one thing that has shone through during this conflict has been the unification of the doctors, and with progressively more colleges speaking dimly of the imposition the threat to training could be negated. Added to this, the financial detriment would be mitigated, as there are some months to save in preparation for August - the likely timeframe for such action.

It would not be surprising if we did see some further industrial action as a show of defiance, however, prolongation would be unwise. Perhaps the mandate and threat of mass resignation would be preferable. The process of securing a strong result and subsequent threat of implementation would keep the debate in the public eye and be bargaining tool enough for the government to back down and concede on key points. If this fails the legal action would be the only costly tool left in the book, barring individual acts in seeking employment in anywhere but the NHS. One thing is for certain; the future is muddy and supremely ugly.