The Right To Strike: Why Doctors Should Know the Small Print

The time when 84% of the vote wasn’t enough…

Did you know that in the UK, there's no positive constitutional legal right to strike? Taking industrial action is actually only legal if you jump through a series of hoops organised by a trade union. First, a union can only call for a strike if it holds a properly organised postal vote, and at least 50% of members must turn out to vote. Oh, and it only counts if the dispute is with your direct employer, which in today’s world of subcontractors, umbrella companies, and agency workers, can be as difficult to interpret as a badly written Op note.

Take the recent dispute between the Royal College of Nursing and their employer. Despite 84% of those voting in favour of strike action, the turnout was just 43%. The result? No strike. That’s right—thousands of nurses were ready to take action, but the turnout rules prevented it.

This is something doctors should definitely keep in mind during future pay disputes. In the last pay dispute, we saw strike fatigue setting in and engagement diminishing with every repeated vote. Many Doctors assumed the vote would pass easily. But as the fine print shows us, it’s never that straightforward.

Understanding strikes is all about grasping the power balance—or lack thereof. Since the 1980s, the law has been handing employers what feels like a cheat code, giving them the upper hand at every turn.

Slow postal ballots have become their best friend, letting them make big changes (like redundancies) before workers can even think about legally striking. And with companies now operating as a maze of different entities, trying to figure out who’s really your boss can be more puzzling than needs be. Us medics need to keep paying attention—avoiding apathy is our only defence…

Gifts and Gratitude: Where to Draw the Line

It's always nice to feel appreciated for your hard work, but when it comes to accepting gifts from patients, things can get a little tricky. Naturally, it all boils down to maintaining that fine balance in the old doctor-patient relationship.

According to BMA guidance, any gifts over £100 need to be registered—so, no sneaky Rolex flying under the radar. Meanwhile, the GMC makes it clear that doctors shouldn’t accept anything that could affect patient care. No "accidentally" finding a £10 note in your scrubs in exchange for fast-tracking a CT scan. The ethics here can be a bit subjective, though—it’s not always easy to know where the line is. A general rule is that If a gift ‘seems’ like more than just a token of appreciation, you might find yourself in hot water.

We all know the tricky part is the grey area and the subjectivity of words like ‘seems’, that’s the real challenge. But one thing’s for sure—no all-expenses-paid Mediterranean vacations in exchange for a quick diagnosis!

Do We Need to Beef Up Our COW Supply on the Wards?

How technology in the NHS costs each of us thousands of hours…

Our new health secretary, Wes Streeting, has announced his master plan to turn the NHS into a 'medical technology superpower'. Fingers crossed it involves computers that actually turn on.

Many of our Oncall community have clocked up years in the NHS. But here’s a question: how many hours do you think you’ve lost to waiting on an NHS computer? A typical day may start with five minutes searching for a computer on wheels (COW), followed by a couple of minutes waiting for it to let us in and then another five minutes waiting for the desktop to load to check the CRP.—only for the battery to die during the ward round.

Post-lunch, the nurse has taken the COW for medication rounds, leaving no computers available, wasting another fifteen minutes. When you finally get the pharmacist’s computer, you are promptly told it’s “pharmacists only”. You walk back to the Doctors office to find another computer and wait seven minutes for it to load.

This adds up to hours of wasted clinical time per day, or around thousands of hours over a resident doctor's career. Why on earth can the NHS not issue us laptops that connect to local systems wherever we rotate, or provide more COWs reserved for clinicians? If offering rotational staff a laptop proves difficult, perhaps offering laptops to permanent ward staff could be the solution, allowing the COW to be used by the rest of the team?

“Over-investigating, seniors asking for scans that us juniors need to chase up is frustrating. I’m not saying it’s right but perhaps the system makes them like this. Investigating a sub-arachnoid haemorrhage is probably a lot easier than explaining why you haven’t in the coroner’s office”

“Cardiology is an area of medicine with a huge evidence base and research culture underpinning it. This leads to many doing PhD/MD which adds 2-3 years. In some deaneries research is mandatory.”

“If a farmer attends A&E and hasn’t finished the job they were doing then free up a resus space immediately, there’s something big going on!”

Email us to share what’s on your mind in our next issue!

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At the OnCall community, we like to chat about money too—shout out to Damian from Damiantalksmoney, who shared a fact we want our community to know: 1 in 7 UK adults have no savings, which amounts to about 7.9 million people. Even more concerning, 40% of UK households are just one paycheck away from financial disaster. Enter the concept of an emergency fund—your financial safety net.

Many think the odds of something going wrong today (like your car suddenly quitting) are low. However, over time, the chances of facing a financial hiccup rise dramatically. Having an saved-up emergency fund that covers 2-3 months of expenses isn’t just smart—it helps you avoid panic-selling investments or dipping into long-term savings. And the best return on your investment? A peaceful night’s sleep.