A panic measure with hidden hazards

Abstract

The first important strike in the NHS was in 1968 when medical laboratory technicians stopped work for one day over a pay dispute. Two years later elec tricians took industrial action and since then almost all the major groups of Health Service employees?in cluding doctors and nurses?have taken part in some form of protest action. So from perhaps the most quiescent and undeveloped industrial relations system among State enter prises the NHS has become one of the most active and strike prone in Britain. Though the widespread national disputes over pay that oc curred last winter may be more memorable, the most typical strike is localised, unofficial, and usually focused on issues quite unconnected wTith pay. Because local disputes of this kind were becoming common place the former Secretary of State for Social Services, Mr David Ennals, took the initiative of calling a round table conference of those who were principally concerned?repre sentatives of the unions (including the BMA) and the manage ment.1 The conference discussed whether agreement could be reached on a new NHS disputes procedure which would cut to a minimum the number of disputes that led to unnecessary industrial action. Afterwards, in October 1978, the DHSS published details of a proposed procedure.This was designed to cover local disputes and problems other than those concerned with pay. The DHSS statement gave as examples of the issues to be covered : duty rotas, staffing levels on the wards, arrange ments for parking bicycles, or even personality clashes between staff. In short, it was intended to cover a wide range of residual matters outside the Whitley Council system, most of which had been traditionally decided by management without any kind of formal consultation or negotiations with representatives of the staff affected. Since the round table initiative the proposed local disputes procedure has been under negotiation by unions and manage ment. While some differences of opinion remain, the manage ment and the staff sides agree on the basic guidelines. Some of these are unexceptionable. It is proposed, for example, that disputes should be resolved at the lowest possible operational level with the minimum of delay; and that there should be an agreed four-stage procedure for referring the dispute upwards if the local manager cannot resolve it, firstly, to the next layer of management, then to the chief officer of the employing authority, and finally to the employing authority. Such disputes procedure is a common feature of industrial relations machinery in other organisations and industries. The proposed procedure also contains what is commonly known as a status quo provision. This requires that the arrangements extant before the dispute should be reintroduced until the dispute has been resolved? namely, the unions should withdraw sanctions and the manage ment should unscramble any change in working practices it had introduced. The intention is to provide a conciliatory climate in which the dispute may be resolved.