Diagnosis: undervalued. A psychoanalytic exploration of doctor strikes in the British National Health Service, 2023-2024

Abstract

This work explores recent industrial action by doctors in the British National Health Service (NHS) through a psychoanalytic lens, exploring psychosocial context and the role of unconscious phantasy. Doctor strikes are conceptualised as a protest against devaluation. Expressed motivation for strike action, a real-term pay reduction, is symbolic of deeper societal devaluation of healthcare and those who provide it; pay restoration serves as a phantastic object through which amends can be made. Layers of holding and containment are identified, from the function of the health, or rather anti-death, service in containing deep-rooted anxiety around illness and death, to the holding, typically in limited supply, experienced by staff members working in health services, to the containing function individual staff provide for their patients. Strike action shatters the NHS as a container, primitive anxieties emerge and primitive defences are activated. Anger expressed through protest causes an impact, expressing a demand to be recognised and valued. The time and space of the strike has generative potential; implications of breaking the 'broken' NHS give impetus to finding a way forward. Exploration of unconscious phantasy underpinning industrial action and public response may bring insight to negotiations, enabling grounded and coherent solutions to be derived.