THE prospect of doctors, whose role is so vital, going on strike is particularly unsettling.

Relief at the decision yesterday not to go ahead with strikes by hospital doctors this winter, however, must be tempered. The result of the ballot by the British Medical Association (BMA) has revealed considerable numbers would be prepared to go on strike and more, including consultants, would be willing to take industrial action short of walking out.

It is clear from this exercise that hospital doctors in Scotland are both angry about changes to the NHS pension scheme, which will require them to work longer and pay more in contributions, and frustrated at the failure of the Scottish Government to offer an alternative to these conditions imposed in England and Wales by the UK Government.

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In June, doctors throughout the UK, including GPs, took industrial action for the first time in nearly 40 years in protest at the pension reforms but failed to force the UK Government to back down on the reform programme. In the breakaway ballot by the BMA in Scotland this month, 72% of junior doctors and a majority of staff grade and specialists in hospitals were prepared to strike. Consultants rejected a strike but were in favour of other industrial action, with only public health doctors against any form of action. All these results, however, must be seen in context. Fewer than half of hospital doctors voted and, in the case of junior doctors, only 28% took part.

The low turnout may be due to the June strike failing to achieve new terms. However, it is also a reflection of a great reluctance on the part of doctors themselves to walk out even when there is emergency cover.

They are right to hold back. While large numbers of their patients are unemployed or restricted to part-time or temporary work, most medics are very well rewarded. Increased longevity means that almost everyone will have to work longer and contribute more to their pension schemes. Doctors, however, will remain among the dwindling number who can still look forward to a pension based on final salary. Nevertheless, there is, a case for re-examining whether they should have to work until the age of 68 when other frontline public sector employees can retire sooner. For example, there is a proposal that the normal retirement age for the police should be 60.

The strike ballot by the BMA in Scotland was presumably intended to force the pace of negotiations with the Scottish Government that have been going on since March with little or no progress. The Scottish Health Secretary, Alex Neil, is relatively new in the job but he has stated that he is opposed to the UK Government's policy of large and rapid increases in pension contributions. Failure to come up with an alternative for Scottish doctors under Scotland's NHS pensions scheme, however, suggests that Mr Neil cannot secure the funding to match the soundbite.

Both sides must regard the ballot result as a mandate to abandon empty promises and threats and return to the negotiating table to find a fair and affordable solution.