Carry on Striking !

Resident doctors are striking because they say the system no longer gives them what they need to work safely or sustainably. Pay erosion plays a role, but so do long hours, gaps in training, and the pressure of keeping services running when demand keeps rising. It is a dispute about conditions, but also about what kind of system modern healthcare has become.

Strikes create a moment where the familiar routines of hospitals are disrupted and the underlying structure becomes visible. Most of the time the NHS continues to work through sheer professionalism. People go above and beyond to keep things stable. But Foucault would remind us that institutions are not simply practical tools. They develop their own habits and incentives. Sometimes inefficiency is not a failure but a by-product of how complex systems organise themselves. When problems exist, an institution can measure them, plan around them, and justify further activity. When everything runs smoothly, there is less space for oversight or reform. Stability can be strangely difficult to manage. Efficiency, it has been noticed, is rewarded with cut backs. Inefficieciency is the pathway to increased funding.

This is not a criticism of individuals. It is simply the way large organisations behave. Staff, managers, and policy makers all work within pressures that shape their decisions. Over time, the system can become a patchwork of routines that no one person designed but everyone must navigate. Doctors often see this up close: duplicated tasks, multiple reporting structures, and procedures that persist because altering them would require a level of coordination the system struggles to achieve. In that context, the strike becomes more than a stoppage. It breaks the rhythm that keeps the institution moving. Foucault would say it interrupts the quiet expectation that professionals will always compensate for structural strain. When that expectation is paused, the balance of power becomes clearer. The state depends on the cooperation of those who work inside its institutions just as much as the workers depend on the system. The strike makes this relationship visible without needing to assign blame to either side.

Foucault would also be interested in the narrative around responsibility. Public debate often places the focus on individual choices: whether the doctors should strike, whether the timing is fair, whether they have chosen the right strategy. For Foucault, this reflects a wider tendency in modern societies to translate structural tensions into personal moral questions. It simplifies a complex system into a story about intention and character. This is not unique to healthcare; it is how many institutions maintain coherence when under pressure. However, he would not see this moment as negative, Foucault believed that every system contains the possibility of reflection and adjustment. Resistance does not always mean rebellion. Sometimes it is simply the moment where people step back and notice the shape of the institution they inhabit.

Foucault would also note that the previous strike and the unconditional pay rise didn’t just resolve a short-term dispute, it recalibrated the power dynamics within the system. By giving in without conditions, the state signalled that collective withdrawal of labour could extract concessions, reinforcing the strategic value of resistance. In other words, the system itself taught participants how to exercise power effectively. This current strike is not merely about pay or working conditions, it is a structural consequence of the prior encounter. The institution’s own responses have created a new logic of expectation: if striking yields gains without compromise, then strikes become a rational tactic. Foucault would see this as the interplay of disciplinary and strategic forces: the state tries to maintain order and authority, while workers navigate, bend, or exploit the rules of the system.

Strikes can trigger practical improvements, deeper thinking, or a reassessment of how work is organised. In that sense the disruption could be constructive. The resident doctors strike does not tell us the system is broken or corrupt, it tells us that large institutions, especially those under strain, need periodic moments of pause to rethink how they function. From a philosophical view, the strike is a reminder that even the most established structures rely on the participation, judgment, and well being of the people who work within them. It is also a reminder that tension does not always signal failure. Sometimes it simply signals that a system is ready to evolve. Moreover Foucault reminds us that our political and business leaders must exert influence over the institutions they are responsible for. If they lose that control, the system becomes self-governing, and that self-governing enterprise does so without moral agency or social intent.