The Impact of an Employees' Strike on a Community Mental Health Center

Stovall, Jeffrey; Hobart, Marie; Geller, Jeffrey L.

doi:10.1176/appi.ps.55.2.188

Cited by 6 publications

(24 citation statements)

References 11 publications

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“…Strikes are a strategy used by an employee or group of employees in an attempt to force an employer to meet their demands whether economic or otherwise [2,4,41]. Specifically, strikes are used as a deadlock breaking mechanism when employer/employee negotiations have reached an impasse during collective bargaining [4,41,42].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, strikes are used as a deadlock breaking mechanism when employer/employee negotiations have reached an impasse during collective bargaining [4,41,42]. It has been suggested by some authorities that in the absence of the right to strike 'collective bargaining' would amount to nothing more than 'collective begging', in the context that without the threat of a strike or withdrawal of labour, the employee would have no choice than to accept whatever payment or wages proffered by the employer [43].…”

Section: Discussionmentioning

confidence: 99%

“…The primary target of a strike action is usually the offending employer, who is expected to suffer damages such as loss of income or negative public relations [2], which would force such an employer to accede to the employee/s demands [4,41]. Collective bargaining has been described as an adversarial process which is designed to win over partial or full control of something that is held by another, especially where wages and improved conditions of service are concerned [3,41,42]. Unfortunately for a strike to be meaningful and effective it must severely affect the employer or a 'third party' who is then expected to bring pressure to bear on the employer to accede to the striking employee/s demands [4,41].…”

Section: Discussionmentioning

confidence: 99%

“…Collective bargaining has been described as an adversarial process which is designed to win over partial or full control of something that is held by another, especially where wages and improved conditions of service are concerned [3,41,42]. Unfortunately for a strike to be meaningful and effective it must severely affect the employer or a 'third party' who is then expected to bring pressure to bear on the employer to accede to the striking employee/s demands [4,41]. Unfortunately, in healthcare service delivery the affected third parties are usually vulnerable patients and the public who are powerless either because of sickness or lack of alternative means of obtaining healthcare, and who also lack the power to apply the necessary pressure on the employer and employees to break the impasse, due the asymmetric power relationship that exists between patients and the contesting parties, in this case HCWs and their employers [9,20,21,41].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, in healthcare service delivery the affected third parties are usually vulnerable patients and the public who are powerless either because of sickness or lack of alternative means of obtaining healthcare, and who also lack the power to apply the necessary pressure on the employer and employees to break the impasse, due the asymmetric power relationship that exists between patients and the contesting parties, in this case HCWs and their employers [9,20,21,41]. The impact of HCW strikes on the community at large is usually significant [2,17,21,41,47]. It is this negative impact on healthcare service delivery that usually leads to public controversy and opprobrium being heaped on the striking HCWs from both within and outside the medical profession [9,10,18,20,48-51]…”

Section: Discussionmentioning

confidence: 99%

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Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

Chima

2013

BMC Med Ethics

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BackgroundDoctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society.DiscussionIt has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated.SummaryThe right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society. Employers should implement legitimate collective bargaining agreements in a timely manner and high-handed actions such as mass-firing of striking HCWs, or unjustifiable disciplinary action by regulators should be avoided. Minimum service level agreements should be implemented to mitigate the impact of HCW strikes on indigent populations. Striking employees including HCWs should also desist from making unrealistic wage demands which could bankrupt governments/employers or hamper provision of other equally important social services to the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

Chima

2013

BMC Med Ethics

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The impact of strike action on patient morbidity: A systematic literature review

Essex

Milligan

Williams

et al. 2022

Health Planning & Management

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Strike action in healthcare has been common over the last several decades. The overarching aim of this systematic review was to synthesise and analyse the empirical literature that examines the impact of strike action on patient morbidity, that is, all patient outcomes except mortality. After conducting a search and apply eligibility criteria, 15 studies were included in this review. These articles included a variety of outcomes from hypertension control to rates of chlamydia. Strikes ranged from 13 to 118 days, with a mean strike length of 56 days. A textual narrative synthesis was employed to arrange studies by whether they had a positive, mixed or neutral or negative impact on patient morbidity.Results suggest that strike action has little impact on patient morbidity. The majority of studies reported that strike action had a neutral or mixed impact of strike action on patient morbidity. One study reported positive outcomes and three studies reported negative outcomes, however in both cases, the impact that the strike had was marginal.

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The impact of strike action on healthcare delivery: A scoping review

Essex

Ahmed

Elliott

et al. 2022

Health Planning & Management

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Background: Strike action carried out by healthcare workers raises a range of ethical issues.Most fundamentally, as a strike is designed to disrupt, it has the potential to impact patient outcomes and healthcare delivery. This paper synthesises and analyses the empirical literature that details the impact of strike action on healthcare delivery.Methods: A systematic scoping review was utilised to examine the extent, range and nature of research activity. Embase, Medline, CINAHL, Bioethicsline, EconLit and Web of Science were searched, yielding 5644 results. Papers were included if they examined the impact that strike action had on healthcare delivery (i.e., admissions, presentation). After screening 43 papers met inclusion criteria.Results: Nineteen studies explored presentations to emergency or admissions to hospital. Both dropped dramatically when comparing non-strike to strike periods. Ten studies examined length of stay in hospital and waiting times. No relation to either was found in relation to strike action, with some studies showing that wait times decreased. Nine studies examined the impact of strike action in facilities that were not on strike, but impacted by nearby strike action and the impact that strike action had on treatment seeking. Hospitals dealing with these upstream impacts often saw increase in presentations at hospitals, but results relates to treatment seeking during strike action were mixed. Conclusion: Strike action can have a substantial impact on the delivery of healthcare, but this impact is not felt uniformly across services. While many services are disrupted, a number are not, with several studies reporting increased efficiency.

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The Impact of an Employees' Strike on a Community Mental Health Center

Cited by 6 publications

References 11 publications

Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

The impact of strike action on patient morbidity: A systematic literature review

The impact of strike action on healthcare delivery: A scoping review

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