Bob Crow addresses a TUC rally in Hyde Park on October 20, 2012. Photograph: Getty Images.
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What Bob Crow knew: better pay can’t be won without a fight

While many pay lip service to the need for higher wages, the RMT general secretary was prepared to take the action required to secure them.

Bob Crow would have appreciated the irony of his many tormentors (he was more hurt than most realise by the press intrusion into his private life) mourning his untimely death today. Most are remembering him as a tireless fighter for his members - and that is what he was. During Crow's time as general secretary from 2002 onwards, the basic pay of a tube driver rose to £46,000 plus perks (including free travel for them and their partner) and will reach £52,000 in 2015. As Ken Livingstone quipped on Sky News this morning: "The only working class people who still have well-paid jobs in London are [RMT] members." While cursing Crow's name as they squeezed onto rail replacement buses during one of his union's strikes, many workers reflected that they could do with such a leader fighting their corner. After the news of his death, the Daily Mail's Tim Shipman tweeted: "If the NUJ had represented me like Bob Crow did his members, I might still be a member of the union." There was no greater tribute to Crow's efforts than the rise in RMT membership from 57,000 to 77,000 (making it the fastest growing union) at a time when others were in permanent decline. 

It is common now for politicians and columnists of all stripes to bemoan the widening gap between the rich and the poor and the fate of the "squeezed middle". But far fewer support the measures required to improve workers' lot, including stronger trade unions. The dramatic decline in union membership in recent decades cannot be separated from the living standards crisis.  In 1981, 50 per cent of UK employees belonged to a union; today just 26 per cent do (although, encouragingly, membership rose by 59,000 in 2012 to 6.5 million). ­The fall in membership has eroded workers' collective bargaining power and wages have stagnated as a result. Since 2003, long before the recession, 11 million low-to-middle earners have seen no rise in their incomes.

It is no coincidence that the most equal countries in the world are those where union membership is highest. In Finland 69.2 per cent of workers belong to a union, in Sweden 68.4 per cent do, in Denmark 66.6 per cent do, and in Norway 54.4 per cent do. If they are to live up their rhetoric on equality, our political leaders should be doing all they can to promote their British counterparts. Strong unions are an essential guarantor not just of social justice but also of economic efficiency. As a recent IMF report noted, the inevitable result of stagnant real wages is that "loans keep growing, and therefore so does . . . the probability of a major crisis that . . . also has severe implications for the real economy."

There was a time when David Cameron sought cooperation, not confrontation with the unions. He became the first Conservative leader in more than decade to meet the TUC general secretary and appointed a union emissary, the former Labour MEP Richard Balfe, who spoke glowingly of unions as "great, voluntary organisations". But he soon reverted to Thatcherite type, refusing to rule out making Britain's anti-strike laws - already the most draconian in the western world - even more restrictive. The next Conservative manifesto is likely to include Boris Johnson's proposal of a 50 per cent turnout threshold (N.B. just 38 per cent voted in the last London mayoral election) for strikes if unions take further action against cuts to jobs, pensions and services. Crow rightly opposed this measure and every other policy that would limit the ability of unions to fight for their members. 

Crow should not be hagiographied. He may have been one of the greatest modern union leaders and a lifelong anti-fascist activist, but he was also a supporter of the death penalty, of EU withdrawal (as Nigel Farage opportunistically noted this morning) and an apologist for Stalinism. He led the disaffiliation of the RMT from Labour, the party it helped to found, in 2004 and never returned despite Ed Miliband's repudiation of New Labour. But in recognising the necessity of militancy to raise living standards, he served as an example to all. 

George Eaton is political editor of the New Statesman.

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All doctors kill people – and the threat of prosecution is bad for everyone

We must recognise the reality of medical practice: just because a doctor makes a mistake, that doesn’t mean they’ve all broken the law. 

On 15 November the Court of Appeal quashed the 2013 conviction for gross negligence manslaughter (GNM) of a senior consultant surgeon in London, David Sellu. Sellu, who had completed his prison term by the time the appeal was heard, will never get back the 15 months of his life that he spent in jail. Nor will the personal and family trauma, or the damage to his reputation and livelihood, ever properly heal. After decades of exemplary practice – in the course of the investigation numerous colleagues testified to his unflappable expertise – Sellu has said that he has lost the heart ever to operate again.

All doctors kill people. Say we make 40 important decisions about patients in a working day: that’s roughly 10,000 per annum. No one is perfect, and medical dilemmas are frequently complex, but even if we are proved right 99 per cent of the time, that still leaves 100 choices every year where, with the benefit of hindsight, we were wrong.

Suppose 99 per cent of those have no negative consequences. That’s still one disaster every 12 months. And even if most of those don’t result in a fatal outcome, over the course of a career a few patients are – very regrettably – going to die as a result of our practice. Almost invariably, these fatalities occur under the care of highly skilled and experienced professionals, working in good faith to the very best of their abilities.

If one of these cases should come before a crown court, the jury needs meticulous direction from the trial judge on the legal threshold for a criminal act: in essence, if a doctor was clearly aware of, and recklessly indifferent to, the risk of death. Sellu’s conviction was quashed because the appeal court found that the judge in his trial had singularly failed to give the jury these directions. The judiciary make mistakes, too.

Prosecutions of health-care professionals for alleged GNM are increasing markedly. The Royal College of Surgeons of England identified ten cases in 2015 alone. This must reflect social trends – the so-called “blame culture”, in which we have come to believe that when a tragedy occurs, someone must be held responsible. In every one of these cases, of course, an individual’s life has been lost and a family left distraught; but there is a deepening sense in which society at large, and the police and Crown Prosecution Service (CPS), in particular, appear to be disconnected from the realities of medical practice.

Malpractice investigation and prosecution are horrendous ordeals for any individual. The cumulative impact on the wider health-care environment is equally serious. In a recent survey of doctors, 85 per cent of respondents admitted that they were less likely to be candid about mistakes, given the increasing involvement of the criminal law.

This is worrying, because the best way to avoid errors in future is by open discussion with the aim of learning from what has gone wrong. And all too often, severely adverse events point less to deficiencies on the part of individuals, and more to problems with systems. At Sellu’s hospital, emergency anaesthetic cover had to be arranged ad hoc, and this contributed to delays in potentially life-saving surgery. The tragic death of his patient highlighted this; management reacted by putting a formal rota system in place.

Doctors have long accepted the burden of civil litigation, and so insure themselves to cover claims for compensation. We are regulated by the General Medical Council, which has powers to protect patients from substandard practice, including striking off poorly performing doctors. The criminal law should remain an exceptional recourse.

We urgently need a thorough review of the legal grounds for a charge of GNM, with unambiguous directions to the police, CPS and judges, before the spectre of imprisonment becomes entrenched for those whose only concern is to provide good care for their patients. As Ken Woodburn, a consultant vascular surgeon in Cornwall who was accused and acquitted of GNM in 2001, has said: “You’re only ever one error away from a manslaughter prosecution.”

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage