Mal Fletcher considers the implications of the threat to carry forward the junior doctors' strike indefinitely.

Mal Fletcher

With its threat to carry forward the junior doctors' strike indefinitely, the British Medical Association is in danger of scoring an own goal.

By pursuing ever more aggressive strike action, it may inadvertently add the medical establishment to a register it doesn't want to join.

Since 2007, a growing number of Britain's foundational institutions have joined something I like to call the Trust Deficit Register.

In the last few years, the public's relationship with society's foundational institutions has arguably taken a turn for the worse.

It began with attitudes toward the world of business - and particularly banking - at the outset of the near global recession. The political classes were soon similarly affected, in the wake of the MPs expenses scandal.

In both cases, levels of public anger grew substantially almost overnight. Bankers and MPs were perhaps never among the most trusted professional groups in the country, but quite suddenly they were being vilified to an unusual degree.

The trustworthiness of the police and the courts was also subject to question in the aftermath of the London riots of 2011. Universities lost a great deal of credibility as they introduced tuition fees - which now ensure that the average UK student graduates with a massive debt of £44,000.

The press - having made loud noises about keeping everyone else honest - then succumbed to public mistrust amidst widespread accusations of illegal phone-hacking.

In more recent times, the British electronic media and the entertainment industry have suffered a loss of public confidence too. Claim after claim has emerged about sexual abuse. At times, the public outcry has been so great that authorities have over-reacted, accusing innocent people.

Meanwhile, sections of the institutional church have been rocked by reports of child abuse going back decades.

The trust deficit continues to rear its head within the in/out referendum debate about Britain's membership of the EU. Current polls reveal real uncertainty as to which way people will vote. At the core of the problem is the fact that people don't know whom to trust.

Until now, the medical professions have managed to escape the worst effects of this creeping trust deficit. Indeed the NHS, a symbol of all things medical, is still considered almost sacrosanct by a great many people.

However, if junior doctors and the BMA are not careful, they may yet find themselves and the wider healthcare community added to the Trust Deficit Register.

In the trust stakes, medicos have more to lose than most other professionals. Theirs is regularly listed among society's most admired and dependable classes.