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

BackgroundStrike 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. MethodsA 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, presentations, waiting time). After screening, 43 papers met inclusion criteria. ResultsNineteen 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 clear relationship was found with 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 were impacted by nearby strike action along with 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. ConclusionStrike 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.

Automated summary

Strike action by healthcare workers has the potential to disrupt patient outcomes and healthcare delivery. This paper synthesises and analyses empirical literature on the impact of strike action on healthcare delivery. The results show that during strikes, emergency presentations and hospital admissions drop significantly, but the impact on hospital stay and waiting times is unclear and varies across studies.