Thousands of junior doctors marched in London and Manchester last week against the Conservative government’s attacks on their pay, terms and conditions.

Last month, the Junior Doctors Committee (JDC) of the British Medical Association (BMA) announced that they would ballot for industrial action against the enforcing of new contracts on 53,000 junior doctors in England.

The doctors are being supported in their campaign by medical students as well as the presidents of 11 Royal Colleges.

Conservative Health Secretary Jeremy Hunt had talks with representatives of the junior doctors earlier this month, amid growing opposition to these attacks. The talks broke up without reaching a settlement. Last July, Hunt stressed that the consultants and doctors’ contracts would be changed whether they agreed or not, claiming the government’s aim was to have a seven-day service in the National Health Service (NHS).

Like other low paid NHS workers, junior doctors whose starting salary is £23,000 per year depend on enhancement pay for unsocial hours to cover living costs. Many doctors come out of medical faculties with tens of thousands of pounds of debt, thanks to tuition fee hikes by successive Labour and Conservative governments. They have to pay large sums of money for their ongoing training, along with payments to professional bodies.

At work, they face a severe shortage of medical and non-medical staff and lack of facilities because of budget cuts and are often compelled to work long stressful hours. As front-line staff, they see first-hand the massive erosion of patient care and often spend unpaid extra hours in wards looking after patients to compensate for a crisis created by the systematic running down of services.

Speaking to the Guardian, Foiz Ahmed, a junior doctor in emergency plastic surgery, pointed out that the “new contracts will strike a pernicious blow to the NHS and patient safety.”

“This isn’t just about salaries, although of course a 10-30 percent pay cut is unmanageable for most of us. Let’s ignore the fact that I used to earn more an hour while working for a mobile-phone company as a student. ... With the continued denigration of public perception of doctors, there is a sustained attempt to make the NHS fail. A demoralised workforce performs less efficiently, and a less-efficient system can be broken up and sold to private firms,” he said.

The overwhelming opposition of junior doctors to contractual changes is an indication of the growing anger over the dismantling of public health care and attacks on wages, terms and conditions.

With the new contracts, the government plans to reclassify 7 a.m. to 10 p.m. from Monday to Saturday as normal working hours, whereas now normal working hours are defined as 7 a.m. to 7 p.m. from Monday to Friday. If implemented, this would significantly reduce the unsocial hours enhancement pay.

Hunt and the Department of Health (DoH) shed crocodile tears, complaining of how current contracts are unfair for both doctors and patients. The DoH stated, “We are not cutting the pay bill for junior doctors and want to see their basic pay go up just as average earnings are maintained. We really value the work and commitment of junior doctors, but their current contract is outdated and unfair.”

In reality, in December 2014 the DoH recommended to the NHS Pay Review Body (NHSPRB) that contractual arrangements needed to be reformed in order to achieve seven-day services. Among its key endorsements were an across-the-board reduction in payments for working unsocial hours and changes to the incremental pay progression scheme.

The DoH declared, “National employment contracts to support the delivery of seven day services for emergency, urgent and elective care must be affordable and this means employers must make better use of their pay bill—around £44 billion in total across the employed NHS workforce.”

The new contracts would effectively reduce junior doctors’ pay by 15 to 30 percent, with more extended and unsafe hours. This is part of an ongoing offensive against the pay and conditions of the NHS’s workforce that began in the aftermath of the 2008 global financial crisis. Every section of the working class is being forced to pay for the crisis, while ever more wealth is transferred to the pockets of the financial oligarchy responsible for the crisis.

With the collaboration with the trade unions, the 2010-2015 Conservative-Liberal Democrat coalition carried out a series of attacks on public sector workers, including NHS workers. In 2011, the age when workers are entitled to a pension was increased, along with an increase in employees’ contribution for pensions with reduced benefits.

In 2012, NHS employers in South West England formed the South West regional pay consortium as a Trojan horse to attack the pay, terms and conditions of health workers across the country. The business plan it issued was widely praised and adopted by NHS employers.

During the same year, under the bogus claim that they were avoiding implementation of regional pay systems proposed by the South West consortium, the unions struck a deal with government effectively introducing performance-based incremental progression, an end to sickness absence enhancements and the removal of accelerated pay progression for some workers.

The government then went on the offensive, imposing a four-year pay freeze for NHS workers, reducing their pay by 10-15 percent.

The coalition tried to impose changes to consultants’ and junior doctors’ contracts in 2012, but failed to do so because of the opposition from the rank and file of the BMA.

The current Tory government is renewing its efforts to slash the wages of the 1.3 million NHS workforce by targeting junior doctors first. Once again, they rely on the suppression of any opposition by trade unions with hundreds of thousands of members in the NHS. Unison, Unite, GMB and the Royal College of Nursing have stopped even their occasional whimpering about the proposed cuts to unsocial hour payments, now that a section of the workforce is actually in struggle against it. The BMA has simply left the fate of junior doctors to its JDC wing.

There is no lack of opposition from the NHS workers and working people against the ongoing dismantling of the NHS and attacks on wages and conditions. However, the unions deliberately restrict these struggles to the writing of petitions and letters to the very MPs who are hell-bent on the eventual full privatisation of the NHS. The unions have isolated every struggle, restricting them to token local protests, and have prevented a united offensive by NHS workers. They oppose an independent political struggle against the attacks of the government.

The Socialist Equality Party and NHS FightBack calls on all doctors and health workers to build action committees, independent from the unions, and based on a socialist strategy to fight against the attacks on pay, terms and conditions as the only way to defend public health care.