The 24-hour strike by junior doctors across England today is part of a wider movement in opposition to austerity-based attacks on the National Health Service (NHS). Last Saturday thousands demonstrated in London against the Conservative government’s plans to scrap bursaries by 2017 for nurses and midwives.
It is more than 40 years since the last national strike by junior doctors over pay and conditions. Prime Minister David Cameron’s government is intent on imposing new contracts that will reduce payments for unsocial hours and lift safeguards against excessive hours.
The first day of action is due to be followed by a two-day stoppage starting from 8 a.m. on Tuesday, January 26, with both sets of action allowing for emergency care only. An all-out one-day strike is planned for Wednesday, February 10.
The fact that the one-day stoppage is taking place at all is despite the best efforts of British Medical Association (BMA), which postponed the rolling series of stoppages planned for last month. Over two-thirds of the workforce (37,700 junior doctors) were balloted by the BMA and returned an emphatic majority of 98 percent in favour of strike action. Trampling on this mandate, the BMA postponed the strikes to re-enter talks with NHS Employers and the Department of Health via the Advisory, Conciliation and Arbitration Service (ACAS).
The negotiations only confirmed that the government will not countenance any retreat on the substantive issues. The main content of the changes to pay is to reclassify weekend working as normal working in order to eliminate premium rates currently paid for this and for night shifts. The attack on junior doctors is a test case for moving NHS staff over to seven-day working for more services without receiving payment for unsocial hours.
The “offer” of an 11 percent rise on basic pay will not compensate for the loss of premium rates for unsocial hours during the week and weekend working, which the government aims to introduce by August this year. According to the BMA, junior doctors could lose up to 30 percent of their income.
Junior doctors would only receive time and a half for any hours worked between 10 p.m. and 7 a.m. and time and a third for hours worked between 7 p.m. and 10 p.m. Saturdays or Sundays. The mandatory enforcement against unsafe working hours would be lifted. This will impact negatively on recruitment, leaving already overworked and exhausted junior doctors to provide patient care.
In an attempt to reverse public opinion, which is overwhelmingly on the side of the junior doctors, the government has orchestrated a dirty-tricks campaign via the media to claim the strike action places the lives of the public in danger.
Details have emerged that back in November Health Secretary Jeremy Hunt vetted a press release to the BMA from the Medical Director of NHS England, Sir Bruce Keogh, which aimed to portray the strike action as a threat to national security. NHS England is meant to be independent of government. The press release went through several changes to ensure it spread alarm about the possibilities of a Paris-style terror attack, with the junior doctors’ strike undermining an emergency response.
More than a thousand doctors have put their name to a letter expressing their outrage and calling for Keogh to stand down. A letter written in protest declared: “You implied that, were a similar event to occur during junior doctors’ industrial action, we might not return to work to help the victims, an insinuation we found deeply offensive. ... Imagine now our dismay in discovering that you engaged in covert crafting and re-crafting of this letter with Whitehall officials, in order to ensure the final product was as ‘hard-edged’ as possible.
“Do you really feel that we, the country’s junior doctors, deserve to be attacked—with your permission—by the full force of the Government’s spin machine? To have the public’s trust in us put at risk by the Government’s actions?”
This breakdown in protocol and medical ethics is not an aberration, but points to the intimate connection between the criminal foreign and domestic policies pursued by the British ruling elite. The parliamentary vote for bombing Syria has set the stage for another illegal war in the Middle East, the fourth in 14 years. The financing of new wars places further strains on the funding of the NHS and other public services. The response is to deploy the supposed “war on terror” as a pretext to outlaw all manifestations of protest and opposition against the socially destructive impact of austerity. The government’s Trade Union Bill is similarly aimed at further curtailing the right to strike, particularly in the public sector “essential services.”
In addition to disorientating public opinion, the lies and smears of the government and the media are aimed at disciplining the Labour Party and trade unions to clamp down on the suppressed discontent over rising social inequality and dismantling of the welfare state.
No confidence can be placed in the BMA to wage a struggle in defence of junior doctors. Nothing worthwhile will emerge from the ACAS negotiations. Instead they will be used to grind down opposition and force acceptance of a repackaged version of the cuts.
The main health unions such as Unison, UNITE and the GMB have smothered opposition to a succession of attacks on the NHS.
The Health and Social Care Act 2012 has created the conditions for the wholesale privatisation of the NHS and passed without any mobilisation against it by the unions. Protests against Accident & Emergency closures have been diverted down the dead end of petitions to the government and MPs. In the rare instances where strikes have taken place, such as over pay restraint, these have been on the most ineffective basis and were wound down after accepting a pitiful 1 percent pay increase on the grounds that this was “the best deal that could be achieved through negotiation.”
The only way forward in the junior doctors’ dispute is to break out of the stranglehold of the trade unions and link the struggle with a broader offensive to defend the NHS, mobilising all health workers and the entire working class in the struggle for a workers’ government and socialism. The Socialist Equality Party and NHS FightBack urges all those wanting to take up this fight to make contact and discuss how this can be achieved.