Around 3,000 junior doctors in the National Health Service (NHS) in Wales have taken three days of consecutive strike action in opposition to a 5 percent pay offer for 2023-4 by the Labour-run Welsh Assembly.

The pay award was tabled as a “first and final offer” back in August last year when the RPI rate of inflation stood at 9.1 percent. The 72-hour walk began Monday at 7am and ends on Thursday 7am. The action saw well attended picket lines at hospitals attracting widespread public support.

The starting rate of pay for a newly qualified doctor in Wales is as low as £13.65 an hour. Junior doctors have experienced a drop in real terms pay by 29.1 percent since 2008, one of the sharpest falls in a broader trend suffered by their colleagues in the NHS across the UK. The members of the British Medical Association (BMA) are demanding pay restoration as their counterparts nationally have been fighting for, with the taken place in England between January 3-9, marking 34 days of stoppages since March 2023. The three-day strike in Wales followed a 98 percent majority on a 65 percent ballot turnout for action.

In response to the strike, Welsh First Minister Mark Drakeford doubled down on the sub inflation offer stating on January 15 it was at the “far end” of what could be afforded and citing tight budgetary restraints from Conservative central government.

Junior doctors have emphasised that their pay demand is bound up with the defence of the NHS, with low pay and overwork undermining patient care compounded by the growing numbers of medics exiting the NHS. A junior doctor who had recently emigrated from Wales to Australia for work told the BBC how they had only earned £13.65 to £14 an hour and on his last shift in the NHS was responsible for 35 patients in a urology department.

These concerns were raised with WSWS reporters by junior doctors and displayed on home-made placards among some 500 who attended the BMA protest organised on Tuesday outside the Senedd (Welsh parliament) in Cardiff. See interviews here.

The struggle by junior doctors across the UK raises critical issues over the way forward. This is a fight which has the potential to galvanise working class support against a Tory government widely reviled for its sacrifice of public health for profits in a pandemic which has already claimed over 230,000 lives, and the further drive to dismantle and privatise the NHS.

Prime Minister Rishi Sunak has buttressed the argument against the pay restoration demand by contrasting it with the settlements reached with all other health unions across the NHS last year. This cosy relationship was built on the back of the union bureaucracy dividing the million plus NHS workforce and ending an unprecedented strike wave, with below inflation deals set by the benchmark for nurses of just 5 percent.

The NHS Fightback in its statement on the junior doctors’ struggle advanced a strategy for a unified fightback through establishing a network of rank-and-file committees. It explained this “has left other health workers out of pocket and junior doctors out on their own.” It noted that the BMA has also withdrawn tens of thousands of consultants and specialists with strike mandates from any action, on the pretext of a balloting over revised government pay offers which do not redress historic levels of pay decline.

The BMA junior doctors committee (JDC) has undermined a joint fight for pay restoration. In Scotland last year the JDC suspended three days of mandated strike action by junior doctors and pushed through a 12.3 percent deal for 2023/4 in August with the Scottish National Party government. This was after a 4.5 percent deal for 2022/3 and in return for the BMA accepting “yearly negotiations with the Scottish government that must make credible progress in real terms towards FPR (Full Pay Restoration) to 2008 levels.” This was well short of the 28.5 percent decline in junior doctors pay in Scotland since 2008. In Northern Ireland, the JDC only started a six-week ballot for industrial on January 6, as junior doctors have suffered a 30 percent decline in pay over 15 years. The strike action in Wales was also kept entirely separate from the recent extended walkout in England.

Conservative Health Minister Victoria Atkins issued an ultimatum at the end of the six-day strike in England that the JDC must take strike action off the agenda before talks reopen, reiterating that the pay restoration demand was “unaffordable.” The government has not relented since, only offering an additional 3 percent to the 8.8 percent implemented for 2023/4.

A January 9 BMA press release by co-chairs Dr. Robert Laurenson and Dr. Vivek Trivedi stated, “No strikes are currently scheduled and now is her [Atkins] moment to come forward with a credible offer that delivers the reasonable outcome of pay restoration.”

Trivedi had already proposed on the first day of action watering down the core demand, telling the BBC, “We’re not even saying it has to happen in one year… We are very happy to look over deals that would span a number of years.”

The JDC presents itself as a militant opposition and goes through the motions of insisting the pay restoration is affordable, but this has become a dead letter and replaced by calls for a “credible offer.”

To justify its de facto pay cut the Welsh Labour Assembly claims it is purely the result of a Conservative government in Westminster. However, Labour’s Shadow Health Minister Wes Streeting has repeatedly displayed his hostility to the strikes by junior doctors in England and ruled out meeting the demand if Labour was in government. Rather than a “reform” of the NHS, he has signalled Labour’s direction of travel by hailing the example of Singapore’s part-privatised health system as a model.

When it comes to war, money is no object. The Sunak government has granted an additional £2.5 billion in military support to Ukraine as the bloody conflict grinds on into it second year. The claim that this is a response to Russia aggression is exposed by the Tories’ full backing of the genocidal siege on Gaza by Israel and launching military strikes on Yemen—a country devastated by famine and death resulting from military intervention by Saudia Arabia. This has the full approval of Starmer’s Labour Party.

The defence of the NHS and a cost-of-living increase for its entire workforce requires a fight against the twin parties of austerity and war to champion the defence of social need and public health care.

NHS FightBack, established by the Socialist Equality Party and affiliated to the International Workers Alliance of Rank-and-File Committees, seeks to organise workers throughout the healthcare sector. Get involved today.