Socialist Appeal - British section of the International Marxist Tendency

Fair pay; no to privatisation; proper investment in the NHS: these are the demands among junior doctors, who are to be balloted for industrial action after over 82,000 people (at the time of writing) have signed a petition started by junior doctor Matt Egan calling for strike action. Unite and fight: defend the NHS! Fight for socialism!

Fair pay; no to privatisation; proper investment in the NHS: these are the demands among junior doctors, who are to be balloted for industrial action after over 82,000 people (at the time of writing) have signed a petition started by junior doctor Matt Egan calling for strike action.

After negotiations broke down between the Tory government and the British Medical Association (BMA) over the new contracts, the Tories have decided to impose the changes without consulting the BMA any further. In fact, NHS employers have decided to bypass the doctors’ elected representatives completely and undermine them by holding large meetings to discuss the new contracts with junior doctors. This is a move designed to break the power of collective bargaining and united action.

Pay, privatisation and profit

The proposed changes mean, in effect, a 30% pay cut for junior doctors by changing the definition of working hours deemed “normal” from 7am to 7pm Monday to Friday, to 7am to 10pm Monday to Saturday. This attack on pay follows on from below inflation pay rises for the last five years. Thanks to the Tories’ tuition fee increases, junior doctors, who spend 5-6 years at university, are saddled with extraordinary debt of £60,000 - £100,000 which they are expected to start paying off with a starting salary of £22,636.

One doctor at a central London hospital told Socialist Appeal that the proposed changes were “scandalous, to say the least”. He explained that, as it is, many doctors already end up working for many hours each week for free, simply because the NHS is under-resourced.

The Tories say that the current contracts are outdated and unfair. But at the same time as cutting doctors’ pay by 30%, Tory MP's have recently voted to increase their own by 11% - an extension of the industrial scale embezzlement of public funds through parliamentary expenses. The justification for increasing politicians’ pay was that it’s necessary to attract the best talent into Parliament. By that logic, these proposals for junior doctors’ contracts will drive away the best talent from the profession.

In fact, this is already taking place. Thousands of junior doctors have signed up to work in Australia and New Zealand to escape the way they are being treated by the Tories. One doctor at a Cambridge hospital told Socialist Appeal that she thought she’d probably end up moving abroad if things carry on the way they are. “I want to stay and fight it out because I care a lot about the NHS,” she said, “but when you’ve got everything ranged against you, and it’s all pointing in one direction, what else can you do?”

It is true that the history of capitalism all points in one direction. In its insatiable quest for profit, capital must constantly open up new markets. This need is especially acute in periods of capitalist crisis, such as we are in today. The NHS represents a new potential market for the capitalists, and is now coming under increasing pressure to open up to big business. All the doctors who spoke to Socialist Appeal said that they thought the Tories were trying to introduce “privatisation by the back door”. In short, the Tories are selling off the NHS to increase the profits of the capitalists.

The presidents of the various royal colleges of medicine have all written to Jeremy Hunt, the Tory health secretary who is imposing these contracts, pointing out that these changes will cause an increasing reliance on agency and locum doctors, as others are driven out of the profession. While detrimental to levels of patient care, this is exactly what the Tories want: workers with lower pay, few employment rights and working through private contractors.

Stripped of its halo

The result of all this is that we are seeing doctors, a group of workers never normally associated with militant industrial action, being radicalised and willing to take strike action. One doctor told Socialist Appeal that the petition for strike action had captured the mood at his hospital in central London. “We’ve been getting more and more angry at how the government is treating us for quite a long time” he explained. “I think everyone is definitely ready for strike action.” Another junior doctor at Oxford University Hospitals told us that “me and my friends would definitely go on strike. I think everyone would”. The petition got 25,000 signatures within just one day of going up online, and the BMA has now agreed to ballot junior doctors for industrial action.

In the Communist Manifesto, Marx and Engels explained that “the bourgeoisie has stripped of its halo every occupation hitherto honoured and looked up to with reverent awe. It has converted the physician, the lawyer, the priest, the poet, the man of science, into its paid wage labourers.” This is the logic of capitalism - as the rich get richer, everyone else is forced deeper and deeper into the ranks of the exploited working class.

All the doctors who spoke to Socialist Appeal explained that they were fully supportive of the BMA, and especially the Junior Doctors’ Committee, but felt that they needed to go on the offensive over the question of these contracts. The decision to ballot for industrial action is therefore a welcome step forward.

Unite and fight: Defend the NHS! Fight for Socialism!

The BMA potentially has a lot of power in its hands because it is backed up by ordinary doctors who are ready and willing to fight for the future of the NHS. A junior doctor in Oxford pointed out that “what gets lost in all this is the massive impact on patient care that these kind of cuts will have”. A big publicity campaign around what the Tories are doing to the NHS and the impact that it will have on the quality of healthcare in Britain, would be sure to get the public backing industrial action by doctors.

And the BMA need not take action alone. In May this year, the General Secretary of the Royal College of Nursing issued a “strong warning” to the government that nurses would take strike action if new contracts were imposed. Last year the Royal College of Midwives took strike action against the government for the first time in its 133 year history. Unions like UNISON, who represent healthcare workers in the NHS, have been fighting the government on austerity for years. A strategy to unite all these unions in joint industrial action, with a broader perspective for a general strike against austerity, is the best way for doctors to stay the Tories’ hand and assert their collective strength in the face of these attacks.

Ultimately we are trying to stand up against the might of the capitalist system. Unless we break entirely with this system then we will be forced to submit to its laws, which require austerity and privatisation. Doctors, the BMA, the unions and the Corbyn-led Labour Party need to put forward a clear socialist alternative to capitalism and link it to militant industrial action to defend ordinary people against the employers, the rich and their Tory agents.

This is a struggle in which we must all get involved. In this period of massive attacks on the working class and enormous political turbulence, we cannot afford to stand on the sidelines. If we want to save the NHS, we have to stand up and fight for it. If we want a socialist society, we have to work to build it. In the words of Che Guevara, the great revolutionary Argentine doctor, “the revolution is not an apple that falls when it is ripe. You have to make it fall.”