45,000 junior doctors began a five-day strike Thursday, the latest in an industrial dispute ongoing since February and the longest single walkout by doctors in NHS history. The members of the British Medical Association (BMA) previously held a 3-day strike in March, a 4-day strike in April and another 3-day strike in June.
A separate 48-hour consultants’ strike, also organised by the BMA, is due to start next Thursday and a two-day strike by the Society of Radiographers the following Tuesday.
Junior doctors are demanding a 35 percent increase in pay to make up the real terms losses suffered since 2008. Government underfunding of the National Health Service and its workforce has led to intolerable working conditions and plummeting outcomes for patients.
The government imposed a 2 percent pay rise for 2022-23, a year in which prices rose by 11.4 percent according to the Retail Prices Index. It had grudgingly offered 5 percent in recent negotiations for 2023-24 but cancelled all talks when new strikes were scheduled.
On Thursday, however, Prime Minister Rishi Sunak announced a “final” series of public sector pay offers, to be funded by cuts to government budgets, including a 6 percent pay rise for junior doctors. He told the press, “Today’s offer is final. There will be no more talks on pay. We will not negotiate again on this year’s settlements and no amount of strikes will change our decision.”
Sunak’s speech was accompanied by a joint statement signed by himself, Education Secretary Gillian Keegan and the leaders of the four main teaching unions hailing a 6.5 percent offer for teachers, declaring the unions’ intentions to recommend it to their members and breathing the sigh of relief: “This deal will allow teachers and school leaders to call off strike action and resume normal relations with government.”
On the day doctors began a new round of action, the education unions pulled strikes set to involve hundreds of thousands of school workers. All talk a few months ago of solidarity and coordinated action has evaporated.
Sunak’s ultimatum is designed to bring all the remaining national strikes to an end in the same way. Although BMA Chair of Council Prof Phil Banfield denounced the offer as “yet another pay cut in real terms” which “serves only to increase the losses faced by doctors after more than a decade’s worth of sub-inflation pay awards,” for the union bureaucracy it is only a question of timing, presentation and finessing some sell-out deal.
Even prior to the announcement of 6 percent, BMA co-chairs Vivek Trivedi and Robert Laurenson had promised, “We can call this strike off today if the UK government will simply follow the example of the government in Scotland and drop their nonsensical precondition of not talking whilst strikes are announced…
“The pay offer on the table to junior doctors in Scotland and how it was reached throws into sharp relief the obstinate approach being taken by the prime minister and the health secretary.”
Strikes in Scotland were called off last week following an improved offer of a 12.4 percent pay rise for 2023-24 from the Scottish government. This must be taken in the context of the 4.5 percent award made for 2022-23, nearly 7 percentage points below the rate of inflation.
In other words, doctors’ pay was massively outstripped by price rises last year and they are now playing catch up. With inflation stubbornly high, the deal could well amount to a real terms cut by the end of the period, worsening the fall since 2008.
Specific details of the deal aside, the front has been broken with doctors in England, representing the vast majority of the workforce—Scotland’s population is less than a tenth of England’s.
Junior doctors represented by the BMA in Wales have not even been balloted for action, with the union explaining, “In Wales, we’ve not had to make the difficult step of moving towards a ballot or taking IA just to get the government to talk… the Welsh Government has been open to discussing pay with us.”
Like doctors in Scotland, those in Wales received a 4.5 percent award for 2022-23. A survey conducted by the BMA in Wales was published last December showing 78 percent of members wanted a pay rise that matched or exceeded inflation, and two thirds were prepared to take industrial action. This sentiment, fully aligning doctors in Wales with their colleagues throughout Britain, has been squashed.
Globally, the trade unions use international borders to divide workers doing the same job at the same company in different countries. In Britain, they have the benefit of doing the same internally.
The Scottish and Welsh devolved governments, overseeing a small section of the workforce, are given the freedom to make relatively better pay offers, then used to split off sections of workers from a national strike action. This creates a precedent for the same process, almost invariably involving a smaller offer, to be played out in England.
Nurses suffered the same at the hands of the Royal College of Nursing as part of the union’s efforts to grind down workers’ resistance to this May’s sellout pay deal. The national rail strike has been carved up the same way, with similarly disastrous results even before the plug is finally pulled on action in England.
It is in large part thanks to these union-inflicted defeats, especially of the nurses and other NHS workers, that the government feels so bullish in its dealings with the BMA.
By favourably citing the 12.4 percent offer in Scotland, the BMA leadership is not seriously suggesting that the Tory government match that figure but beginning the process of lowering its members’ expectations from the 35 percent demand. The march towards the government’s 6 percent, perhaps with a sweetener or two, has begun.
A year of strikes has proved beyond all question that workers cannot defend their pay, jobs and conditions while they remain shackled by the trade union bureaucracy. A working-class offensive is being turned by a handful of privileged leaders into a rout.
This must be reversed by the most militant workers acting today to form the rank-and-file organisations and networks necessary to take control of their struggles out of the hands of the union apparatus. Those who agree should write to NHS FightBack and begin a discussion with likeminded colleagues: info@nhsfightback.org.uk