By Barry Mason
The British Medical Association (BMA) announced the result of its ballot of junior doctors on Thursday. The doctors voted overwhelmingly to strike in opposition to the Conservative government’s attempts to impose a new contract on them.
Some 98 percent of junior doctors voted in favour of a strike and 99 percent in favour of action just short of a full strike. Over two-thirds of the workforce (37,700 junior doctors) were balloted and 76 percent of these participated in the ballot.
They will provide only emergency care cover over a 24-hour period from 8 a.m. on December 1 until the same time the following morning. This will be followed by a complete walkout of junior doctors on December 8 from 8 a.m. till 5 p.m. and again on December 16.
The junior doctors voted to strike after talks between the BMA and government broke down. Health Secretary Jeremy Hunt then threatened to impose the new contract, which he wants in place for the new intake of doctors in August 2016.
The government is seeking to extend weekend coverage by medical staff but only on a no-overall-cost basis. Under the current contract, weekend and out of hours work is paid at a premium. Hunt wants to increase the standard time when premium rates do not apply from 60 hours to 90 hours. Reclassifying anti-social hours as standard would result in many doctors losing money, as well as posing an obvious risk to patient safety.
The new contract would also abolish the banding system whereby junior doctors receive annual pay increments based on their length of service. According to the BMA, it would also remove “vital safeguards which discourage employers from making junior doctors work dangerously long hours, and in doing so protect both patient and doctor safety.”
In the run-up to the launch of the ballot, Hunt offered an 11 percent pay increase and proposed that rather than all-day Saturday being classed as base pay hours, it would only apply to hours between 7 a.m. and 10 p.m.—hours outside this range being paid at premium rate. Junior doctors dismissed the last-ditch attempt by Hunt to head off the dispute.
The BMA has estimated junior doctors could lose up to 30 percent of their pay. Many have to rely on their current out-of-hours premium pay to manage. The number of junior doctors seeking Certificates of Current Professional Status (CCPS) to enable them to work abroad has shot up recently.
Hunt’s belligerent stand has also had the impact of increasing militancy among junior doctors, who have held a number of vocal protests. Their action is being widely supported by other hospital staff and the general public who correctly see the government’s proposals as part of the on-going attack on the health service.
Senior doctors who will be expected to bear the brunt of the strike action have publicly expressed their support for their junior colleagues. While the ballot was being conducted, over 500 consultants at the Royal Free London National Health Service foundation trust wrote to Hunt supporting the junior doctors and their possible strike.
In a copy sent to the Guardian they stated, “An empowered, rested, happy and appropriately remunerated workforce across all cadres of medical, nursing and allied health professional staff is essential to sustain high clinical standards. … We regret, yet clearly understand that public protest and possible industrial action by doctors has become necessary to safeguard these basic requirements.”
More than 360 senior doctors working for Leeds Teaching Hospital NHS Trust wrote to Hunt expressing their support. The Yorkshire Post regional newspaper carried a copy of the letter. They wrote:
“Dear Secretary of State for Health, We wish to express our grave concerns about the proposed changes to the contract for junior doctors. We write in our personal capacity as Consultants working in one of the largest NHS Trusts in the UK.
“We view the proposed changes as demoralising and potentially detrimental to the quality of patient care and to clinical outcomes … Coercing staff is demotivating, breeds distrust and discontent and will result in further difficulties in recruitment and retention. … We urge you to show them the professional respect they deserve by listening to their concerns and entering a genuine dialogue without the threat of contract imposition.”
The NHS Accident and Emergency (A&E) service is already under threat and many NHS professionals fear the new contracts will make the situation worse. In a letter to the government, 350 A&E consultants highlighted the problems recruiting and retaining A&E staff.
Writing in the Independent November 15, Christopher James, a junior doctor, states: “Under the new contracts A&E is under threat of complete collapse. … Jeremy Hunt, your contract is short sighted and damaging. If it is indeed your intention to bring down the NHS for privatisation … come out and say so. … NHS staff are uniting. We are galvanized and we are ready. … I will see you on the picket line.”
Many workers have been heartened by the determined fight of junior doctors to stand up to the Tory government. Over the past few weeks, many thousands have marched and attended protests in support, seeing it as a defence of the NHS.
The NHS is under sustained attack. Following on from measures introduced by the former Labour and Conservative-Liberal Democrat governments, the current Conservative government is imposing the biggest financial squeeze on the NHS in its history. The government has demanded £22 billion in “efficiency savings” over the next five years on top of the £20 billion in similar “efficiency savings” under the previous government. According to the health think tank, the Kings Fund, all NHS trusts will be in deficit to the amount of £2 billion by April 2016. This squeeze is being made at the same time as demands on the NHS are increasing.
For junior doctors to defend their conditions and NHS provision, they must not place their trust in the BMA or the health trade unions. The defence of health care, along with other basic social rights, can only be taken forward by breaking with the unions and Labour Party. Form action committees to unite junior doctors along with patients and other health workers.
We urge junior doctors and all health workers to read the NHS Fightback site and contact the World Socialist Web Site.