Junior doctors in England, outraged by the Tory attacks on their terms and conditions and the dismantling of the National Health Service (NHS) are mounting a 24-hour strike Tuesday, followed by industrial action on December 8 and December 16.
Almost 100 percent of doctors voted for strike action in a 76 percent ballot turnout. This is a powerful example of the growing militancy among hospital workers in opposition to the systematic rundown of services and attacks on pay, terms and conditions. Recent junior doctors’ protests have attracted the support of thousands of other hospital staff and people across the UK, whose lives are bound with the NHS.
The Conservative government, which was adamant that it would impose new contracts unilaterally by August 2016, entered talks with the British Medical Association (BMA) last week through the Advisory, Conciliation and Arbitration Service (Acas). No one should have any illusions that this will produce justice for junior doctors. The government is getting ready to deploy army medics into hospitals for a scab operation against the striking junior doctors, reminiscent of past operations against firefighters, and a practice normally associated with military police dictatorships.
The government claims to be trying to impose new junior doctor contracts to create a better 7-day service. But the new contracts will effectively slash the pay of junior doctors by 20-30 percent and create working conditions that will put patient treatment and safety in jeopardy. This is the prelude to an across the board slashing of enhanced payments for unsocial hours and attacks on incremental pay progression for the entire NHS workforce. Faced with the slashing of government funds and increasing demand for services, NHS employers insist, “the national pay and conditions of service for all NHS staff need to continue to adapt in order to make them affordable and sustainable.”
The Tory government is demanding a further £22 billion in “efficiency savings” over the next five years, by which they mean cuts. The previous Tory-led coalition with the Liberal Democrats recorded the lowest ever funding increase for the NHS in its entire history and imposed a devastating £20 billion in “efficiency savings”, with callous disregard for patient care and safety.
Dozens of hospitals, Accident and Emergency Units (A&Es), maternity units, children’s heart units and ambulance services have been shut down or downgraded. Reports indicate a widespread rationing of vital health services across the country.
All performance indicators show a massive erosion of patient care and safety. Targets of A&Es, cancer treatment, elective waiting lists and diagnosis tests have all been missed. Experts assert that the massive funding crisis in social care created by underfunding will drastically increase pressure on NHS services which are already at breaking point.
The Health and Social Care Act implemented in 2012 seeks to expedite the privatisation process in the NHS. Around 10 percent of NHS spending on health services now goes to non-NHS providers. The next stage of the privatisation process requires a wider slashing of pay, terms and conditions to attract private companies and bring about a deliberately created crisis within the NHS to justify further outsourcing.
The assault on junior doctors’ contracts and the NHS by the ruling elite is part of the general attack on the working class. The capitalist class hates the NHS as the main symbol of all the hard-won social gains of the working class in the postwar period and is determined to abolish it along with the rest of the social security system on which millions depend.
No faith should be placed in the trade unions, which have strangled one struggle after another. They have played the key role in enabling the government to push its measures through by restricting opposition to job losses, wage cuts and hospital closures to local or regional campaigns, organising token protests, petitions and writing letters to MPs. They sowed illusions that a future Labour Party government would defend the NHS, despite the opposite being the case when the party was in office, as it laid the basis for the privatisation and cuts carried out over the last five years. This perspective was left in tatters by Labour’s catastrophic defeat in the election.
The BMAs record is no different. They deliberately avoided their members participating in the 2011 pension struggle, in which millions of public-sector workers took part. Like other health-sector unions, the BMA mounted no opposition to the Health and Social Care Act and privatisation process which the junior doctors have fallen victim to.
The ruling elite will not be satisfied until they have destroyed all the gains and conditions won by the working class. The economic crisis which erupted in 2008 exposed how successive governments enabled the super-rich to plunder social wealth, rig markets and cook the books. Having spent billions of pounds bailing out the banks at taxpayers’ expense, governments in every country are imposing vicious austerity measures. Their aim is to use the economic crisis to carry through a social counterrevolution against living standards and vital social provision.
Greece has been at the sharp end of this offensive, but a similar process is underway in every country, above all in Britain. The betrayal of the struggle against austerity by the Syriza-led government proves that the working class can place no trust in the anti-austerity rhetoric of the Jeremy Corbyn faction of the Labour Party and the trade unions that back him.
The defence of health care and every other basic social right can only be taken forward through a break from the unions and the Labour Party. The Socialist Equality Party and the NHS Fightback campaign call on striking junior doctors to build action committees to defend the NHS, which is facing death by a thousand cuts. Hospital workers and the workers and youth whose lives and health are being jeopardised must be organised collectively.
The problem is not a lack of funds or resources, but the monopoly of wealth by the super-rich. This monopoly can only be broken by a mass movement of the working class to bring down the government and replace it by a workers’ government based on socialist policies.
Such a government would carry through a radical redistribution of wealth in favour of working people, which would include ending the obscenity of medicine-for-profit and restoring the health service as a free, high quality state-run facility for all.