By Robert Stevens
Conservative Health Secretary Jeremy Hunt announced yesterday that he would impose an inferior contract on England’s 55,000 junior doctors after failing to reach an agreement with the British Medical Association (BMA).
Addressing Parliament, Hunt said that the government’s negotiator, Sir David Dalton, had reached consensus on 90 percent of issues with the BMA, but no contract agreement had been finalised by a deadline of the previous evening.
Hunt said Dalton and National Health Service (NHS) England’s chief executive, Simon Steven, had requested that Hunt now step in to end the dispute, meaning to unilaterally impose a contract that is regressive in relation to the pay and shift patterns of junior doctors and detrimental to patient care. It will now be enforced from August 1.
The government’s unprecedented and authoritarian move signifies a new stage in the efforts of the ruling elite to dismantle the NHS.
The announcement came the day after junior doctors struck nationally, leading hospitals to cancel around 3,000 non-urgent operations. In the face of growing public support for the doctors, reflecting wider opposition to the ongoing destruction of public health care, the government and sections of the media reported that doctors’ support for the struggle was flagging.
Hunt claimed just 43 percent of doctors participated in the strike, that it was “unnecessary” and was causing “terrible suffering.” He declined to mention that his figure included doctors carrying out emergency care, who were exempt from the action; a fact that the employer, NHS England, had to clarify.
The BMA has done everything possible to head off the growing opposition by junior doctors. It only reluctantly proceeded with the strike but scaled the action down from a complete withdrawal of labour to a one-day strike with emergency care provided. This follows the BMA’s earlier decision to call off a two-day stoppage in late January, in favour of continued talks with the government via the arbitration service, ACAS. The BMA welcomed Dalton to the negotiations, claiming last week that “good progress” had been made. In reality, Dalton’s remit was not to budge an inch on any of the government’s demands, with the outcome being his recommendation that the contract be forced through.
In a letter sent by the BMA to Hunt on Wednesday, and published on its web site, they outlined the content of the “progress” referred to, which fell just short of a total surrender. The letter by Johann Malawana, chair of the BMA junior doctors committee, stated, “Like you, we deeply regret the continuing dispute between junior doctors and the Government and are keen to bring it to a conclusion.”
Malawana pleaded that Hunt “recognise the significant concessions that the BMA has made throughout negotiations.” He continued, “The pay model that we offered to your negotiators in late December redistributes a small fraction that NHS Employers allocated to basic pay in the ‘firm offer’ of November of last year, to unsocial hours payments, thereby reducing basic pay. This would give you the cost neutrality you seek and junior doctors the appropriate recognition for evenings, nights and weekends.
“If you are able to accept this model and withdraw the threat of imposition, we believe that our dispute with the Government would be concluded, leading the way to detailed discussion about implementation,” he offered.
Even this was not enough for the government. On Tuesday evening, it offered the BMA a “final take-it-or-leave-it” proposal. With the strike about to get underway, the BMA rejected the offer fearing a rebellion by doctors if it was seen to accept everything demanded by the Tories.
As the strike began, Chris Hopson, the chief executive of NHS Providers, the umbrella group for NHS Trusts, warned, “If the BMA won’t accept a fair and reasonable offer, then, yes, it is legitimate and sensible for the secretary of state to consider imposition.”
An article in the Daily Telegraph Saturday warned that junior doctors, and by implication, all NHS employees, had to accept the same attacks on their conditions suffered by firefighters … air ambulance pilots, retail assistants or restaurant staff—all of whom work Saturdays on their standard rate of pay. Most care home nurses and managers work Saturdays at their normal rate too.”
The Labour Party, under new “left” leader Jeremy Corbyn, and the trade unions have conspired to undermine and isolate the junior doctors’ struggle. On Wednesday, as the strike was underway, Corbyn was in parliament at Prime Minister’s Question Time, where he is permitted to ask six questions of David Cameron. In the course of the allotted 30 minutes, Corbyn did not ask a single question about, or even mention, the doctors’ dispute.
The conspiracy of silence was maintained by all Labour MPs and those from other opposition parties, including the Greens, with the government getting a free pass.
In the run-up to the strike, Labour refused to support it, with Lord Falconer, the shadow justice secretary, stating, “The precise level of industrial action is not for a political party to decide but for the doctors to decide … we support their [the doctors] cause but we are neutral in relation to the industrial action.”
In parliament, Corbyn wore a badge declaring “Heart unions”. This was in support of the bogus “week of activities” (February 8-14) being held by the Trades Union Congress in protest at the government’s plans for a new anti-strike Trade Union Bill. The main event was a “big workplace meeting”, which consisted of TUC leader Frances O’Grady being interviewed for 15 minutes about the Bill, and streamed to a few trade union meetings held nationally. The TUC held the interview at lunchtime to cause the least possible inconvenience to employers.
Neither the TUC nor any of its 52 affiliated unions has organised a single strike or protest in support of the doctors. The same holds true for the Trade Union Bill. Their isolation of the doctors is most graphically revealed in the case of the largest public-sector union, UNISON. Nearly half a million of UNISON’s 1.3 million members work in the NHS and for organisations providing NHS services. This equals nearly 40 percent of the entire NHS workforce.
What the Labour Party and the unions fear as much as the Tories is that the junior doctors’ dispute becomes the focus for an offensive against the government by millions of workers who have suffered years of unrelenting cuts, of which the onslaught against the NHS is pivotal. This was the crux of the response of Labour Shadow Health Secretary Heidi Alexander, who said in reply to Hunt’s announcement, “Does he not realise that this decision could lead to a protracted period of industrial action which will be distressing for everyone—patients, doctors—everyone who works in or depends upon the NHS?”
Corbyn echoed this fear yesterday, warning, “More strikes now look likely. If that happens, it will be clear that the blame lies with the government, not the doctors. Even at this late stage, I appeal to Jeremy Hunt to go back and negotiate with the BMA.”
The betrayal carried out by the BMA is summed up with its statement Thursday that, “The health secretary can end this dispute, but he must put politics to one side and concentrate on agreeing a fair contract that delivers for patients.” The truth is that to defend a single one of its past gains, the working class must also mobilise their collective strength in a political struggle against the government, which cannot be waged under the leadership of the unions and the Labour Party, but only in a rebellion against them.
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[30 November 2015]