By Robert Stevens

The unprecedented decision by 55,000 junior doctors to not provide emergency cover during the 48-hour strike that begins today is a measure of their determination to beat the attack being mounted against them and the National Health Service by the Conservative government.

The strike will have a major impact, with at least 12,711 non-urgent operations and 112,856 outpatient appointments cancelled ahead. In their four previous strikes since January, the British Medical Association (BMA) ensured emergency cover was in place, as has been the case since the NHS was founded in 1948.

The BMA has repeatedly sought a face-saving compromise in order to allow them to call off the dispute. BMA leader Dr Mark Porter said to the government yesterday, “If you agree to lift imposition while talks resume, we will immediately call off the industrial action.”

But the Tories have rebuffed all offers made to them. They are not only determined to impose contracts that endanger patient safety, their aim is to inflict a decisive defeat on the junior doctors in order to intimidate anyone seeking to oppose the reorganisation of the National Health Service in line with full privatisation.

The profession’s regulator, the General Medical Council, has warned that medics who go on strike could face disciplinary action or even be struck off if their actions “caused patients serious harm.” For its part, the right-wing media is seeking to whip up hostility to the strike.

Junior doctors have refused to back down in the face of all these threats and workers overwhelmingly continue to support the action. But the danger of a defeat grows with each day that the BMA, other health unions and the Labour Party are allowed to isolate the strike.

From the very beginning, the BMA has insisted that this is not a political dispute, while unions such as Unison, with nearly half a million members, have not organised a single action in support of the junior doctors.

Last week, BMA junior doctors committee chairman Johann Malawana wrote to Health Secretary Jeremy Hunt offering to call off the strike if the government agreed to halt its plans to impose the new contract. Malawana said, “With a week to go to the start of the first full walkout of doctors in this country, I am writing to make a clear offer in a bid to avert industrial action. Simply put, if the Government will lift the imposition, junior doctors will call off next week’s strike action. …” He called on the government to “get back around the table” for talks “at any time between now and the start of next week’s industrial action.”

Hunt replied curtly that it was not possible to “change or delay” the introduction of the contract.

While new Labour leader Jeremy Corbyn and his Shadow Chancellor John McDonnell make vaguely supportive noises, the Labour Party acts as an implacable enemy of the junior doctors. Earlier this month, Shadow Health Secretary Heidi Alexander told a meeting in parliament that she had not been on a junior doctors’ picket line and had no intention of ever doing so. She is now playing a leading role in seeking to get the dispute called off.

On Sunday, a cross-party group of MPs, led by Alexander, wrote to Hunt proposing that if he piloted the new junior doctors’ contract before introducing it across England, the BMA would call off its strikes. The letter stated, “If it remains your intention to introduce this new contract, we believe it should be piloted in a number of trusts/across a number of deaneries and for its impact on patients, staff and the ‘weekend effect’ to be independently evaluated.”

This proposal would bring opposition to the contract to an end and only delay its implementation nationally. It was presented by Alexander alongside Conservative MP Dr Dan Poulter, Liberal Democrat MP Norman Lamb and the Scottish National Party’s Dr Philippa Whitford. The letter assured Hunt that a pilot scheme could not only end the strike, but “would allow genuine progress towards your manifesto commitment of high quality emergency care across seven days a week.”

Doctors and nurses will be justifiably sickened by such a statement being made about a government that has imposed tens of billions of pounds in cuts and “efficiency savings,” leading to the loss or reduction of many emergency services over the past six years. No wonder that one of Britain’s most right-wing newspapers, the Daily Mail, said the government should consider accepting it.

The offer was once again rejected, with Hunt tweeting, “Any further delay just means we will take longer to eliminate weekend effect.”

According to the Guardian, Prime Minister David Cameron “told Hunt to maintain his firm stance in the bitter dispute in two separate conversations late last week. The prime minister was adamant that there should be no climbdown from the tough rhetoric and combative tactics Hunt has employed since the row first flared in September.”

On Monday, a government source told the BBC that the two all-out strikes this week “were aimed at toppling the government and Health Secretary Jeremy Hunt.” He said there could be no compromise as BMA leaders had radicalised a “generation of junior doctors” and any retreat would mean the government facing similar industrial action by other unions, which were watching this dispute “like a hawk.”

In reality, the other unions are watching the junior doctors only in the hope of seeing them brought to heel. The junior doctors can only win by waging an implacable political struggle to bring down the government. And to do that requires a completely different strategy and orientation.

Junior doctors must build their own rank-and-file committees to take the strike out of the hands of the BMA. They must call for a rebellion against the other health unions by the more than 1.3 million workers employed in the NHS and for united industrial and political action against the government. Above all they must appeal for solidarity action to be taken by the millions of workers and young people throughout the UK who want to see the NHS defended and who face similar attacks on their jobs, wages and conditions.

The Socialist Equality Party’s NHS Fightback provides junior doctors and other health workers with the means through which to organise such a counteroffensive and the socialist programme and leadership required to lead it.