By Robert Stevens
The British Medical Association (BMA) agreed a deal with the Conservative government and National Health Service (NHS) employers Wednesday, in an effort to sell out the struggle by more than 40,000 junior doctors.
The doctors have been in a bitter dispute over the terms of a new contract since 2012 and have held four strikes since January. Last month, in a signal of their determination, doctors carried out the first all-out strike by health workers, without the provision of emergency cover, in the nearly 70-year history of the NHS.
The contract agreed by the BMA is even worse than that previously overwhelmingly rejected by junior doctors. The BMA is recommending what it describes as a “good deal” in a “referendum” of its members to be held from June 17 to July 1. It agreed to ensure no further strikes are held for the duration of the referendum, with the result to be published July 6.
The rejected contract slashed premium rate pay for out-of-hours work, evenings and weekends. Doctors faced an increase in their already notoriously long working hours in a move highly detrimental to their health and to the safety of patients. That contract was set to be enforced in August, after Health Secretary Jeremy Hunt took the unprecedented decision in February to impose the contract, following a second day of strikes.
After holding a fifth strike last month, the BMA agreed to fresh talks. These were held without any preconditions on its part, with the right-wing media noting this was a significant retreat.
The new deal, which will not be published in full and available to BMA members to review until the end of May, includes the following:
· A proposed rise in basic pay is reduced from 13.5 percent to between 10 percent and 11 percent.
· Weekends will no longer be divided up between normal and unsocial hours. Saturday and Sundays will count as normal working days between 9 a.m. and 9 p.m. Premium payments will not be offered as standard for working unsocial weekend hours as previously.
· Junior doctors working on Saturdays and Sunday will only receive extra payments if they work seven or more weekends in a year. Those working less than seven weekends a year will be paid at their normal rate.
· The contract stipulates that doctors will receive a percentage of their annual salary for working weekends. They will receive just 3 percent of their salary for working one weekend in seven, and up to 10 percent if they work one weekend in two.
· Any nightshift which starts at or after 8 p.m. and lasts more than eight hours, and which finishes at or before 10 a.m. the following day, will only be paid at an additional rate of 37 percent for all the hours worked. This is a cut from the 50 percent rate in the rejected contract.
The deal was announced after 10 days of talks brokered by the Advisory, Conciliation and Arbitration Service (Acas). It was hailed by Acas chief Sir Brendan Barber, who has a long record of collaborating in the sell-out of workers’ jobs, terms and conditions as the head of the Trades Union Congress (TUC) from 2003-2012.
Barber was knighted under the previous Conservative/Liberal Democrat government after stepping down from the TUC for his 38 years of “services to employment relations.” He was lauded from the stage of the TUC’s annual conference in 2010 by then head of the Bank of England Mervyn King. Referring to the TUC’s role following the world financial crash in 2008, King said, “Brendan has helped us through some extremely turbulent times. I am grateful.”
The Tories have secured everything they wanted with a contract they view as instrumental in imposing seven-day working as standard on all NHS workers, without allocating any extra funding or staffing. In Parliament, Hunt said it was a “historic agreement,” adding that the government had crossed none of its “red lines” and the proposed contract was cost neutral. Regarding the cost of rostering junior doctors at weekends, the government said the deal cuts costs by a third.
News of the deal provoked anger from junior doctors. Dr. Manish Verma told the Guardian, “It doesn’t seem like an improved deal. It’s the BMA’s turn for propaganda to try and sell this as a good deal. Looking at the Acas document there seems to have been lots of areas where we have conceded. It’s unclear where we have gained anything.”
Will Rook, a junior doctor in general medicine, said, “It hasn’t addressed a lot of the concerns I had in the first place around trying to spread a five-day service over seven days without having extra people to do the job. He added, “A 10 percent supplement for working one in two weekends a month is a joke. The disruption it causes is immense.”
A doctor from Birmingham said, “There is still a deep sense of anger, injustice, and lingering distrust. The reduction in basic pay compared to the previous offer, the reduction in pay for night working, and the pay changes for Saturdays and Sundays will feel like a concession too far for many doctors.”
A nurse from Lancashire said the agreement “doesn’t address our main concerns regarding patient safety. I already know of valued colleagues who have resigned from the profession.”
A nurse from Plymouth was concerned “that people who work the most weekends may be worse off under the new proposals. … Currently any doctor who works one in two weekends gets a 50 percent banding of their salary, but it seems possible under this new contract that they will only receive a 10 percent banding.”
In a reference to Johann Malawana, the junior doctors committee chair who led negotiations, one doctor said on Twitter that a comment was overheard in a staff mess room: “Johann must have taken a bung. There’ll be a lump sum in a Panama bank account.”
The BBC reported Thursday that the BMA acknowledged it faced an “uphill struggle” to win the support of its members for its rotten betrayal of their interests.
The Guardian described the anger of BMA members as being “so intense” that Malawana was forced to post a message Wednesday on the junior doctors’ Facebook page: “I truly understand that people are scared and worried. I know there is fear and a hell of a lot of anger.”
Referring to the government declaring it had won a significant victory, Malawana added, “I know that the government’s reaction to the contract this evening has not been helpful.”
The 12-page agreement concludes with an “Implementation Process” which details that the BMA will hold “road shows” throughout England as part of selling the deal and will campaign using “materials” that are “jointly agreed” with NHS employers and the Department of Health. On “Contract Implementation,” it states that pending agreement in the ballot, parts of the new contract will be in place in August, with all junior doctors and all new entrants employed under its terms by August 2017.
The Socialist Equality Party calls on junior doctors to reject the contract. However, that is not enough. The dispute cannot be left in the hands of the BMA, whose stranglehold must be ended. Doctors should form independent committees to take their fight forward, in a unified struggle with other health staff and workers throughout the UK.
At the same time this fight is a political struggle. The defence of pay and the fight against closures cannot be carried out through the unions or the Labour Party. It means a challenge to the grip of the financial and corporate elite based on a socialist and internationalist program. The SEP is building the new leadership in the working class for this fight.