Junior doctors and other NHS workers and campaigners outside Homerton hospital in Hackney, east London (Picture: Guy Smallman)
The junior doctors’ strikes underline how groups of people who are seen at one point as very different to ordinary workers can be drawn into class struggle.
It’s not the first time the junior doctors have struck—they did so, for example, over a sustained period in 2016.
Capitalism constantly reshapes the working class, and its general trend is to draw more people into jobs where autonomy and control are stripped away from the workforce.
The university lecturer who at one point may have had far more control over their work, is drawn into a market driven enterprise policed by managers who act like the corporate titans they so admire.
Most white collar workers now endure repetitious work where they have about as much autonomy as someone working in a supermarket.
The junior doctor is pushed around by higher levels of management. It’s not like being a porter, but it’s also not being part of an elite. The logic of the factory, with all its pressure and dictation from the top, is transferred to wider and wider layers.
As Karl Marx predicted, “The bourgeoisie has stripped of its halo every occupation hitherto honoured and looked up to with reverent awe. It has converted the physician, the lawyer, the priest, the poet, the man of science, into its paid wage labourers.”
Marxists call this process “proletarianisation”.
At one point teachers or civil service workers were seen as very different to manual workers with pay, conditions and snooty attitudes to match their exalted status. Now few people would be at all surprised to see them on a demonstration alongside rail workers or Royal Mail workers. And the complaints about bosses would be very similar among all these groups.
For Marxists the basic definition of the working class includes all those who don’t own or control the means of production—factories, land, call centres, offices, state services and so on.
They possess nothing beyond their power to labour, which they sell to capitalists or the government in return for their pay.
The definition is a starting point. It covers, for example, some managers who have much more control over their work and are part of disciplining the rest of the workforce.
But the definition is important because it underlines how many people have an objective interest in fighting the system.
However, while it creates new elements of the working class, capitalism also differentiates workers. It systematically, for example, uses notions of skill, gender, ethnicity and citizenship rights to divide up the working class.
It’s not simply an ideological construct. In Britain today the worker on a zero hour contract or working for an outsourced cleaning company clearly does not have exactly the same life as the worker on a permanent contract with five times as much pay.
The pandemic underlined the differences.
Some workers were able to stay at home—and have continued to have at least part of the week away from the workplace. Others never had a moment when they withdrew from hazardous roles working alongside others and faced far more danger from Covid as a result.
The job of socialists is not to pretend there are no differences but to stress that whatever the varied experience, there is a common enemy in the profit system and those who defend it.
That’s why the snobbish advert from the British Medical Association was wrong. It said, “Pret a Manger has announced it will pay up to £14.10 per hour. A junior doctor makes just £14.09. Thanks to this government you can make more serving coffee than saving patients.”
That can entrench division—the idea that doctors should be much better off than mere coffee-servers.
Instead we should celebrate and build on the best of the strikes—the sense of unity and common struggle.
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