By Yuri Prasad and Thomas Foster
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Junior doctors say keep up pay fight under Labour

NHS workers spoke about the current state of the NHS, why it’s right to strike during a general election and the expectations of an incoming Labour government
Junior doctors on strike

Junior doctors on strike in Richmond, north Yorkshire (Picture: BMA Junior Doctors)

The junior doctors’ long-running pay strike will be one of the first tests for an incoming Labour government. Last week saw the eleventh round of walkouts in England, with action running until just days before the general election this Thursday.

The wave of doctors’ strikes that began in 2023 followed those of nurses and other health workers. They were a response to a deep health service crisis, workers’ heroic but unrewarded efforts during the pandemic and pay so low that it was insulting.

During the Tory years, health spending has fallen drastically—once inflation and Britain’s ageing population are taken into account. The result was collapsing hospitals, massive waiting lists, huge numbers of staff vacancies, patients treated in corridors and in the backs of ambulances and an exodus of skilled workers.

The crisis has driven millions of people to vote Labour this week. But Labour shadow health secretary Wes Streeting will immediately face two conflicting pressures.

On the one hand, ending the doctors’ dispute is a crucial step toward bringing down the waiting lists for NHS treatment. As one of the biggest general election issues, future voters will judge Labour on how well it does this.

On the other hand, Streeting is under pressure from the Treasury to impose a new round of austerity, including pay freezes for hundreds of thousands of health workers. Any win for the doctors’ BMA union could scupper that.

So, Labour will look for a deal that falls well short of the BMA’s demand for full pay restoration for junior doctors— a rise of 35 percent. And, rather than cut hours and reduce pressure on health staff, Streeting wants extra shifts and more “flexible” hours to cut the backlog.

And he hopes all health unions will sign up to his plans. During last week’s junior doctors’ strike, Socialist Worker spoke to several union activists about the challenges ahead and how they think the unions should respond.

Paul, radiology doctor, east of England

Accepting below-inflation pay offers, year after year, is how we got into the mess we are in now. So, there is absolutely no justification for the BMA agreeing to a deal with a new Labour health secretary that doesn’t meet our demand for full pay restoration.

Where would accepting a lower offer get us? It would mean the problem of thousands of doctors leaving the NHS would simply get worse, and that means a worse outcome for patients.

Labour keeps promising that it will recruit more people to work in the NHS, which is great. But then they say there’ll be no extra resources.

My question is, without more money how do we recruit and keep more experienced staff? It’s impossible to do that.

That’s why I don’t sense any appetite among doctors to compromise on our demands. But I think a lot of doctors would accept a multi-year deal if it brought our pay back up over time.

That’s probably where our dispute will end up. For that to happen, the new government must accept the principle of restoring our pay.

That would be a huge milestone—and would make our long strike worthwhile. After the election, the big question for us will be how to keep the pressure on the government.

That means we must keep the strike mandate live. There’ll be a lot of pressure on us to give ground.

Labour will doubtless say they can’t negotiate while looking down the barrel of a gun. Yet the only reason we are having negotiations at all is because we’ve been prepared to strike.

That’s why we have to stand firm.

Amisha, a stroke doctor in Birmingham

I’ve just completed six years of medical training and now I’m on strike. Even in my fourth year of training, I knew we were going to strike.

We do this job because we want to help people and there’s an assumption that if you do good work you’ll be rewarded—but not in this job. Throughout all those six years, junior doctors’ pay has kept falling.

And this dispute is not just about pay, it’s about everything that’s linked to pay too. Because we are short staffed, we work too hard and we worry about mistakes.

Then, when we get home, we find it hard to switch off and we are anxious about the patients we saw during our last shift. I’m not the only person I know who gets to work early so that I can check up on the people I cared for the day before.

That’s a result of stress and it interferes with your sleep and your home life. Striking in the run-up to the election was necessary.

We needed to send a message, and the new government needs to know what it is in for.

Junior doctor, Homerton hospital, east London

We are putting our dispute at the front and centre of the general election. We set a deadline for the government and we won’t give up until our demands are met.

If Labour doesn’t meet up demands, we should continue striking. Our demand is our demand.

It is constant irrespective of who is in government. Whether it’s Wes Streeting or a Tory health minister, we demand pay restoration.

We don’t deserve anything less than 35 percent. We’ve been in our dispute for an incredibly long time.

I’m proud of junior doctors for maintaining their resolve. We have a renewed mandate that’s stronger than ever.

And we massively appreciate all of the solidarity from the community, the nurses and everyone who comes out to support

Johnny, surgical doctor

We are on strike because we haven’t been given the pay offer we wanted. And so, we are bringing our fight to the government.

We are doing this to show the next government that we mean business and we still want to fight for our pay. The strike shows how precarious the modern NHS is for doctors.

And, if it’s precarious for junior doctors, think how much worse it is for NHS workers like nurses and cleaners. That’s why we need to join up all of our fights.

Whoever the next government is, we need to get the waiting lists down but that should not come as a result of sacrificing our pay or making workers work longer hours.

John, junior doctor

You have to fight for your rights. We aren’t asking nicely.

Austerity ravaged the NHS and we want to fight back. I hope that Labour will be willing to listen but we need more drastic opposition to privatisation.

Labour introduced the Private Finance Initiative (which privatised hospitals and health centres) and that was an unmitigated disaster. And privatisation leads to private bosses often denying people workplace protections.

That’s why we need all our services to be provided in-house and all NHS workers to be treated with respect. There’s no place for corporate profiteering in the NHS.

We let our pay conditions slide for too long. We have the support of other NHS workers and that solidarity is the bedrock of our campaign.

Jordan, occupational therapist

It’s right for junior doctors to strike before the election. Other unions have paused their battles for the general election but that’s a huge mistake.

The fight for NHS pay cannot be delayed. It doesn’t matter who’s in government, NHS workers need a pay rise.

We are furious about what the Tories have done to the NHS but we aren’t going to accept just anything from Labour. It isn’t stepping up at the moment.

All staff are right behind the junior doctors. Their struggle is our struggle, and if junior doctors win, then other health workers are more likely to win

Victories in local disputes show it is right to fight

Health workers are at their strongest when they fight together. And under Labour, activists must seize every opportunity to strike, regardless of union tops that pressurise them not to.

Sometimes this will mean taking up local fights over bonuses, hours, allowances or even demands for free on-site parking. Every small dispute can encourage others and create pressure for the national action we need.

An example of successful resistance can be seen in the recent victory at Barts, the largest NHS trust in London. There, hundreds of cleaners, porters and facilities workers have fought a long-running battle for the government’s £1,650 Covid bonus.

Their Unite union announced last week that workers had accepted a deal to end the dispute with a “historic victory”. Unite says workers will receive added “special leave” equivalent to the bonus.

The win has huge implications for all outsourced NHS workers who didn’t get the payment. Meanwhile, healthcare assistants (HCAs) in the Unison union are winning battles over pay banding, leading to back payments of up to six years.

Hundreds of HCAs across Teesside, north England, last week accepted a re-banding offer that moves them from band 2 to 3, and gives them five years of backpay. The deal will be worth thousands of pounds to some of the worst paid workers in the NHS.

In Leicester and other parts of the East Midlands, hundreds of nursing assistants who work on hospital wards and clinics struck this week. Strikers there are confident they will soon join the ranks of others who’ve beaten their bosses over pay grading.

With Labour in office, there will be massive pressure on the unions to put an end to these disputes. Wes Streeting must be given time to fix the NHS crisis, Labour supporters will insist.

But health workers have already waited too long for proper pay and conditions. Many will not accept the argument that their needs are less important than Streeting’s career.

Every battle for NHS workers is part of the wider struggle to defend the NHS and improve care. We must not let Labour con us into thinking that workers’ interests and those of patients are opposed.

And neither should we fall for the idea that unions should give Labour years to “sort out” the health service.

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