The junior doctors’ six day strike (7am Wednesday 3 January to 7 am Tuesday 9 January) in England1 was the longest in the history of the National Health Service (NHS).
These medics have completed five years of medical school. They then undergo an average of another ten years before they become a consultant who is a specialist with protected tenure and superior salary. Junior doctors, even after all their training, start in hospitals on around £14 an hour, which is only a few pounds above the official minimum wage. They do nearly all the day to day work in hospitals and often work hours beyond their normal shifts. The effects of their recent actions shows the NHS cannot run properly without their work and commitment.
Over the past year nurses, ambulance drivers, consultants and other NHS staff have taken many days of strike action. Last Sunday on the BBC Rishi Sunak, the Tory Prime Minister, wrongly stated that he had resolved all the disputes in the NHS. Further ballots for strike action are being planned by nurses and doctors. There are also legal challenges pending.
The essential problem behind the Junior doctors and other disputes is the severe underfunding of the NHS. Rising numbers of older people with health needs as well as the effects of the Covid pandemic means the NHS needs above-inflation increases just to stand still. Inflation has hit higher levels (11.2% plus) in Britain than in the rest of Europe. Today it is still above 5%. Over the years Junior doctor pay awards have been well below inflation, that is why they are demanding a 35% salary adjustment to restore their salaries to what they used to be.
From the point of view of people wanting to access medical care the situation is complete crisis. Ambulances have to queue up with patients outside the hospitals to wait for a bed to be available. Patients are being taken in and kept in corridors. Britain has fewer beds per head of population than France or Germany. Beds in hospitals are blocked – occupied by elderly people who cannot be safely discharged from hospitals because there are no places available for them in a residential or nursing home. The care sector for older people – along with residential accommodation for all people with special needs – is now increasingly privatised and run for profit. Even hedge funds are now investing in groups of homes regionally and nationally. Care systems are fragmented and operate outside of any rational plan. Quality is very uneven as revealed in the regular scandals of abuse exposed by the press and TV.
The failure of government to curtail the food and catering industry in its production and distribution of sugar/salt rich, ultra-processed foods contributes to an obesity and diabetes epidemic that is also putting pressure on NHS resources. Generally both Tory and Labour governments have failed to do anything to prevent the growing social inequality and poverty in Britain. A recent report from the Institute of Health Equity at University College London led by Sir Michael Marmot calculated that austerity policies from 2010 onwards have produced at least one million unnecessary, premature deaths.
Consequently junior doctors’ struggle for a decent, fair wage is also part of a more general campaign to build an NHS that is fit for purpose and that can respond to all these growing needs. 2024 is an election year and it is most likely that Keir Starmer’s Labour Party will become the next government in the autumn. It has pledged to cut waiting lists for elective care (= not emergency) that are currently at a staggering 7.7 million and growing.
The crisis in the NHS means that increasingly people are turning to private medical care. Private care has increased from 11% to 13% from 2020 to 2022. Personally, I know a number of people who are totally against private care and want to be treated on the NHS but are forced to pay otherwise their pain will remain for a year or more.
Labour has publicly stated that it will not meet the junior doctors’ 35% restoration claim and has proposed only limited increases in funding – totally inadequate for the need that exists. Starmer has stopped any of his shadow cabinet from standing on health workers’ picket lines. As can be seen in the photos many local activists from the unions, left groups and the Labour party have defied this edict.
Labour has long given up actually challenging the private health services that operates inside NHS facilities and cherry picks those procedures that are profitable. Failure to pay the Junior doctors will mean many will opt for working in private practice. Wes Streeting, Labour Shadow Secretary of State for Health and Social Care, has recently questioned whether the annual cries of alarm from NHS doctors about the dangerous winter crisis is really just crying wolf and that there is a internal complacency about “reforming” the NHS. He has already said that increasing the role of the private sector would not be a problem for Labour.
The junior doctors have mobilised strikers very effectively and, despite the government’s refusal to negotiate, are planning more strike action. Only by supporting the junior doctors and campaigning for a much better NHS, funded by redistributive taxation, can the NHS crisis be resolved.
Footnotes
- The strike was in England because the NHS is organised in different ways in the four countries of the United Kingdom. Junior doctors in Wales have voted for strike action from 15-18 January for example ↩︎
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