The Fight of Junior Doctors for the Future of the Health Service
The junior doctors committee of the British Medical Association (BMA) is currently balloting 53,000 doctors in England over the government announcement that it will impose a new contract on them in August 2016. Although they are described as junior doctors, the contract affects all doctors below consultant level from trainees to very experienced medical doctors who are not General Practitioners (GPs). The Scottish and Welsh governments have said that they will not impose the Tory government contract on junior doctors, whilst the Northern Ireland Assembly has not yet made a decision.
The demands of the junior doctors are opposed to the new contract that will see their pay for the unsocial hours they work cut and the safeguards removed on employers extending their hours of work. The doctors’ demands are that “the government withdraw its threat to impose the new contract, proper recognition of unsocial hours as premium time, no disadvantage for those working unsocial hours compared to the current system, no disadvantage for those working less than full time and taking parental leave compared to the current system, pay for all work done, proper hours safeguards protecting patients and their doctors”. The BMA junior doctors committee points out that “the Government has not provided us with these assurances and so we are balloting on industrial action”.
The action that the junior doctors are voting on in the ballot is whether to take industrial action. The BMA guidance states: “We believe a mandate for industrial action will send a clear message from the profession to the Government that a fairer way forward should be found, while ensuring patient safety is protected. To maximise legal protection and to provide flexibility, there are two questions on the ballot paper – one asking whether you are prepared to take part in a strike and a second whether you are prepared to take industrial action short of a strike. To provide a mandate for the emergency care model (most likely Christmas day working) and for the withdrawal of all junior doctors’ labour, you should answer ‘yes’ to both questions.” The ballot concludes on November 18.
Over recent weeks massive demonstrations have taken place supporting the junior doctors not only against the attempt by the government to impose a worse contract on them but against this whole anti-social direction for the NHS. This resistance is building alongside the whole movement of the working class and people against the government’s austerity agenda and the massive support for the junior doctors is a another upsurge that has taken the government by surprise.
On November 4, on the eve of the start of the ballot, Jeremy Hunt, secretary of state for health, was forced to make a hurried “concession” to the imposed contract to try and head off this movement of the doctors. However, whilst Jeremy Hunt’s increase of the basic pay of doctors by 11% made good headlines for the monopoly media what he failed to mention was that the cutting of out-of-hours pay and the scrapping of yearly incremental pay to make pay rates stay the same for longer could reduce the income of doctors that work out of hours by 40-50%. This move also discriminates against women doctors, and both doctors that work part-time and those that work the longest hours. Jeremy Hunt also continues with his plans to press ahead with removing what the BMA says is “a vital safety net that prevents hospitals from forcing juniors to work excessive hours that could leave medics so tired that they pose a threat to patients”. For this reason the BMA has rejected this latest manoeuvre by the government and is continuing with the ballot.
On May 18, shortly after the Conservatives staged their electoral coup, Cameron made his announcement of a “new 24/7 NHS”. This astonished health workers and health professional when in the real world where most NHS workers from Consultants, junior doctors, nurses, to porters and domestics already work a 24/7 week. At that time, Workers’ Weekly pointed out, “What is hidden in Cameron’s promise is that 24/7NHS is in fact more about satisfying the demand of the competing NHS employers and private health companies to cut health workers’ pay, specifically at this time their weekend and unsocial enhancements. This is why the trade unions reacted angrily that this was an attack on health workers’ conditions.” In other words, it was more about what health workers were paid for 24/7 working in order to make health workers work longer hours for less pay to make the NHS more attractive to the wrecking and privatisation plans of the government.
What followed this announcement on 24/7 NHS has been precisely an attack on the pay and unsocial hour payments to junior doctors as part of their plan to roll it out to all health workers. At the same time, there are specific issues facing junior doctors in the NHS although many of the issues also affect nurses and other health workers.
There are 53,000 junior doctors in England in the NHS. But the UK has fewer working doctors per head of population than almost all other European Union countries (EU). Figures show that although investment in the number of doctors increased between 2000 and 2012, particularly in Scotland, in 2014 Britain still had less doctors per population than 24 of the 28 EU countries: 2.8 doctors compared to the average of 3.4 doctors per thousand population.1 Norway which has a reputation for one of the best public health services in Europe according to the 2014 Euro health consumer index has 4.2 doctors per 1000 of the population. These figures are further confirmation of why the NHS is so reliant on junior doctors working so many extra hours to the standard working week and for which they are paid unsocial hours payments. The government change of contract which they want to impose in August 2016 will extend the standard working week of junior doctors from 60 to 90 hours a week. The present contract is 7am – 7pm as standard hours and what the government is demanding is standard hours from 7am – 10pm. Doctors working these extra hours could lose 30% of their presented contracted unsocial hour payments. This is why the figures that the government claims for an increase in 11% pay are deliberately misleading.
The government sees the doctors like all NHS workers as an obstacle to their plans to increasingly pay the rich more, whether by increasing payment to the rich from the process of cuts to the NHS budgets and other public services, or by wrecking and opening up the NHS further to private profit at the expense of the pay and conditions of the health workers. The monopoly mediatry in vain to claim that junior doctors are opposing the government’s “24/7 NHS” merely to increase their income, while the reality is that there is already a 24/7 NHS as a necessity to meet the needs of patients.. The struggle of the junior doctors is entirely just.
The facts show that the junior doctors in defending themselves are taking up the fight against the anti-social offensive of the government, defending their pay and safe working hours and striving to open up the alternative direction for the people so as to safeguard the future of the NHS. The people must recognise the stand of the Scottish and Welsh governments in refusing to impose the British government’s junior doctors contract as acting in favour of all. It must also be recognised that the working conditions of the junior doctors are the conditions for the health care of hospital patients.
WWIE calls on the working class and people to go all out to support the fight of the junior doctors. A victory for the junior doctors is a victory for all!
1Source: Health at a Glance: Europe, 2014 OECD
– See more at: http://www.rcpbml.org.uk/wwie-15/ww15-32.htm#third