Link to this page: https://www.socialistparty.org.uk/issue/885/22061
Editorial of the Socialist
United workers' action can save NHS
As this editorial of the Socialist went to press the British Medical Association (BMA) junior doctors' committee had just called off its planned strike on 26 January, reporting "early progress" in talks. This could be positive if the key demands over the new junior doctors' contract are met and would be proof that striking works.
But if the government backtracks or there are no concessions on the central issues, the planned strike on 10 February should go ahead.
This dispute has again put the future of the NHS centre stage. The health service is under attack like never before. The Tories, linked organically to private for-profit 'healthcare', are driving forward its destruction.
£20 billion of cuts are being made under the guise of NHS 'efficiency savings'. Meanwhile NHS Private Finance Initiative (PFI) payments cost £2 billion a year.
Beyond providing emergency care and ambulances, clinical commissioning groups are now licenced to provide services as they see fit.
The idea is spun that our NHS as it is loved and defended - for all and free at the point of use - is an unaffordable anachronism in the 21st century.
It is the market system that is utterly out of step. For example, the government demands less money is spent on agency staff and then they get rid of nursing bursaries meaning it is harder for nurses-to-be to enter training... increasing the need for agency staff.
Job cuts, pay freezes and poverty pay, zero-hour contracts, insecurity - these conditions are spreading like a virus through the health service.
Readiness to resist and organise among workers - expressed, for example, in the 2014 strike by midwives or by GPs calling a special conference to discuss the crisis in general practice - is rising.
On 12 January there was the first strike action by junior doctors in 40 years. This section of workers has been forced to enact the Hippocratic Oath, broadly interpreted as 'do no harm,' by fighting the government.
In this they have support among the general public. An IpsosMori poll found 66% support for the action, while online polls had over 90% backing the junior doctors.
The campaign is against Tory Health Minister Jeremy Hunt's plan to impose a contract on junior doctors, a model of management that could then roll out across the service.
If implemented, the contract would mean a cut of up to 30% of junior doctors' income via a major reduction in the number of hours classed as unsocial for which there is extra pay.
Many said they never imagined going on strike but the government's intransigence in negotiations inspired the 98% support for strike by junior doctors.
Attempting to win support for his onslaught, Hunt claims he is fighting for a seven-day service against a workforce stuck in the past. But doctors already provide a seven-day emergency service. A seven-day 'acute' service without increased funding means a cut in existing services.
Junior doctors explain that this contract is about opening the way to the NHS offering non-acute services at the weekend for private patients for profit. It will also open the way for other workers to see their conditions deteriorate.
Since the first strike, Hunt and the government have indicated their preparedness to 'resort to the nuclear option' and impose the contract on junior doctors. Ultimately the Tories represent the capitalist class who drive constantly towards increasing their enormous wealth.
These vultures, in a period where opportunities to profitably invest are limited by the extent of the world economic crisis, see public services and particularly the health service as extremely lucrative. The Tories are legislating to assist them, including by driving down workers' pay.
Many doctors spoke about colleagues who have left the NHS to work under better conditions in Australia, Canada, etc. As pay and conditions have been attacked among nurses, cleaners and other sections of the NHS, there has been a turn by health managers and private companies to recruit workers from overseas on lower wages and worse conditions. The unions must organise and unite workers in defence of the rate for the job across the service to fight this race to the bottom in health.
The Tories are introducing drastic measures to increase the precariousness of migrant workers. For example, under new rules that will hit nurses hard to be introduced in April, non-EU workers who earn less than £35,000 after six years in the UK will be deported.
Victory by the junior doctors would embolden other sections of workers in the NHS and beyond to take action against their multiple grievances on pay, conditions, pensions, and more.
The Tories hope that this struggle can be a 'miners' strike moment' for professional workers who have a new and urgent appetite for struggle - a defeat of a celebrated struggle that undermines the confidence of other workers to fight. But there was nothing preordained about the defeat of the miners.
Like the doctors today, they had enormous support in society and most importantly across the trade union movement. What was lacking was a trade union leadership prepared to recognise and do what was necessary - organise solidarity action to support the miners' heroic struggle. That mistake must not be repeated.
The Socialist Party is campaigning for a national demonstration to be called in defence of the health service. This would give those workers who beeped their horns in support of the junior doctors, or delivered biscuits to picket lines, the chance to show their solidarity more forcefully.
Local marches, solidarity meetings, lunch time rallies of local trade unionists on any future strike days and inviting BMA speakers to union meetings should all be pursued to this end.
More effective, however, would be other sections of workers, especially those in the NHS, taking the lead from the RMT rail union (which called action for 26 January too) and coordinating action. On picket lines doctors expressed their readiness to support action on nurses' bursaries, for example.
The leaders of the health unions have proved over the last few years that they will have to be pushed hard into leading action. Until victory is assured, every labour movement meeting should debate the demand that trade unions back the doctors to defend the NHS (see model motion above).
The anti-union legislation will be used as an excuse for inaction. Militant struggle has been the vital ingredient in the major advances in health services, including the foundation of the NHS.
These struggles were forced to challenge the legal limits of the day on workers' action because they had to show that withholding concessions was not an option for the capitalist class.
A 24-hour strike across health would build on the lesson of the junior doctors› action - that it is workers who are the true and capable defenders of the NHS. Workers and their trade unions would need to democratically decide and plan emergency cover in such an event.
The long fight for health services for all, among other improvements for the working class, was one of the consequences of the process of building a new mass workers' party, the Labour Party.
What a change from the pro-privatisation Blairite years it was to see John McDonnell, Labour's shadow chancellor, visit the doctors' picket lines. As has become the pattern, the following day he faced recriminations in the press, including from shadow health secretary Heidi Alexander who said that party policy was not to support industrial action. When Alexander was deputy mayor of Lewisham, south London 2006-10, she consistently supported PFI and New Labour's other NHS marketisation policies.
To be able to assist health workers in their battle against privatisation and in defence of jobs and services McDonnell and Jeremy Corbyn will have to mobilise their anti-austerity supporters in the Labour Party and beyond to fight the right wing.
Jeremy Corbyn's defence of the right to strike and of solidarity action will inspire many. Linked to that, to mobilise the potential mass movement that is needed to defend the NHS and fight austerity and the austerians, is the need for a clear socialist programme on health as part of a democratic plan for the economy.
That would need to include the nationalisation of the pharmaceutical industry under democratic control and a massive expansion of well-staffed services.
Model resolution for labour movement meetings
Defend the NHS
This [branch/ union/ meeting] welcomes the fantastic action by junior doctors in defence of the NHS. The widespread opposition to privatisation is expressed in their action and the support they received.
But they face a determined enemy in the Tories and the private healthcare companies behind them.
To defend the NHS and ensure victory for the junior doctors will need a mass movement to be built, mobilising the anger and determination which exists but requires a channel.
We propose to:
- Invite local BMA members to address our next meeting
- Contact other unions to organise a local trade union rally at lunchtime on the next BMA strike day to bring together unions in resistance of the Tories
- Call on the [trade union] leadership to coordinate with other health unions in the calling of a national demo
- Look at the potential to co-ordinate widespread industrial action in the NHS alongside any group of health workers under attack, as the junior doctors have been
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