|Volume 53 Number 22, July 26, 2023
Thousands of senior doctors across England walked out on a 48-hour strike from 7am on Thursday 20 July to 7am on Saturday 22 July. It is the first time consultants have taken part in strike action for nearly 50 years.
As the British Medical Association, which represents consultants, points out, the strike is for the survival of the NHS in conditions that are creating an "exodus" from the profession. The action was called after an overwhelming ballot of 86% in favour on a turnout of 71%.
BMA analysis of NHS and government data reveals that the pay of senior doctors has "flatlined" in past the 14 years, increasing by only 14%. Over that same period, average pay in Britain rose by 48%, itself not enough to keep up with rising inflation. While it is the case that consultants earn higher than average salaries, it is also true that it is highly skilled work adding massive value to the economy, and due to conditions in the health service, involves longer working hours as well as on-call work and overtime. As a result, many consultants are burning out or "voting with their feet" and moving overseas or to the private sector, says the BMA .
Health Secretary Steve Barclay simply urged doctors to end the dispute. The previous week, the government had made a below-inflation pay offer of 6%, declaring the offer "final". Yet, according to the BMA, the government has not even spoken with the BMA Consultants Committee since announcing their action.
A 6% rise was recommended by the Doctors' and Dentists' Remuneration pay review body (DDRB). The government both manipulate and choose to accept or reject at their whim the reports of these "independent" bodies. The BMA gave it short shrift, condemning the figure as "derisory" and "an insult to consultants" .
The BMA is demanding a reform of the DDRB, and points to a recent article in the i newspaper, which quoted a Conservative backbencher as saying: "We basically rig [public pay recommendations] anyway, they are told what the budget is. ... then the Government can agree to a 6 per cent rise and it looks positive." 
While Steve Barclay claimed to have "listened", the reality is that the government has hardened its stance and is refusing to negotiate at all.
Rather than listening, the Health Secretary and the government have arrogantly attacked the profession and the dignity of the doctors. Doctors are seen as a highly valued contingent of the workers and people who are also in struggle at every level. As the BMA says, consultants "know their value".
The government's take-it-or-leave-it stance must be seen as a confrontation with workers, their unions, and the working class as a whole, with the NHS staff currently in the forefront and holding the line. The situation with the senior doctors calls for the support of the entire working class and people in the general struggle, which sees the possibilities for a developing counter-offensive. The junior doctors' five-day strike had ended just two days earlier. Though such settlements have been reached for now, as well as with nursing staff, they will not resolve the issues of recruitment and retention, or stress and workload, which exist across the board. Without appropriate improvements in pay and conditions, recruitment and retention are at risk and there is an existential threat to the NHS as it stands.
Doctors are having none of it, and the government's nonsensical talk. This is seen by the widening of the dispute to involve doctors at every level. The stage is set for another major embarrassment for the government if the doctors hold the line and there is every indication that they will do so.
If the government continues to dig in, this will only sharpen the struggle around the aims of defending the rights of all. Their intransigence threatens systemic disruption and credibility of governance not seen in decades. The NHS, and its existence, is seen as crucial by the people. It is fundamental to their aspiration for a human-centred society that looks after their security in life, their wellbeing and the health of their families. It is the will of the people that the NHS be maintained and funded to the maximum, which includes those who work for it.
Support the doctors and all NHS workers! Enough is enough!
1. "Consultants' strike 'for the survival of the NHS'", B. Ireland, British Medical Association, July 20, 2023
2. "Upcoming consultant strike days", British Medical Association, July 2023
3. "Rishi Sunak faces threat of Cabinet revolt over record public sector pay rises", inews, July 12 2023