Workers' Weekly On-Line
Volume 53 Number 25, August 19, 2023 ARCHIVE HOME JBCENTRE SUBSCRIBE

The struggle for the future of the NHS

Junior Doctors Hold Four Further Days of Strike Action, Rejecting Sunak's "Final Offer"

Junior doctors on strike in August - Photo: Personnel Today

In the latest escalation of their campaign for a meaningful pay rise in the face of government intransigence, junior doctors in England staged a 4-day full walkout from August 11-15, continuing a wave of action involving various sections of staff across the NHS that began in December last year.

Junior doctors striking at Arrowe Park Hospital, Wirral, Merseyside - Photo: John Brace

Most unionised junior doctors are organised in the BMA. However, those belonging to the smaller Hospital Consultants and Specialists Association also took part in the strike.

On the first day of the strike, over 100 doctors gathered outside Downing Street, holding placards and BMA flags. The union points out that F1 doctors, the newest medical recruits, were among those attending, whose very first action as doctors was being forced to strike for their pay and working conditions [1].

The doctors are demanding a 35% pay rise, having suffered a 26% real-term pay cuts since 2008, which has led to a crisis in recruitment and retention, with dire consequences for the future of the health service.

In the lead-up to the action, Prime Minister Rishi Sunak had announced his "final offer" of a mere 6% increase in 2023-24, together with a £1,250 consolidated payment, stating strike action will not alter the decision.

NHS workers have been making themselves felt through their actions, which have resulted in over 820,000 cancellations of operations and hospital appointments since last year, with 7.5 million people now awaiting non-urgent treatment [2].


NHS chief executive Sir Julian Hartley had claimed the strikes have cost over £1 billion. He estimated 1 million appointments to be cancelled and rearranged by the end of this round of action. [3]

The BMA is currently balloting for further action.

The junior doctors' strike coincided with a 2-day walkout of radiographers, and consultants in England will begin another round of strike action on August 24.

NHS England last week also set out plans to prepare this winter for unusually high levels respiratory diseases, including Covid, flu, and RSV.

"Junior Doctors and their patients need change now. While workload and waiting lists are at record highs, junior doctors' pay has been cut by more than a quarter since 2008," explains the BMA.

"A crippling cost-of-living crisis, burnout and well below inflation pay rises risk driving hard working doctors out of their profession at a time when we need them more than ever. To protect the NHS, the Government must engage and address doctors' concerns. But so far, they have refused to meet with us. This has left doctors with no other option but to vote on whether to take industrial action. If junior doctors are forced out of the NHS because of poor pay and conditions, the services we all rely on to look after our loved ones will suffer".

Their campaign aims to:

  1. Achieve full pay restoration to reverse the steep decline in pay faced by junior doctors since 2008/9.
  2. Agree on a mechanism with the Government to prevent any future declines against the cost of living and inflation.
  3. Reform the DDRB (Doctors' and Dentists' Review Body) process so pay increases can be recommended independently and fairly to safeguard the recruitment and retention of junior doctors.

At the rally, BMA Junior Doctors Committee co-chairs Rob Laurenson and Vivek Trivedi told the assembled doctors:

Photo: SSTHC

"We're here yet again to fight for what we're worth, to show this government that we will not roll over... Sunak has the audacity to suggest that this 'final offer' ends our dispute but make no mistake, our dispute is far from over. He wants you to give up and accept another pay cut. He wants you to think that he has the power and not you as doctors."

Writing for the Daily Mail in a rabid attack, Health Secretary Steve Barclay defended the Government's pay offer and said: "Yet, the BMA continues to act recklessly by going ahead with further unnecessary strike action this week, which serves only to harm patients and put further pressure on their own colleagues." [4]

The struggle appears as government intransigence versus the persistence of the junior doctors.

On the one side is the government and Sunak himself, who pledged in January that waiting "lists will fall and people will get the care they need more quickly". This is a government that has only its failed "deliverology", blind to real human beings and their relations.

Government intransigence only masks their real weakness. It has been reduced to introducing anti-strike laws, trying to use the courts over ballots to offset actions. Yet even the judiciary can see what is at stake, and now a High Court ruling has blocked NHS England from using agency staff to undermine the strikes.

The government also crudely attempts to divide and rule by concocting disinformation, resorting to blackmail and scaremongering. Yet the public have seen through the deceit, and they support their doctors, nurses, paramedics, ambulance drivers, and all who work in the NHS.

All of which brings us to the "final" offer. How can such "finality" be reconciled with the fact that there is an existential crisis without health for all citizens? If the government continues to dig in, this will only sharpen the struggle around the aims of defending the rights of all, and conflicts with the popular will, which is for the NHS to be maintained and funded to the maximum, including those working for it.

Sunak himself points to the essence of the matter: Who decides? He declares that this is his decision, and that no amount of strike action will alter his decision. But as Laurenson and Trivedi counter, it is "not for... Sunak to decide that negotiations are over before he has even stepped in the room."

Sunak's stance, arbitrariness backed by naked police powers, serves the private interests he represents that demand every aspect of society pay tribute, regardless of the consequences. It is the doctors and other health professionals, and public opinion on their side, who represent the general interests of society. The issue is, whose will will prevail?

1. "Junior doctors' rally descends on Downing Street", Tim Tonkin, BMA, 14 August 14, 2023
2. "Junior doctors in England to strike for four days in August", Financial Times, July 26, 2023
3. "Barclay claims strike action by doctors causes 'harm' to patients", Richard Wheeler, The Independent, August 11, 2023
4. "Our offers to doctors are fair and final. This strike only serves to harm patients" Steve Barclay, Daily Mail, August 10, 2023


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