14.01.2016
Giving lie to Tory claims
Support for the junior doctors remains firm, writes James Linney
On January 12 the first of three planned strikes by junior doctors in England took place - the first time doctors had taken such action since 1975. It meant a withdrawal of all non-emergency care by junior doctors for 24 hours. The second strike is planned for Tuesday January 26, and will once more involve a withdrawal of non-emergency care (this time for 48 hours), but the final planned action, on February 10, would involve, for the first time ever, a full withdrawal of labour between 8am and 5pm.
The British Medical Association balloted its junior doctor members in November over the government’s proposed new contract. Negotiations between the BMA, the department of health and national health service employers began back in July 2013, but the BMA withdrew in August 2014, when the government threatened to enforce a contract that the union deemed unsafe for patients and unfair for current and future junior doctors. The strikes, which were supported by an overwhelming 98% of BMA junior doctors in the ballot, were originally planned to start on December 1, but were suspended for a month when at the last minute the government agreed to re-enter negotiations.
Those negotiations have been almost entirely fruitless, thanks to the government’s stubborn intransigence. Health secretary Jeremy Hunt, whilst surely initially taken by surprise by the number of doctors prepared to go through with a strike, has since November been reconciled to this and has clearly been given the green light by prime minister David Cameron. Hence the final round of negotiations lasted no more than 60 minutes, leading Mark Porter, the BMA’s council chair, to laconically comment that the government is still not taking junior doctors’ concerns “seriously.”
The main areas of disagreement are over patient safety and pay. The proposed contract would weaken the current (far from perfect) safeguards aimed at preventing junior doctors from being overworked. It would permit employers to impose longer shifts, more night and weekend hours with fewer breaks and rest days. The current system of financial penalties for not adhering to safe working limits would also be significantly weakened. The inevitable result of this would be hospitals full of more sleepless, stressed and exhausted doctors. Having myself worked as a junior doctor doing seven consecutive 13-hour shifts, I can attest that a direct result of this increased workload would be much greater risk of patient harm. This will be the reality of Jeremy Hunt’s 24/7 NHS.
Hunt’s proposed contract would also change the way junior doctors are paid by increasing the basic by 11%, whilst at the same time reclassifying Saturday and evenings as part of the normal working day. For many this would lead to an overall income reduction, with some seeing their salaries reduced by 20%-30%. The BMA argue that this would lead to further demoralisation and directly reduce the number of people applying to medical school - that number is already in sharp decline due to the fact that, after their five-year medical degree, newly qualified doctors now face an average of £70,000 debt (outside of London).1
So on January 4 it was announced that the strikes were on once again. And if you were wondering how Jeremy Hunt and his team had been spending all the time freed up by not taking the negotiation process seriously, it became immediately obvious that they had been working on their media strategy. Hunt’s tactics have been twofold: to try and cast the BMA as a militant left wing union which is misleading gullible doctors, whilst at the same time (and somewhat contradictorily) painting the dispute as being simply about pay and reluctance to work weekends. Without actually saying so, Hunt and co are implying that doctors are so greedy and lazy that they are happy to abandon their patients. This a disgraceful slur on a group of workers who are so committed to patient care that they regularly stay at work for up to an hour after their shift ends without pay.
Political shift
Hunt released a statement just after the negotiations once again broke down, commenting that junior doctors are “basically saying, ‘We won’t be there for you in life-threatening situations’ … some elements of the BMA are using the strikes as a political opportunity to bash a Tory government that they hate.”2 Similarly Boris Johnson claimed the BMA had “Corbyn fever” and is “more interested in politics than patients”.
Firstly the idea that the BMA has suddenly morphed into a fighting, socialist crack squad has no basis in reality (unfortunately). The BMA leadership is made up of doctors who are elected by their peers: people who on the whole are not known for their revolutionary politics, not least when it comes to specialists and consultants. This is because there is truth in the fact that such doctors get paid well above the average wage and are therefore more privileged members of the middle class. Many still come from well-off, Tory-voting backgrounds.
Of course, social positions can shift and with this comes a shift in political allegiance. During the past few decades we have seen an increasing proletarianisation of the medical profession and this will tend to lead to a move towards the left. Hopefully the experience of the current contract dispute will politicise more doctors and destroy any illusions that the Tory government represents anything other than a cancer on the NHS. So we obviously welcome any kind of “Corbyn fever” as a good start - this is one disease we don’t want to cure. So it was hugely encouraging to see both Jeremy Corbyn and John McDonnell visiting the picket lines and expressing support for the strikes.
Secondly doctors and their BMA representatives have made it very clear, both in media interviews and on social media, that for them the dispute is not mainly about pay, but about patient safety and the future of the NHS. For Jeremy Hunt though, truth and reality are not the foremost considerations - when you have a close relationship with powerful, rightwing media tycoons there is no need to get too caught up with little things like the truth.
It was no surprise that News Corp led the charge to discredit the BMA and the strikers. The Sun managed to hit new lows in lazy journalism, even by its own abysmal standards, when it published photographs of junior doctors on holiday taken from their Facebook accounts under the headline, “Moet medics”, followed by captions aimed at highlighting their shockingly lavish behaviour.3 In the pictures doctors were shown having the audacity to sit on beaches, some even drinking alcohol. Readers were informed that one BMA committee member, “Dr Yannis Gourtsoyannis, 32, last year signed a letter supporting Jeremy Corbyn for Labour leader.” Outrageous. But this pathetic attempt to discredit the doctors backfired, when it was revealed that some of the ‘holiday’ photos they had chosen were taken whilst the doctors concerned were working voluntarily in poverty-stricken countries such as Nepal.
While it is easy to laugh off such amateurish and easily exposed smear stories, we must not underestimate the power of the state-media alliance and its ability to dominate and control political dialogue. Thus in the same way that the mainstream media normalises the idea of Corbyn being an ‘extremist’ for not wanting to bomb Syria or opposing nuclear war, so it – by and large – willingly accepts that Hunt is making a necessary, genuine attempt to improve the NHS. His 24/7 scheme is certainly not seen as part of the attempt to demoralise NHS workers on the Tory-sponsored one-way trip towards full privatisation. So, for example, the media gives little space to ask the obvious: how can an NHS that is massively understaffed, underfunded and generally in permanent crisis suddenly increase its planned care provision by adding two extra days per week for routine treatment?
On the whole the public have seen through the blatant attempts to misinform and to discredit the junior doctors. In fact a BBC poll held on the eve of the strike found 66% supporting it, with only 16% opposing, the remainder being undecided.4 This reflects what I encountered on the picket line: I did not hear a single negative comment from the public, with many people going out of their way to show solidarity by stopping to encourage us, donate food or simply beep their horn in support as they passed. This is in large part due to the fact that workers are well aware that NHS staff do their best, in very difficult circumstances, and that they have patients’ best interests at heart.
It is therefore crucial for junior doctors to continue to link their struggle to the defence of the NHS as a whole. If rumours are to be believed, then the BMA and the department of health are close to coming to some kind of agreement, thus ending this round of doctors’ industrial action. If the final contract meets our concerns over safety, and does not impose extra hours or reduce anyone’s pay, then good.
In the short term the next step for junior doctors, irrespective of a contract agreement, should be to show solidarity with their nursing comrades as they mobilise to save student NHS bursaries.
Notes
1. www.pulsetoday.co.uk/your-practice/practice-topics/education/medical-students-unlikely-to-repay-student-debts-during-working-life/20009752.fullarticle.
2. www.telegraph.co.uk/news/nhs/12090372/Jeremy-Hunt-warns-junior-doctors-strike-will-harm-patients.html.
3. www.thesun.co.uk/sol/homepage/news/6850988/Luxury-lifestyles-of-junior-doctor-strike-leaders.html.