28.07.2016

No time to stay silent

BMA members must insist that the union’s decisions are followed through, argues Richard Galen

At the beginning of the month, in a clear rejection of their union’s recommendations, a majority of junior doctors and medical students voted to reject the renegotiated junior doctors’ contract. This came after several weeks of talks between the British Medical Association and the department of health, resulting in a revised set of terms and conditions. In the ballot of BMA members, turnout was high at 68%, with 58% voting to reject the new contract.

Having spent the weeks leading up to the vote touring the country to push the union’s position - namely that the new conditions represented significant gains and urging a ‘yes’ vote - the chair of the BMA junior doctors’ committee, Dr Johann Malawana, announced that he would stand down from his position in the wake of the result. His replacement, Dr Ellen McCourt - described as a “militant medic” in The Sun¹ - has not ruled out further industrial action, but so far the union has been decidedly quiet on the issue of where to go next in terms of fighting the imposition of the new contract.

Aside from a number of token statements expressing “disappointment” that the government was pushing ahead with the contract imposition, the only action thus far has been a survey of BMA members asking for the reasons they voted against the contract and how far they would be willing to go in terms of further industrial action.

Given that the results have not yet been released, it is difficult to see how the union will be able to inform its members of further plans before the nationwide changeover of doctors’ posts on August 3. This will leave many medics, including new foundation doctors just starting in their first posts, uncertain of both their future rotas and their pay packet - not an ideal situation for those who have mortgages to pay and families to support.

Meanwhile, the government is pressing ahead with its plans to impose the new contract in October. Notably, health secretary Jeremy Hunt managed to keep his job in the post-Brexit cabinet reshuffle, even smugly tweeting, “Reports of my death have been greatly exaggerated”, after the BBC reported earlier in the day that he had been sacked from his post.²

This can only be seen as a declaration of support from new prime minister Theresa May, who has shown no signs of deviating from the Tories’ current strategy with regards to the NHS. May has remained stubbornly silent on what Brexit will mean for the health service, refusing to comment even after Simon Stevens - head of NHS England - asked her for reassurance that the thousands of EU nationals currently working for the NHS would still be welcome. All this against the background of one of the lowest real-term funding increases in NHS history, with no sign that the mythical £350 million a week supposedly gained from leaving the EU will suddenly appear in the health service budget.

The contract imposition is still facing a legal challenge, however, with the campaign group, Justice for Health, which is led by junior doctors, currently engaged in a case against the department of health. Its argument is that Hunt has no legal power to impose the contract, and can only recommend it to any NHS bodies.

On July 21, a high court judge ruled that a full judicial review hearing must take place, commenting that the case has “merit” and such a review would be “in the public interest”. It will most likely take place in September, before the planned introduction of the contract. This followed an outlandish attempt by Hunt’s legal team to derail the case by demanding £150,000 from the campaign to cover costs in the event of Justice for Health losing the legal challenge. Not only was this revised downwards to just £70,000, but the original demand was met by crowdfunding in just six days after more than 5,000 answered the appeal for donations, bolstering the efforts of the legal team.

Encouraging as this news is, this cannot be the only avenue used by junior doctors to fight the government imposition. The BMA must now step up and outline a clear plan to its members regarding further measures. This should include joint action with other trade unions, including the National Union of Teachers, which has stated several times its desire to coordinate further strikes with junior doctors and other public-sector workers.

It is also vital that the doctors themselves do not succumb to apathy in what has become a protracted battle with the government. Regarding the BMA survey mentioned above, Ellen McCourt passionately appealed for greater participation after revealing that, with four days to go until the closing date, just 10% of those polled had responded. This cannot be taken by the BMA as an excuse to abandon the fight, nor to fuel division between those who disagreed over whether the new contract was acceptable. If they are to succeed, doctors need to rediscover the unprecedented unity of the profession that saw 98% of those who took part in the original ballot voting in favour of industrial action back in November 2015.

Much like the BMA leadership at this point, they cannot turn silent now. Members must insist that the decisions of the union’s May conference to approach the Trades Union Congress with a view to winning TUC-organised action, including a national demonstration, and discussing BMA affiliation be followed through.

Notes

1. www.thesun.co.uk/news/1403350/prospect-of-further-junior-doctors-strikes-increases-after-militant-medic-becomes-bma-interim-leader.

2. https://twitter.com/jeremy_hunt/status/753560479658901504.