Support pay restitution for doctors; defend the NHS!

The British government is holding both patients and staff to ransom.

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NHS doctors are on strike, demanding a pay rise that addresses the huge real-terms cuts they have been bearing since 2008. The massive debt levels and declining pay for new doctors means that increasing numbers are travelling abroad to work, fuelling an already calamitous staffing shortfall.

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Government holding patients and staff to ransom

British workers are being bombarded with propaganda demanding that we take a pay cut. We are told we ‘must’ do this in a ‘difficult international economic situation’, and that wage rises will simply lead to ‘more inflation’, so ‘more’ will really be less.

Rishi Sunak said that the 6% offer for doctors’ pay was not negotiable. Tory health minister Steve Barclay says his “door is always open to talk about doctors’ concerns”, but NOT about the 35 percent real-terms pay cut doctors have sustained.

Ministers and media accuse the BMA of holding ‘patients to ransom’ by trying to defend their pay. In reality, it is the British government that is responsible for holding both NHS patients and NHS workers to ransom. Ministers have overseen decades of managed decline and privatisation of our services, with the aim of maximising corporate profit, not delivering improved healthcare.

Why should doctors get more?

All workers are facing a crisis, with raised costs of living in every respect decreasing real wages. Consultants’ pay in England has fallen by more than 35 percent since 2008, far more than that of the wider working population. The 2016 junior doctors’ contract enforced a similar pay cut at a stroke.

As the BMA says: “We don’t care for 35 percent fewer patients, carry out 35 percent fewer procedures or work 35 percent fewer hours. The 6 percent offered is in fact a pay cut of at least 5 percent compared to soaring inflation this year alone.”

In the Republic of Ireland, new consultant pay starts at £185,000 – double that offered in England. Those who leave training to work in the NHS find themselves saddled with a huge debt that they struggle to pay off. No wonder 10,000 doctors left the medical workforce in 2021, half of them to work overseas. Right now 13,000 British-trained doctors are working abroad. This is fuelling a massive staff shortfall in the NHS.

Why is NHS pay under attack?

Health service privatisation REQUIRES lowering wages across the health sector.

Back in 2015, staffing cost (along with insufficient funding and the lack of social care for patients fit for discharge) was cited by the Circle Health group as the main reason for its failure to manage Hinchingbrooke hospital at a profit. The group pulled out of its ten-year contract after just three disastrous years in charge. The message was clear: to make a profit out of healthcare requires cheap and flexible staff with minimal rights and long working hours.

During the Covid pandemic, £450bn of taxpayers’ money was lavished on business bailouts and huge emergency healthcare contracts were awarded outside of the NHS. Another £10bn was pledged by the government to private hospital groups in 2020 for “buying operations and treatment in the private sector over the next four years to reduce waiting times [!]”

This massive haemorrhaging of public funds to the private sector is in full swing, and far outweighs the costs that would be involved in funding the NHS adequately, and paying NHS staff to do the job.

Having refused to negotiate a just pay settlement, the government is spending more trying to break the resultant strike than would be needed to meet a decent wage bill. This is not the action of administrators who are prudently trying to balance the NHS’s books for the future. It is a concerted attempt to break the workforce while leaving the disastrous and criminal privatisation policy in place.

Steady decline of the NHS

Following Covid, the NHS waiting list has ballooned to more than 7 million patients. ‘Rationing’ is now in full force, and demand for private healthcare is booming. More than 5 million Britons have taken out insurance policies and record numbers are seeking self-paying private appointments. These are the signs of systemic stress.

This is not a result of the pandemic alone. There is a perfect storm of conditions against which NHS staff battle on a daily basis, which are the combined effects of the deliberate undermining, under-resourcing, restructuring, dismantling and corporate fleecing of NHS and social care funding streams over decades.

It is enough to note that NHS bed capacity in England has been slashed from 300,000 to 140,000 over the past 30 years, of which just 100,000 are acute hospital beds. So when Rishi Sunak announced a ‘flagship’ policy of “creating 900 beds”, it was, frankly, an insult to the nation’s intelligence.

The policies that have been pursued to destroy our NHS (by successive Labour, ConDem and Tory governments) are: the internal market, patient ‘choice’, decreased clinical autonomy and decision-making, the revolving door between NHS and corporations, a target-driven ethos, ‘performance-based’ funding (rationing), private finance initiatives (PFI) to ‘build hospitals’ (the great NHS heist), clinical commissioning group (CCG) GP fundholding (dismantling of planning and the takeover by the ‘big four’ accountancy and insurance firms), subcontracting ‘peripheral’ and then ‘core’ services. The coup de grace will be the rolling out nationwide of ‘clinical networks’, making way for the private healthcare and insurance industries to take complete control of NHS funding streams.

What can we do?

First, don’t be duped. The problem with low NHS pay, including for junior and consultant doctors, is real. As of June 2023, there were 125,572 vacancies in secondary care in England, of which 10,855 were medical, amounting to 7.2% of all medical posts.

Second, be assertive in our demands. The attack on medical pay is part and parcel of the attack on all workers’ pay, and of an attack on the NHS itself. We should not be shamefaced in demanding pay restoration; this is central to our fight to save the NHS. We must demand MORE FOR ALL, not less for this or that group of skilled and vital workers. The current economic conditions of inflationary crisis are beyond workers’ control and not of our making. Workers should not accept paying with their poverty to protect the capitalists’ obscene profits.

Third, defend national provision and demand the reversal of NHS privatisation. This must be our consistent demand across all medical, dental and pharma services.

Fourth, we must recognise that the political game is rigged. The media acts in concert with the government to represent the interests of finance capital against the interests of workers. Workers must build class-conscious media and political leadership to win the battles to come.

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