On Thursday 23 October, following a ballot in which 97 percent of those participating voted for strike action, junior doctors announced a five-day walk-out in England, starting at 7.00am on Friday 14 November. They are striking over pay that remains far behind 2008 levels, despite recent rises, and over the steady disappearance of speciality training positions in NHS hospitals.
Despite massive and growing undercapacity and huge waiting lists, the NHS is training fewer doctors every year. At present, there are 20,000 more applicants for specialist training than there are places. It doesn’t take a genius to work out that it won’t be long before there will simply be too few gynaecologists, urologists, surgeons, psychiatrists etc etc to fill all the consultant and senior registrar posts needed to keep the NHS operating as a universal and nationwide healthcare provider.
In response to the strike announcement, health minister Wes Streeting gave a series of interviews to the press, telling the Sunday Times: “My message to resident doctors is: the fewer doctors who go on strike, the more jobs I can create.”
From which we can only conclude that Mr Streeting is not only a loyal servant of the zionist lobby, but of the entire City of London financial elite – of British imperialism in toto.
As part of his general servility towards finance capital, Streeting has been assiduous in using his role as health minister to promote the interests of the private health lobby in Britain.
He has, for example, forced through £7bn in cuts to the budget of an already struggling NHS. As a result, 90 percent of hospital trusts anticipate they will soon need to cut services and clinical posts (doctors, nurses, physios, midwives and all those who actually deliver care).
All while waiting lists are already screaming as a result of a chronic undercapacity that has been deliberately cultivated and sustained over decades.
Didn’t Labour create the NHS?
The idea that the Labour party ‘created’ (and is therefore uniquely interested in preserving) our health service is a myth that has been heavily promoted to working people for many decades, but it is simply not true.
The NHS was created as part of a raft of social measures aimed at buying off revolutionary sentiments amongst the British working class in the wake of two world wars, the Great Depression, and the rise of the socialist Soviet Union, the anticolonial national-liberation movements and the socialist bloc of countries in eastern Europe and east Asia.
In essence, it was a social stabilisation measure taken by the British (and other imperialist) ruling classes when the balance of class forces had shifted in favour of the working and oppressed masses.
A Labour government was installed in 1945 and tasked with overseeing the implementation of healthcare, social housing, free education and various other measures that collectively formed what is known as the ‘welfare state’ (ie, a social safety network that provided minimum guarantees for workers to receive education and healthcare, a home, a pension, and a basic stipend if no capitalist would employ them).
The setting up of this ‘welfare capitalism’ was agreed upon by all bourgeois political parties because it was needed to provide a breathing space for a very much weakened British imperialism. While the mass of British workers did indeed benefit greatly from the measures enacted, the Labour government of 1945 was fundamentally motivated not by their interests but by the need to save the monopoly-capitalists from expropriation and dethronement.
This explains why subsequent Tory administrations also protected the welfare state for as long as it was considered necessary by the ruling class. It also explains why it is that so-called ‘neoliberalism’ or ‘Thatcherism’ (ie, the later strategy of dismantling the welfare state) began to be pursued as the economic crisis of capitalism was reasserting itself in the 1970s, and why it accelerated after the fall of the USSR and east European socialist states in 1991.
The economic situation and the balance of class forces had changed, and the capitalists were back on the offensive. They no longer feared the revolutionary sentiments of the working class, whose class consciousness and organisation had been much diminished. They no longer feared the example of the European socialist countries. Indeed, they optimistically predicted that it would not be long before they had reconquered every remaining liberated territory and brought all the world’s people back under their control.
We should note that while the attack on social services and workers’ rights may have been started under a Tory administration, it was the Labour regimes of Tony Blair and Gordon Brown that moved towards the comprehensive disbanding of the NHS. And today, it is Labour ministers such as Keir Starmer and Wes Streeting who are putting the final nails into its coffin.
The funding pipeline diverted
The incredible sums of money that the Treasury (ie, the British working people) pour into the funding stream still known as “the NHS” has been placed in the hands of 43 Quangos, known as ‘integrated care boards’. This year, ICBs will use our money to buy six million private appointments for NHS patients. That’s one million more than last year.
This is how privatisation is being effected. The NHS is being abolished in front of our eyes. This is why fewer people are being trained by it and for it. In future, ever fewer appointments will be available in its hospitals, surgeries and clinics. The ICBs are being given ‘NHS’ money – and will continue to spend a growing proportion of it in the private sector, which will continue to grow (and to profit from taxpayers’ money) as the public sector shrinks.
Our money is being given away. The number of trained and available staff able to deliver genuinely public health services are being steadily whittled down. And if striking staff and their unions keep failing to point this out, we will soon be left with only the faintest shadow of a health service – and very few medics capable of striking in defence either of the NHS or of the pay and conditions of NHS staff.
Without a mass and urgent campaign of coordinated action, involving not only medical staff but also the wider working class (recipients and potential recipients of NHS care), there will be precious few NHS staff remaining. The services that used to be planned at a national level by the NHS will be run instead via big health-linked ICBs, and the care that was formerly delivered by NHS staff will be provided only if a profit can be made from doing so by medics working directly or indirectly for the health and insurance monopolies who are steadily taking over all the NHS’s operations.
Mass campaign urgently needed
While the corporate media’s commentariat lament the doctors’ strikes, we lament the fragmented and broken manner in which industrial action is routinely carried on in this country. Our unions are broken. And their inability to put up a real fight is enabling the destruction of our health service.
To be effective in reviving the NHS, all staff, patients and unions need to cooperate in organising a mass campaign for the ending and reversing of all privatisation – one capable of forcing the government to its knees. The working class collectively has the power to do this, but no one in the trade union bureaucracy is even trying to organise them to use it.
Instead of organising such a campaign, one after another isolated detachment of workers is being sent out to wage a suicide attack, destined for defeat from the outset, and the government and corporate media are being given a free hand to pick them off one by one.
The picture above is typical of the tokenistic nature of British protests and strikes today: pick up the ‘official opposition’ protest tool; take a Trotskyite SWP lollypop. This is not serious opposition; it is a mind game played upon the working class: “Strike to save the NHS. Kick the Tories out!”
Such banal narratives do nothing to explain the link between striking and saving the NHS, and so the workers are not won over by their seemingly ‘militant’ stance. “Surely you are harming the public” is the lie spouted across the board by ruling-class politicians and media, and this narrative is never effectively challenged by the unions, who do nothing to explain how or why the NHS is being dismantled, and nothing that might enable the power of the working class to be harnessed to stop and reverse this process.
The strikers are thus fighting with both arms tied behind their backs, unable to harness the popular support that would surely be theirs if the wider working class understood what was at stake.
It is no accident that the overall picture of NHS privatisation and dismantlement is not even raised. Very often, those in the lower and middle ranks of our unions don’t even understand what is happening themselves. Those (Dr Bob Gill, for example) who try to bring them the knowledge they need are ostracised, leaving union members rudderless and turning their officials into hapless tools of the very capitalist class they purport to oppose.
Moreover, the link between the battle to save the NHS and the wider global economic crisis: its connection to the cost-of-living/inflation crisis, austerity and rising poverty, overproduction, the drive to war (and the war on Russia in particular) and the absolute decrease in workers’ wages across the board is not convincingly made. But the fight for decent pay and services is not just a struggle for NHS workers; it is the struggle of every worker in Britain against an exploiting class that is determined to pass on the burden of its economic crisis to our backs.
Instead of educating the working class about all these fundamental issues, we are handed the same old slogans of “Kick the Tories Out” (Starmer and Streeting being designated as honorary Tories to avoid having to face uncomfortable truths about what and whom the Labour party really represents). Despite all the lessons of history, this vacuous mantra remains the rallying cry of every organisation of the fake left, from left Labour to the CPB, SWP, Counterfire, Socialist Party (Spew) etc and all our union leaderships.
All these self-identifying socialists align with Labour imperialism. Not one of them has the remotest intention of explaining to the working people that social democracy, and its primary British representative the Labour party, is their enemy and the enemy of the NHS.
Some alleged opposition to “Tory Starmer” or “Tory Streeting” is mouthed by these charlatans as a purely tokenistic sop. Their aim is not to harness but to misdirect workers’ anger; to keep them wrapped up in the ‘hope’ of a better tomorrow, when Labour should have been ‘reclaimed’ or some Labour mark 2 ‘refounded’. (Heaven preserve us!)
Meanwhile, so long as these fundamental lessons remain unlearned by healthcare workers and the wider public alike, we will all pay the price. Workers will be entirely unable to turn around the huge container ship that is the NHS, and which is now foundering on the rocks towards which it has been steered by successive Tory, Labour and ConDem administrations – helped along not only by various highly-paid lackeys from within the service but also by the connivance of Britain’s subservient trade union and Labour party bureaucracy.
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For more detail on how the Labour party is overseeing the final dismemberment of the NHS, see Labour’s Plan for the NHS: ‘Medicare’ for the UK, Lalkar, 1 September 2025.
