|Volume 54 Number 1, January 13, 2024
Between December 20 and January 9, tens of thousands of junior doctors in England took part in six days of strikes, the longest in NHS history.
The doctors, members of the British Medical Association (BMA), unanimously voted for the strikes following five weeks of negotiations with the government. These negotiations broke down early December, and the government has stated that it will not resume talks when industrial action has been called.
The NHS is suffering a crisis in retaining doctors, with many opting for better-paid jobs abroad or leaving the profession altogether in conditions of lack of investment, falling real-terms pay and plummeting morale. Those striking are demanding a 35% pay rise due to 15 years of real-term pay cuts. After nearly 15 months in dispute, the best that the government has offered is 3% on top of the 8% previously given. This does little to offset the erosion over many years of the doctors' claim on the value they create, and still amounts, the BMA points out, to a significant real-terms cut.
After talks broke down at the beginning of December, BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said in a statement :
"We have been clear from the outset of these talks that we needed to move at pace and if we did not have a credible offer, we would be forced to call strikes. After five weeks of intense talks, the Government was unable to present a credible offer on pay by the deadline. Instead, we were offered an additional 3%, unevenly spread across doctors' grades, which would still amount to pay cuts for many doctors this year. It is clear the Government is still not prepared to address the real-terms pay cut doctors have experienced since 2008.
"It is a great shame that even though the approach was more constructive, there was not enough on offer to shape a credible deal, which we hoped would end the dispute. Without enough progress by the deadline, we have no choice but to take action that demonstrates doctors are as determined as ever in reversing their pay cuts."
Though England has seen the largest such strikes, doctors in Wales are organising a 72-hour strike, and in the north of Ireland are being balloted for potential action. Meanwhile, junior doctors in Scotland have reached an agreement with the Scottish government.
Hospitals in England have postponed outpatient appointments and operations. It is reported that over 1.1 million appointments and treatments had already been cancelled over 2023 due to strike action. Nevertheless, the doctors are retaining public support in their struggle.
Other sections of health workers are also in action to defend themselves and safeguard the future of the health service. In particular, the Royal College of Nursing (RCN) has warned that it is ready to launch a fresh battle over pay and working conditions, having been unable, narrowly, to meet the 50% legal threshold in a ballot last June. The RCN has warned that the government's latest 5% pay offer for the sector is "increasingly inadequate", and has called on its half a million members to demand an above-inflation pay rise for nurses, along with commitments over safe staffing levels. 
After striking for four days in April last year, the government's stance has hardened to one of declaring its offer "final".
Health workers have been coordinating their actions. Junior and senior doctors struck together for the first time in NHS history in September 23. At the same time, the government has enacted its new anti-strike legislation and has been considering imposing Minimum Service Levels that would require some doctors and nurses to work during strikes.
Nevertheless, to achieve some movement from the government, which had previously declared its outright refusal to move at all, is testament to the determination and persistence of the doctors, who know that, to safeguard the future of the health service, their pay and conditions must be in line with their dedication, commitment and work. They are determined that Enough is Enough! and that they must make their claims on society as doctors and for the sake of the health service.
In the court of public opinion, the doctors are undoubtedly winning . A fully-funded NHS providing care at the highest level that society can provide to all as of right is the will of the working class and people when they speak in their own name.
As Workers' Weekly wrote in September , the government has forced the issue of who decides. The struggle reveals that the solutions to the problems in the NHS lie with the health workers themselves. The fight they are taking up is as much to do with ending their marginalisation as it is immediately about pay, beginning with speaking out, smashing the silence on their working conditions - which are also the conditions of patients' care - and refusing to be ignored. They are aiming at a new situation where decision-making involves doctors, nurses and all health workers, along with communities and people as a whole, speaking and acting in their own name and as one, without the mechanisms of disempowerment blocking their direct decisions from being realised.
1. "Junior doctors in England announce new strike dates after Government fails to make credible offer to end the dispute", BMA press release, December 5, 2023
https://www.bma.org.uk/bma-media-centre/junior-doctors-in-england-announce-new-strike-dates-after-government-fails-to-make-credible-offer-to-end-the-dispute#:~:text=The strikes dates in England,on the 9th January 2024
2. "NHS nurses could strike again in the new year", Michael Savage, The Observer, December 3, 2023
"Nurses union is ready to strike again over pay in 2024, leader warns", Poppy Wood, inews, December 28, 2023
3. "Striking junior doctors in England say they still have public support", Denis Campbell, The Guardian, 20 December 20, 2023
4. "Consultants and Junior Doctors Hold Joint Strike Action", Workers' Weekly, September 23, 2023