Following talks with the BMA, the government is presenting the recently offered contract as a done deal. But, argues Seb Cooke, it’s a bad one that the junior doctors would be justified in rejecting. If they do, we need to be ready to support them.
The inspiring strike by junior doctors is at a crucial moment. Because of the determined action by medics, there is a new contract on the table. It was announced yesterday after agreement by the BMA and the government following ACAS (Advisory, Conciliation and Arbitration Service) talks. The full contract will be released at the end of the month, but the main details are out and many BMA members are unhappy at what they’ve seen. Junior doctors will have the opportunity to accept or reject the proposed contract in a ballot next month. In the meantime, here are five thoughts on the offer and how it might shape things.
1: Hunt’s bogus ‘7 day NHS’ idea remains intact but with no extra money
One of the strongest arguments that junior doctors and the BMA had for taking action was that the new contract was inherently unsafe for patients and bad for our NHS. Central to this was the point that Jeremy Hunt planned to stretch doctors even thinner over 7 days but was offering no more money to do this. People beyond just health workers understood the madness of this approach and saw it as an attempt to undermine doctors and the whole NHS. It’s one of the reasons why there was such high public support for the strikes. But as the new proposal maintains Hunt’s unfounded ‘7 day’ principle and still claims to be cost-neutral, the untruth at the heart of the contract remains in place. This spells danger for other health workers and the service in general and provides a solid case for further action.
2: The principle of rewarding anti-social working hours is undermined
Under the proposed contract, Saturdays and Sundays will count as ‘plain time’, meaning that they will be paid at the same rate as weekdays. While some doctors will get extra money for working weekends, this is capped at 10% and that rate will only apply for doctors who work every other weekend. Some doctors will get no rate rise for working weekends or get just 3% if they work at least one weekend every two months. Similarly, a junior could work from 8:00pm to 3:00am for no extra pay, whereas currently they could receive a 50% increase. The concession that Hunt has made in these areas will only affect some junior doctors and will be offset by a reduced offer in basic pay, from 13% down to 10%. But the dispute has always clearly been about more than just about pay. It’s about valuing our doctors, appreciating their unsociable work, protecting against dangerous levels of working and ensuring the NHS survives by recruiting more doctors. If doctors reject the deal, it will be in large part because the new contract doesn’t address these points, as many have pointed out. In that situation, their original arguments on these issues will carry just as much weight as they’ve always done.
3: The strikes were working
Before Hunt went into negotiations with the BMA, he had ruled out any further talks and had told parliament that he would impose the contracts and doctors would be defeated. It was the pressure from solid industrial action and the threat of escalation that forced him to climb down from this position. This in itself is a vindication of the doctors’ strategy. There was also increasing support among other sections of workers and from the Labour leadership, coupled with emerging divisions in the government over its handling of the dispute. Public support was predicted to fall during the all-out strike, but this didn’t happen and the growing momentum behind doctors was damaging the government at a very bad time. That momentum has been put on hold for the negotiations, but public backing still remains high and the willingness to deliver support and solidarity from the wider labour movement is still there. If the deal is rejected, we in the left must ensure that this support (including from the TUC and Labour) is effectively mobilised.
4: There is enough money for junior doctors and the NHS
In the background to the doctors dispute is austerity – the idea that money must be cut from public services because the UK is broke. But in truth it comes down to priorities, not money. We have a government that would rather act like a tax haven for the super wealthy than collect revenue to fund our National Health Service. If the super rich paid just a fraction of the tax they owe, we might not be in this situation. But instead of going for them, the government instead is attacking doctors. The Tories are prepared to spend millions on a fighter jet or even billions on a nuclear bomb, but they apparently can’t find the money to fund the best health service in the world. By spreading the NHS even thinner with no extra money, we are accepting the idea that the service doesn’t deserve the investment it needs. We have to be clear and keep making the point: the NHS is worth it. An ACAS deal doesn’t change that argument.
5: Trade union leaders sometimes come back with bad deals, but that’s why there’s a democratic ballot
Even the best union leaders can get it wrong. It’s not surprising when you think about the position they’re in. Senior figures in the BMA and JDC will have faced huge pressure to call off strikes and been given multiple Doomsday scenarios if they didn’t. In their position, it’s understandable that they ended up with this deal and are urging members to vote it through. But that doesn’t mean it has to be accepted. It has been the inspiring action of ordinary members that has led us to this point and it is their decision whether to accept or not. The insistence by some NHS bosses and politicians that it will just sail through is wrong and insulting. There should be no scaremongering about choosing to reject the offer and in doing so disagreeing with the BMA leadership. Afterall, what’s the point of having a member ballot if it only exists to ratify the wishes of others even when the offer is bad?
What is crucial is that junior doctors understand they have wide support for their struggle, and those who decide to fight and organise for a no vote in the coming weeks are not isolated. It is the job of the organised left to try and deliver that solidarity, especially if we believe that further action is the only way to get a better deal for doctors and the NHS.
* The title of this piece was originally “Junior doctors strike: five reasons to reject Hunt’s offer”. This has been amended to better reflect the content of the article.