Reactions 34. Junior Doctors Are Fighting For The Future Of The NHS

Call To Action

Hello! 

I was due to write my next newsletter on Sunday, but for the second time this week I’ve decided to write to you earlier than planned because of important developments that you deserve to hear about today. Waiting for a few days might not seem like very long in the grand scheme of things, but a few days in UK politics can be extremely important. The news cycle moves at a frenetic pace, and the coverage surrounding this new situation is already ramping up at a concerning rate …

So I thought I’d arm you with some facts to cut through the noise. 

The British Medical Association (BMA), the UK’s largest trade union for doctors, announced yesterday that junior doctors in England will be striking over the Christmas and New Year period. They’ll walk out of work from “7am on the 20th December to 7am on the 23th December 2023 and from 7am on the 3rd January to 7am on the 9th January 2024”, a strike covering 9 days, or 216 hours in total, at which point it will be the longest strike in NHS history. 

For more than a year now, workers across multiple sectors have been engaging in strike action because of the longstanding the erosion of their working rights and conditions. The past year or so has seen industrial action from nurses, ambulance workers, teachers, university staff, train staff and others. In fact, we were all talking about striking workers at exactly this time last year; who can remember Richard Madeley accusing workers of “targeting people at Christmas” during an interview with Mick Lynch of the RMT union? Lynch wasn’t having any of it, which was refreshing to see. However, despite a year passing, and the number of strikes growing, these junior doctor strikes are different and noteworthy, not only because of their length, but also because of the time of year in which they’re occurring. They will be happening right in the middle of an NHS winter. 

The BMA has explained why they are taking this industrial action, and the leaders of the BMA’s JDC (the Junior Doctors Committee) Drs Robert Laurenson and Vivek Trivedi summed it up:

 ‘We have been clear from the outset of these talks 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.’ 

After the recent talks, doctors were offered an additional 3 per cent pay uplift, which the JDC co-chairs said would be ‘unevenly spread across doctors’ grades and … would still amount to pay cuts for many doctors this year’. 

They added: ‘It is clear the Government is still not prepared to address the real-terms pay cut doctors have experienced since 2008.” 

The Daily Mail has wasted no time in writing about the situation. In an on-line column entitled “Junior doctors hold the NHS to ransom”, it says… 

“With nine more days of spiteful and life-threatening strike action planned over Christmas and New Year, it's hard not to despair of the BMA's junior doctors.”

and… 

“Risibly, they also say that by striking for higher pay they are helping to secure the future of the health service. This too is tosh. They are inflicting enormous damage on the institution they claim to love out of petulance and greed.” 

This is not the only piece the Daily Mail has written. In the 24 hours since news of the strikes emerged, they have in fact published four other articles about the situation. 

It can be easy to underestimate the influence of the Daily Mail, but unfortunately it remains by far the most popular paid-for newspaper in the UK, and usually when these sorts of attacks begin, they do not let up. I expect we will see opinion pieces from other media outlets chiming in with attacks on junior doctors soon. It is a pattern we have come to expect - privately-owned media outlets relentlessly attacking workers as they fight for fair working conditions within public services that have been decimated by this government. 

It is understandable that people will feel worried about what is going to happen in the NHS this winter, and unfortunately this means that some will read these pieces in the Mail and elsewhere and feel angry at doctors. After all, things in the NHS have never been worse; there are 7.75 million patients on NHS waiting lists now in England alone, and long waits for treatment are harming patients. All of this is extremely anxiety-provoking and stressful, and so I thought it might be good to share two key facts about the situation, to put the strike action into context. 

1.    Strike Action Has A Minimal Impact on NHS Waiting Lists

As the doctor strikes have ramped up over the course of the year, there has been a huge amount of coverage alleging that doctors are to blame for the lengthening NHS waiting lists. 

The Prime Minister himself said in July that "The reason that the NHS waiting lists are higher today than they were then - after actually being stable for the first months as we put in place new initiatives - is very simple, and that's because the NHS has been disrupted by industrial action." 

However, new analysis from the Health Foundation in October, “finds that industrial action by consultants and junior doctors has so far lengthened the waiting list by around 210,000, just 3% of the overall size of the list, which totalled 7.75 million at the end of August 2023.” This is an incredibly important finding. 

2.     Doctors Are Demanding Restoration of Pay That Has Been Cut in Real Terms for More Than a Decade

The reason junior doctors are striking this winter is because they haven’t been given a credible offer by the government, despite being keen to sit down and negotiate for many months. The government had offered junior doctors an 8.8% pay rise, and then as negotiations progressed, offered an average of 3% on top of this. The BMA are fighting for a 35% rise that will make up for enormous real terms pay cuts since 2008.

This is really important; junior doctors are fighting not for a relative increase in pay, but for restoration of pay that will stop the continual erosion in doctors’ salaries; cuts caused by political choices over a long period of time. 

The erosion of salaries has had a huge impact on individuals. Many junior doctors are carrying staggering amounts of student debt (up to £100,000 in some cases). A significant proportion of NHS trusts now run food banks because workers are struggling to make ends meet. Pay erosion for doctors has been very significant, and the UK has not kept up with medical salaries in other comparable countries.

Since 2010, while many groups of UK workers have experienced significant real-terms pay cuts, MPs have received 10 pay rises.

The erosion of working conditions has not happened in isolation. Politicians are deliberately and systemically undermining the NHS in various ways; they are enabling privatisation, they are underfunding the service, and they are failing to invest in the infrastructure (those of you who’ve read my news letter for a while will be familiar with the unmet repair bill in the NHS in England hitting £10 billion for the first time in 2022). Finally, they are treating NHS staff appallingly, causing many to leave. All of this affects the sustainability of our public healthcare system, and all of this ultimately impacts on patients. I would never blame any individual for choosing to leave the NHS now; I don’t think that’s fair. NHS staff have been expected to endure far too much, for far too long. But it is those staff who have decided to stay, and endure all of this to continue to care for their patients who are being attacked in the media.

Many of these doctors could have left the UK, to be treated better and paid more in another country, but they haven’t done that; they have stayed. Most will have worked through the pandemic, on the frontline of the most significant public health challenge the NHS has ever faced. Many were not provided with sufficient protection when they did so. They are fighting not just for fair pay now, but for their patients and for the future of the NHS. 

This winter will be incredibly difficult in the NHS, but this is because of the actions of politicians, not doctors. Our junior doctors are on the NHS frontline every single day caring for patients. This winter they’ll be at the forefront of the fight for the NHS too. Without a properly supported NHS workforce, we cannot hope for a properly functioning NHS. Please support junior doctors this winter; they’re doing this for all of us.