The BMA and the government have reached a provisional
agreement over the junior doctor contract dispute. The contract will be
published at the end of this month. It will then be submitted to a ballot of
45,000 junior doctors.
This ballot – or ‘referendum’ - is in fact non-binding. The
BMA’s Junior Doctor Committee will take an executive decision regardless of the
result.
But junior doctors will be inclined to vote no to the contract, going
by the initial reaction of many junior doctors yesterday. On the Facebook junior doctor
contract forum (with over 60,000 members), there was a mixture of
anger, bewilderment and frustration.
Why has the government has allowed this damaging dispute to
drag on over several months? On other controversial and unpopular proposals
like tax credits or compulsory academisation of schools, they’ve U-turned. But
in this case, they have been prepared to expend huge amounts of political
capital and popularity in order to ram this through.
That should tell you a lot in itself.
This is about the restructuring of the workforce to bring
down the wage bill to increase profit margins for corporates. It is of course
part of a bigger picture of NHS privatisation ultimately leading to the
introduction of a private insurance system consistent with the direction of
travel of and the various statements of influential policy-makers over the
years.
In other words, the government is prepared to do whatever it
takes in order to get this through because opening up the NHS oyster of over
£100 billion to global capital is a massive project. This is why government
insiders have compared this struggle to the defeat of the miners in the 1980s. Theirs
is an ideology of market fundamentalism, which believes that market forces
should run everything for profit. It is absurd to suggest that the NHS will be
spared.
Jeremy Hunt announced yesterday that the government has
stuck to its red lines. Nowhere is there any mention of increasing funding in
order to extend the NHS from a five day into a seven day elective service.
Two of the most contentious areas were the redefinition of
anti-social hours and the removal of hospital safeguards to prevent doctors
working excessive hours. The former would mean that late evenings and Saturdays
would effectively be paid the same as normal social hours. The latter would
potentially lead to tired doctors and compromise patient safety.
The new deal suggests that pay for weekend hours will be
linked to number of weekends worked, with a bonus of up to 10% of salary if one
in every two weekends is worked. On the second point, there appears to be some
tightening of provision around the monitoring of hours. Elsewhere, non-resident
on-calls is currently paid as premium pay, and this would still be massively
reduced in some cases to levels barely above the national minimum wage. Incremental
pay or automatic pay progression will be converted into a series of nodal
points based on the attainment of milestones. However, this would exclude
periods at which doctors are not on training programmes but still working.
We have reached the anticipated compromise between the BMA
and the government. This reminds us that no hierarchical organisation will save
the NHS from being opened up to global capital. All conventional channels to
effect change have been blocked. The privatisation programme has been enabled
through a cross-party consensus. The corporate media have been largely
complicit. New trade union legislation will make it much harder for all workers,
including doctors to strike.
History is transformed by mass movements - from the suffragettes
to civil rights in the US. So a mass movement is needed to prevent the NHS
privatisation programme and preserve the NHS as a public, universal healthcare
system. Only a mass movement can pressure the establishment into changing its
line. This is why an event is taking place this Sunday called Act Now to Save Your
NHS aiming to launch a mass movement of rank and file health workers,
campaigners, patients and citizens. Join us.
How to Dismantle the NHS in 10 Easy Steps is available from Zero books.
Comments
We encourage anyone to comment, please consult the oD commenting guidelines if you have any questions.