Why Junior Doctors Are Saying Enough Is Enough
Junior doctors have spent the last decade face-to-face with the devastating effects of poverty and austerity on public health, while their own pay has dropped by up to 30% – and they know we can't go on like this any longer.
The UK BMA Junior Doctors Committee entered the fray and announced that they will also be balloting members in England for industrial action in early January 2023. (Shannon Fagan / Getty Images)
When I first wrote about junior doctors joining the strike wave back in July, the Enough is Enough (EIE) campaign was just a twinkle in Mick Lynch’s eye. Since then, the Queen has died, the Queue has formed and ended, Boris Johnson has been ousted, and Liz Truss has become the latest in a long line of incompetent Tory leaders determined to drive workers into the dirt.
It’s not all bad news. The union wave has only got stronger the tougher the fight, with more workers joining the call to industrial action, from posties and communication workers to barristers and bus drivers.
But one thing that hasn’t got better is the cost of living. The crisis has firmly rooted itself as a significant force in ordinary people’s lives—and with the threat of enforced blackouts and the return of ‘austerity measures’, it seems we are heading into a very dark winter.
Austerity 2.0 would be a death blow for the NHS. It’s already on its knees after years of underfunding and Tory mismanagement, with A+E waiting times rising, GP appointments becoming increasingly scarce, and elective operation waiting lists extending over the horizon.
It’s important to say that the steady collapse of the NHS is despite the exceptionally hard and increasingly gruelling work done by NHS staff. Some of the ‘essential workers’ who fought tirelessly through the worst days of the pandemic to care for the people of this country, who were clapped and celebrated as heroes, are now forced to rely on foodbanks or charities to feed themselves or their families.
This is a consequence of an effective decade-long paycut for NHS staff, which has been felt especially acutely by nurses. Some are understandably voting with their feet and leaving at an alarming pace—40,000 nurses in the past year alone. For those left, work becomes increasingly difficult, with inadequate staffing levels the norm across many wards and trusts. In this context, and driven by its grassroots, the Royal College of Nurses, the largest union and professional body of nurses in the world, announced on 6 October that for the first time in their 106-year history, they would be balloting 300,000 of their members for industrial action.
Just before that, after waiting a month for the government to respond to their demand for pay restoration—a response which was no response at all—the UK BMA Junior Doctors Committee entered the fray and announced that they will also be balloting members in England for industrial action in early January 2023, and will immediately begin work to ensure the workforce is ballot-ready. And with a recent survey showing that 72 percent of junior doctors would be prepared to take industrial action if the government did not commit to full pay restoration, they might just get there.
These are significant moves by the RCN and the BMA. As both unions and professional organisations, they have been historically slow-moving when it comes to industrial disputes—but this time it feels like something has shifted. Rather than fighting isolated struggles, those within the NHS are finally joining together.
Enough is Enough
A slighter smaller but no less significant announcement was made by the Junior Doctors Committee a few days before the ballot decision on 1 October, publicly declaring support for and solidarity with the ever growing Enough is Enough campaign. This decision, along with the contribution by the BMA UK Council members of a £1000 to the RMT strike fund in September, signals a new direction for the BMA. Speaking at the time of the donation, Professor Philip Banfield, the new chair of the council, said that
‘Trade unions have always been the bulwark protecting workers in hard times, and the vanguard pursuing better terms and better pay through democratic means and collective action. Whether a doctor, a rail worker, a teacher, a nurse or a hospitality worker, no matter the profession, the BMA stands together in solidarity with other unions, as we seek a fair deal for our members.’
Where the strike fund donation shows the BMA’s desire to forge ties with other unions and link up in a collective struggle, the decision to support EIE shows its recognition that unions and community organisations are the last line of defence against a cost of living crisis that is devastating for many of our patients and their health. Foundation year one doctor and Junior Doctor Committee member Becky Bates, who led the call to support the campaign, explained that
‘For our patients, we cannot ignore the fact that fuel and food poverty directly result in poorer health outcomes. This government knows the statistics—but they do not care. Their policies are ideological, not evidence-based.’
Looking at the five core demands of the campaign, it’s clear that junior doctors have a personal investment in getting pay restoration. But slashing energy bills, ending food poverty, and providing decent homes for all will arguably have the greatest benefit for patients—and that, ultimately, is what many care about most. As Dr Bates puts it,
‘Eroding our pay and conditions while refusing to support with the cost of living crisis is a political choice—and we must force them [the government] to see it is a wrong one.’
Before the announcement of support by the committee, there were unofficial acts of solidarity from other workers, and vice versa. At the junior doctor pay restoration rally outside Westminster in July, the biggest cheers were heard for an underground train driver who had come off shift that day, seen the march, and decided to speak in solidarity. At the same march, nurses, healthcare assistants, and other healthcare staff joined, with an occupational therapist and committed trade unionist leading the chants.
The solidarity goes the other way, too. At the huge EIE rally in London on 1 October, Dr Rita Issa, a GP in East London, spoke to the crowd in support of the campaign. She talked about her ‘shame’ in seeing patients waiting seven days to see a GP when they should be the first port of call for people in pain and distress. For Dr Issa, this all comes off the back of years of ‘chronic underfunding’ by government and a concurrent desire to privatise by stealth, coupled with a cost of living crisis that those in power seem ideologically opposed to alleviating. In this context, strikes are a health intervention when all else fails.
Solidarity Is the Key
What campaigns like this provide for doctors and healthcare staff is a network of solidarity—a means to help ourselves as well as others in resisting the deliberate degradation of public life, to restore the pay of workers up and down the country to a level they deserve, to convert claps into real respect and dignity for essential workers, and to bring about a basic level of health and security for everyone.
Doctors could very easily see themselves as different—members of a historic profession who for a long time sat comfortably in their position. But we too have had our pay eroded and our working conditions degraded. Every day we work in an NHS that is creaking at the seams, and see first-hand the real suffering of our patients as the cost of living worsens. At this crucial time we cannot afford to see ourselves as separate from other workers and their struggles.
Our fight for pay restoration is one shared by all workers in this country, and our desire for an NHS that is properly funded, for decent housing for all, for the elimination of food poverty, and for the slashing of energy bills is one that can only be good for the health of our patients and ourselves. Enough is enough.