Why Junior Doctors Might Join the Strike Wave
Since 2008, junior doctors in the NHS have seen their real-terms pay drop by up to 30%. After working hard through the pandemic, many feel it's time to fight for better.
Current inflation means that for a newly qualified doctor, take-home pay in 2022 is worth £2,172 less than it was last year. (Plyushkin / Getty Images)
It’s 2022, the year of the hot union summer. The RMT have kicked things off with an incredible campaign to protect their jobs, pay, and conditions. It seems likely that workers from teachers to cleaners to NHS staff won’t be far behind.
What do all these workers have in common? During lockdown, while many were (rightly) furloughed at home, these were the individuals out keeping the country moving. Often, they put their lives on the line to do so. They were considered ‘essential’ workers, and people stood on their doorsteps clapping for them religiously, week in, week out.
The currency of claps, sincere as it was, has since failed to translate into a real-life pay rise. Now many have returned to their offices, this ‘essential’ group has seen little remuneration for the work it did and continues to do. Add to this rampant inflation and a cost of living crisis the government is happy to let unfurl, and those same workers, once valorised for their service to society, are turning en masse to the only route proven effective: industrial action.
Junior doctors are part of this group. In a survey undertaken by the BMA in August 2021, 90.7 percent of junior doctors felt the government doesn’t value their work. A further 96.6 percent felt that the August 2021 pay uplift of two percent was either completely unacceptable or inadequate.
There’s a context to this sentiment. Since 2008, continued below-inflation pay uplifts have meant that in real terms, junior doctors’ take-home pay has dropped by between 25 and 30 percent. Current inflation means that for a newly qualified doctor, take-home pay in 2022 is worth £2,172 less than it was last year. For junior doctors close to becoming consultants, the pay cut is worth around £4,002.
At the same time, the cost of living is rapidly increasing, with record inflation driven by the war in Ukraine, supply chain issues, and the obscene profiteering of the private sector. Doctors also have to pay fees to the General Medical Council (the standard fee is £420 a year), fees for examinations which allow them to progress to the next stage of training (£500+ per examination), fees for hospital parking, fees for portfolios, indemnity costs, and the cost of transport to further-away sites.
This is all on top of student loan debt, which, after five or six years of university, can in some cases be as high as £80,000, with absurd levels of interest. Medical graduates on an average salary are unlikely to ever repay the debt in full.
For some doctors, this means worrying about paying their rent and bills. For those more fortunate, it can still limit their career progression and quality of life, driving them away from the NHS and toward other careers where pay and conditions are better at a time when the NHS is in dire need of more doctors. Compared to pay in the private sector and in other wealthy countries it’s clear that all NHS staff, including doctors, are getting a bad deal.
Building Support for Action
Off the back of that sentiment, an independent organising group within the BMA called Doctors Vote (supported by the longstanding Broad Left) was established in January 2022 with the express intent of steering the BMA towards supporting full pay restoration. In that time, this group has gained a wide support base among junior doctors and, to the surprise of some, among consultants and GPs too. 26 Doctors Vote candidates have been elected to the BMA council on a commitment to backing full pay restoration.
In May, the Junior Doctors Conference voted to demand that the government commit to full restoration of pay over the next three pay awards. If that demand isn’t met, the BMA will begin preparations to ballot junior doctors in England for industrial action in 2023, at the latest.
Following quickly on the heels of that win, a motion was passed at the Annual Representative Meeting (ARM) in June—at which all doctors, from medical students up to retirees, are represented—for the BMA to achieve full pay restoration to 2008 value within the next five years. Although this second motion doesn’t mention industrial action, as the junior doctors’ motion does, it nonetheless represents a significant shift in BMA policy and marks a broad base of support among doctors of all levels for full pay restoration.
Some may question the demand, but as Dr Jo Sutton-Klein pointed out at conference, refuse workers in Manchester have recently won a 22 percent pay rise; Gatwick airport workers 21 percent; cleaners and porters at Croydon hospital 24 percent. The precedent is there, and it’s clear that best means of achieving pay restoration is through collective negotiation and the ability and willingness to withdraw labour if necessary.
This isn’t a decision junior doctors would take lightly. Many have friends and families who are patients; many of us have been patients ourselves. But as Dr Sarah Hallett and Dr Mike Kemp, the BMA junior doctors committee co-chairs, point out:
For two years junior doctors have endured unbearable conditions, with many putting their lives on the line to care for patients, often under the most intolerable circumstances. The response from the government has been to simply ignore these sacrifices.
Junior doctors don’t want to be forced to strike, but increasingly it looks like we don’t have a choice.
Fighting for Better
It’s worth pre-emptively heading off one argument already levied at those on strike, and which will almost certainly be presented to us as junior doctors if we take industrial action: junior doctors unequivocally support all allied healthcare professionals and NHS staff demanding a fair pay rise. The paltry offer made to nurses is particularly insulting given the work they do, and we urge the government to offer them a substantial pay rise in line with their demands.
We also support those striking outside the NHS, like RMT members, who suffered through ridiculous attempts by the media and politicians to use NHS workers as a stick to beat them with. When Mick Lynch, head of the RMT said, ‘We have the power. A wheel doesn’t turn, a light doesn’t go on without us,’ he was making the case for all workers.
Junior doctors are there at every level of care, from GPs’ practices to the front door of the emergency department to the operating theatre. No-one who works in the NHS should be worrying about their bills or struggling to pay for their next round of examinations. That fact was recognised by the public during the first wave of Covid, and industrial action is an extension of that recognition: if the government refuses to acknowledge our value, we will prove it by withdrawing our labour.
Echoing these sentiments at ARM, junior doctor Emma Runswick, who proposed the original motion, acknowledged that achieving pay restoration won’t be easy—but that
We should not wait for things to get worse. All of us deserve comfort and pleasure in our lives. Pay restoration is the right, just, and moral thing to do… Do not be tempted to accept a pathetic future for our profession. We are worth more.
We are asking for the real-terms pay cut we have experienced since 2008 to be reversed. If our requests to the government are not met and negotiations fail then we will move to industrial action, and we will win. We ask that the trade union movement and the general public stand with us on this—and be ready, above all, to swap their claps for action.