Aislinn Macklin-Doherty, an NHS doctor and BMA rep, spoke to Solidarity.
It would be fair to say that before this past year I was essentially a campaigning novice. I had strong political opinions. I remember being on my father’s shoulders at marches against Maggie Thatcher’s public sector cuts. I marched against the Iraq war. I signed petitions and attended occasional protests about NHS privatisation. But, like many in the UK, I didn’t feel really connected to a wider voice or a movement. I certainly did not feel represented by any of the mainstream political parties.
Over the last year three things happened. A staunch socialist, Jeremy Corbyn, was elected leader of the Labour Party with an overwhelming majority. That happened just a few months after the Conservative Party gained the power to lead Britain with a historically and depressingly small majority, representing only 24% of the electorate. Bernie Sanders, another staunch socialist, emerged out of the noise created by the political and intellectual equivalent of a foghorn that is Donald Trump. And started to really worry the right of centre. Then 50,000 junior doctors got a total kick in the teeth by the Conservative Government by being told that a contract which 98% of us objected to would be imposed on us.
The government claimed that we didn’t really understand what we were objecting to and that we were being “misled by the BMA”. In November 2015, I came to a Momentum meeting and heard an excellent colleague, Dr Yannis Gourtsoyannis, a member of the central BMA junior doctor committee, and Dr Jacky Davis of Keep Our NHS Public. A fire was ignited in me. I went back to my hospital. I stood and was elected as a union rep for the BMA. I organised picket lines at my hospital. I’ve met other trade unionists from Unite, Unison and NUT and attended multiple Momentum regional evenings, and have seen first hand what can be achieved by getting up and taking action as part of my union and within a wider trade union movement.
A great turning point came about in this dispute when Jeremy Hunt and his party decided, arrogantly and perhaps very foolishly, to take the “nuclear option” and impose the contract on doctors not once but twice, and finally with no further discussion in January 2016. He did that despite the fact that 98% of the profession, every major Royal College for training doctors, and the leaders of the Labour and Green Parties were in complete opposition to the decision, and despite the fact that 66% of the public have been overwhelmingly in support of the junior doctors, not the Government. If there was any doubt about the government's agenda, it is now quite clear for all to see, including many junior doctors who voted for them and who have had a rude awakening. The BMA has woken up to the fact that there will not be a reasonable discourse with this Government on this issue.
This is a government which totally changed the terms of negotiation for a junior doctor contract with a manifesto pledge of seven-day services with no extra funding. A government now exposed as having given absolutely no thought to the costing and staffing implications of stretching the entire workforce across the week. A government that repeatedly misquotes, spins and frankly lies about statistics to create fear in the general public and falsely assign blame to the workforce for deaths at the weekend.
The BMA has now categorically rejected imposition of this contract. It democratically surveyed members up and down the country, who voted to take escalating emergency-only industrial action (i.e. not a full walk out, emergency care to be covered in all hospitals). There will be three sets of 48 hour strikes over the coming months with the potential to escalate to full walkout strikes still in place.
The BMA has also arranged a series of “meet the doctor” public engagement events to counteract the spin of the government and the mainstream press. A judicial review is being sought against the Government on the basis that they have not considered the detrimental effect of the contract under the Equality Assessment Act. Action will be ongoing over the next few months, likely into the summer or even autumn if the government continues with its belligerent rhetoric.
The NHS as we knew it has gone. In 2012, it was broken up into CCGs by the Health and Social Care Act. That effectively fractured the NHS into funding pools which encourage the market to enter and crowbar profits into healthcare where profits have no role. The Secretary of State for Health no longer has the responsibility of providing healthcare for the British population. The NHS has been reduced to a logo which even Richard Branson can stamp all over the Virgin services which have been introduced by stealth to run large and increasing parts of the NHS.
I wanted to be a doctor for as long as I can remember. I thought it would be the single most important thing I could do to be able to listen to someone’s story, pick out the clues from what they say and what their body tells me and then come up with a plan to help them. And I wanted to do that in the NHS - the NHS which gives me the freedom to make decisions to help people not based on cost but based on need, and which gives patients the freedom to be cared for in their darkest moments without fear that they can’t afford it. That is why junior doctors should strike: to get our NHS back.
Many will say that there is no link between the restructuring of the junior doctors contracts to make us work more weekends with no extra staffing or resources and the degradation of the NHS as we know it. But I urge these people to look at the wider context and implications of this contract. If we are all expected to work infinitely more Saturdays with no extra staff or support, who will be looking after our patients for the rest of the week? Who is covering the thousands of unfilled gaps across the country that already exist and which we have been made to fill to the detriment of patients? Who is it that suffers when on a night shift when there is no colleague to support you because the position is unfilled, and you now take on seeing 50 patients instead of 25. Not a single doctor has asked for a pay rise. No amount of money could tempt me risk patient care in the way that this contract will. That is the crux of it all; once the workforce is undermined and the staff demoralised and stretched and exhausted even more than they already are, then the real “reforms” march on in.
When this government has succeeded in bringing the workforce to its knees and cut spending on the NHS on the lines Simon Stevens' five-year plan to reduce spending from the current 8% to 6% of GDP by 2020 - already half the percentage spent in the United States - then the NHS will be sold off fully as an “inefficient” service, deliberately crippled for corporate interests. Tony Benn once predicted that “there would be a revolution in the streets if the NHS were to be privatised”. So they didn’t tell us. They just did it in the background and called it reform. But now we have finally woken up. 50,000 of us are blowing the whistle on these “reforms” and telling this Government that we know what their plans are.
Next up are the consultants and then the nurses. Their contract reform plans have already been tabled. This is an intentional act to cripple us as a workforce and continue the manufactured crisis in the NHS. And we won’t have it.
This Government is not interested in meaningful negotiations or even honest debate. They have proven that time and time again with their spin, misguided use of statistics and shameful belittling of the NHS workforce and their union. Doctors will not stoop to that level. We have demonstrated our determination to uphold the truth at all costs, and above all continue to fight for the right to care for our patients which is what we get up for every morning and stay late for every night. The government cannot counteract such strength and resolve in some of the most dedicated hardworking, educated and united professionals in this country. I grew up under New Labour as an 1980s child with vague memories of the havoc wreaked on public services during the Thatcher era. But at least everybody knew what was happening. What strikes me now as a politicised junior doctor in my 30s is how effortlessly and seamlessly the destruction of the Thatcher era merged with the most mind-boggling era of double-speak and empty politics that has ever been known in British history with the Labour Party under New Labour.
Even though I fundamentally and morally disagree with the ideology of a right wing Conservative Party, one which bases the value of humanity on how much we can exploit others (to gain profit) rather than what we can collectively achieve by collaboration with each other and by investment in basic human rights and need, I could never vote Labour - until now. Now a man called Jeremy Corbyn has brought integrity, honesty, equality and justice back into mainstream politics. And his entire lifetime proves that he means what he says and he says what he means. The Tory Party have found themselves leading the country more because of a lack of any substantial opposition than because anyone believes in a single thing that they stand for. I believe that Jeremy Corbyn and his supporters will change this, and that is why I have become a Momentum member, and most recently Secretary for my local Momentum group.
I'll finish with an anecdote which I think sums up the feeling behind the grassroots socialist movement I find myself in and which I think Momentum epitomises. I met Margaret Thatcher as a junior house officer working in the NHS in my first year of training. I had to insert a needle to give her life-saving medicine and was terrified of the prospect of causing unnecessary harm to her: she was at that point a very frail and vulnerable elderly woman.
It struck me later with great force how much destruction this woman had caused to the healthcare service. She had introduced the market to the NHS which had started this avalanche of fracturing and crippling the care that we can provide. She had directly led an ideological attack during her lifetime on the poorest, the most vulnerable and the most needy in our society. I was floored by the irony of this paradox as I focussed on getting the needle in at first pass. But none of that distracted me, or the nurses. or any other member of the NHS workforce, from doing our absolute best to give her the best care possible, like we do for everyone day in day out. And this highlights the absolute essence of our NHS. This is about a service that goes way beyond personal interest, private investment and profiteering. The NHS is about standing up for the most vulnerable, whoever you are, and treating you with the respect you deserve as a human being, regardless of wealth, status or wage. Every single Labour Party MP must back the reinstatement of the NHS on 11 March 2016, and they must back the junior doctors in their struggle to get our NHS back.