Steve Dobbs reports from Stoke Mandeville Hospital, Aylesbury on 26th April 2016

The British Medical Association (BMA, the Doctors’ Union) have begun a two day consecutive strike (between 9pm and 5pm) against the imposition of a new employment contract by the Tory government. The BMA deem this contract to be detrimental to their work conditions and patient safety.  On behalf of the Editorial Board of Marxist World, I visited the picket line at my nearest hospital equipped with A&E and Maternity ward, Stoke Mandeville Hospital in Aylesbury, to support the industrial action being taken by junior doctors.

The picket line was outside the main entrance to the hospital and was highly visible with banners and placards. It was clear that the junior doctors enjoyed huge support from the public, with cars passing by and honking their horns, and even some members of the public pulling over to give a few words of encouragement! Speaking to the doctors present, many told me about how supportive their colleagues at work were, such as the senior consultants who were covering for them, but also less expectedly the Chief Executive of the hospital! I sold several copies of the Marxist World journal amongst those present.

Polls continue to show that the majority of the public support the strike action and that the majority also place the blame on the Health Minister Jeremy Hunt and the Tory government. On the picket line I interviewed Rebecca Davies, the BMA representative at the hospital, to get her take on the dispute:

SD: Rebecca, I just wanted to get an overview for the background to the strike action by the junior doctors and what has led up to it?

RD: Our contract was due for renegotiation, and the BMA and the Department of Health entered this renegotiation on good faith. Negotiations initially were going well but eventually broke down in October 2014. Following that, the government referred the contract to the Doctors, Dentist Remuneration Board (DDRB), which is something unprecedented, that has never happened before and they have never been tasked to look at our contract before. They came out with some recommendations in July 2015. Following that, the BMA put it to their members and they felt that the recommendations the DDRB had come up with were basically unilaterally with what the government wanted in the contract, and felt this was something we could not negotiate with. However, we did go back to negotiations but they broke down and so we balloted for industrial action, and we received an overwhelming mandate for industrial action. We planned for some action in December 2015, but this was called off because Jeremy Hunt temporarily agreed to lift the threat of imposition of the contract. There were more negotiations but these unfortunately break down, so we are now in a position where we have had several 24 and 48 hour emergency-only care covers in the hospital, and today is the first day of a full walkout of junior doctors in the history of the NHS.

SD: In your view, what is the main point of contention in the contract being imposed by Jeremy Hunt?

RD: Jeremy Hunt would love everybody to believe it is over Saturday pay, but that is categorically not the case! I would like to remind everybody that, as junior doctors, we are all doctors who are not consultants, and most of us are not that junior and have been working for many years. We already work Saturdays and Sundays, we already work evenings and we already work nights. We are paid to do that, of course, but we absolutely do not have an objection to working weekends and nights, and it is part of the job that we signed up to. The main issue for us is the removal of the current safeguard that prevents excessive working hours. It has been removed and what it’s been replaced with is a system that we don’t think will hold up. It doesn’t appear to be, in any way, robust enough to actually prevent excessive working hours. Jeremy Hunt would like more doctors on at the weekend – I believe this is what he is trying to say – but there is no provision for more doctors. So that either means we have to work longer or there will be fewer doctors around during the week, and we don’t think that, without proper planning, it is safe to just impose overnight without proper safeguards.  We’ve done so much in the last 20 years to move away from long, excessive and unsafe hours towards something that we consider being safe, and we don’t want to see that eroded. It’s very clear that tired doctors make mistakes, and the sorts of decisions we make are obviously very important and we need to be at our best.

SD: I can hear support amongst the public is very strong [car horns are continuously honking in the background]. What is support like amongst junior doctors and NHS staff?

RD: The support has been overwhelmingly positive across the board. As you can see, many Junior Doctors are out today. Support amongst the juniors is strong; support amongst our consultant colleagues is very strong – they have, on numerous occasions, sent out letters to the junior staff with messages of support and also of reassurance that they are here. Despite the fact that junior doctors are not providing emergency cover today, the consultants are here providing safe cover for our patients in our absence. The NHS Trust has also been supportive and very good at organising the workload over the last couple weeks to make sure that patients on the wards and coming in to A&E will be safe.

SD: What are you hoping Jeremy Hunt will do in response to the strike action, and what do you think the BMA should do if he does not respond?

RD: In the build up to this strike, the BMA has been very clear and has offered a way out of this to Jeremy Hunt. As long as he lifts his imposition of the contract at any point today or tomorrow, we will call off the strike and we are prepared to go back to the negotiating table with him. He has so far refused to do that. Obviously I am hoping he will take us up on our offer and will lift the imposition of this contract in August, and we will be able to get back to the negotiating table. If this does not happen, I am not sure where we will go from here. That will be up to the [BMA] Union to collectively decide and we will support the Union.

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