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The junior doctors' dispute is over – but the battle against the government to save the NHS is just beginning

The endgame is here. The NHS five year plan consists of massive cuts, devolution, asset and land sell-offs and closures: this is about profit, not patients 

Youssef El-Gingihy
Saturday 21 May 2016 16:21 BST
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The BMA and government have come to an agreement over junior doctors' contracts, but many are still unhappy with the NHS
The BMA and government have come to an agreement over junior doctors' contracts, but many are still unhappy with the NHS

The BMA and the government have reached a provisional agreement and the junior doctors’ contract will be published at the end of May and will then be submitted to a ballot of 45,000 junior doctors.

The importance of the junior doctor movement consists in tens of thousands of doctors on the streets defending the NHS. This level of resistance was not anticipated by the government. However, the issue has been largely contained to the small print of a contract dispute. In fact, it is part of a bigger picture of NHS privatisation ultimately leading to the introduction of a private insurance system.

The endgame is here. Personal health budgets are being rolled out as a way of ultimately enabling insurance top-up or co-payments. The NHS five year plan consists of massive cuts, devolution, asset and land sell-offs and closures.

We have reached the anticipated compromise between the BMA and the government. For this reason, an event has been called this Sunday – Act Now to Save Your NHS – to launch a mass movement of rank and file health workers, campaigners, patients and citizens.

Jeremy Hunt on Junior Doctors

Specifically, the contract is about the restructuring of the workforce to bring down the wage bill to increase profit margins for corporates. After all, the wage bill is the biggest overhead for any organisation.

Healthcare is made profitable for private healthcare and insurance companies by lowering staff wages, restricting patient access and inflating charges. Where private companies have taken over NHS services, we have often seen a deterioration of pay and conditions. In the US, the insurance system works to restrict access and healthcare fraud is endemic.

As a general rule, poverty leads to significantly shorter life expectancy and earlier disability: If you want to some evidence for this, look no further than the tube map of life expectancy. Thus, it is the poorest who are most affected by the introduction of a two tier system of insurance and charging. The NHS was introduced to treat people based on their need rather than their ability to pay. A return to the pre-NHS healthcare system of the 1930s in the 21st century is far from desirable.

One of the intriguing questions throughout has been why the government allowed this damaging dispute to drag on.

That should tell you a lot in itself.

In other words, the government is prepared to do whatever it takes because opening up the NHS oyster of over £100 billion to global capital is a massive project, hence why government insiders have compared this struggle to the defeat of the miners in the 1980s. Remember that this is an ideology that believes market forces should run everything for profit. It is absurd to suggest that the NHS will be spared.

The NHS is an affront to everything neoliberal free market supporters believe in. It is a beacon for the kind of society that we may one day be able to create, addressing people’s needs ahead of the profits of the global elite. Thus, it must be destroyed otherwise it sets an example.

The preface to any discussion of the contract is that nowhere is there any mention of increasing funding in order to extend the NHS from a five day into a seven day elective service. In terms of the small print, the changes appear to be cosmetic as expected.

The privatisation juggernaut has been enabled through a cross-party consensus. The corporate media have largely been silently complicit. Trade union legislation will make it harder for workers to strike. In light of recent events, it is also being suggested that doctors might not be allowed to go on strike, in future, as is presently the case with the police force. Most conventional channels to reverse the damage have been blocked.

From the suffragettes to civil rights in the US, history is transformed by mass movements. A mass movement is therefore necessary to reverse the NHS privatisation programme and preserve it as a public, universal healthcare system. Come to Act Now to Save Your NHS to help launch a mass movement and make history. It is now or never.

Youseff El-Gingihy is the author of How to Dismantle the NHS in 10 Easy Steps

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