BMA - British Medical Association  •  Industrial  •  Unite the union

Health strikes: future of NHS at stake

19 September 2023

By KD Tait

LIKE OTHER public sector workers, BMA members have seen the real value of their pay fall by up to 35 percent since 2008. The government’s ‘final offer’ of 6 percent was rightly rejected by the union. For six months the Tories have refused to negotiate because they hope the public will blame doctors for waiting times and cancelled operations. But these were on the increase even before the pandemic.

Health secretary Steve Barclay accused the BMA of ‘political timing’ of the strikes. But all decisions about the NHS are political. Austerity, privatisation, and pay freezes which have resulted in crumbling buildings, record waiting times and 1 in 10 posts vacant were all political decisions.

In London, nearly 3,000 members of Unite union walked out at four NHS trusts on 13 and 16 September in a dispute over pay and staffing. Cleaners, porters, nurses and technicians, joined picket lines at Barts, Barking, East London, and Guys and St Thomas’s.

The dispute at Barts’ Health trust began after a strike last year forced NHS bosses to bring workers back in-house from outsourcer Serco. But some workers were then denied the £1,655 ‘Covid bonus’ paid to directly employed staff.

Penny-pinching by Barts bosses has naturally angered those who got the bonus as well as those who didn’t—outsourced workers work just as hard as their colleagues, often for much worse pay, terms and conditions.

But the attitude of hospital managers comes from the top. Despite its claims of ‘record investment’, everyone knows the government is deliberately running down the NHS so it can be broken up. The Tories want a health service that looks like social care—quality treatment for those that can afford it, and a third-rate service for those who can’t.

But they know they can’t just privatise it. By keeping pay low, working conditions poor, and waiting lists sky high, they want to push people into taking out private sector health insurance. This process, already under way, will only accelerate the loss of trained staff in the public sector. Just last week the BMA Journal reported 1 in 3 medical students plan to quit the NHS within two years of graduating, citing poor pay, working conditions and work life balance.


That’s why the 5 percent pay rise the main health unions accepted for 2023 was a defeat for NHS employees and those who depend on the NHS. Not only was it a real-terms pay cut, but it will do nothing to stop the haemorrhaging of staff which has left 110,000 posts vacant. Even this paltry pay ‘rise’ is only partially funded—the rest will have to come from budget cuts elsewhere.

All the health unions have rightly pointed out that the fight for pay restoration is a fight to preserve the NHS. But the pay dispute this year was held back by the refusal of the trade union leaders to coordinate their claims and action. A single industrial union for all health workers would be a powerful weapon for unity across grades, departments and the devolved systems in Scotland and Wales. Electing joint shop stewards committees across the trusts and regions can start to coordinate solidarity with ongoing disputes and prepare for the next round of pay negotiations.

Everyone who works in and uses the NHS can see the consequences of ten years of Tory management of the NHS. But as we enter the run-up to a general election, the trade union leaders will be the first to hold back industrial action and campaigns in order not to rock the boat for Labour.

Everyone knows the Tories can’t be trusted with the NHS. But Labour’s shadow health secretary Wes Streeting, who takes donations from hedge funders linked to US private health insurance firms, is an open advocate of handing over NHS work to the private sector. Keir Starmer point blank refused to support the reasonable pay claims of nurses and other health workers.

The crisis is caused by Tory policies designed to run down the NHS. But there must be no holding back for Labour. The NHS’s future depends on a political fight to kick out the profiteers and tax the rich to fund a quality health and social care service under the democratic control of workers and patients.

Everyone should get out to the BMA and Unite Barts’ picket lines this week to show the labour movement’s support, and organise in our workplaces to counter the Tories’ lying propaganda blaming health workers for their own criminal attacks on our NHS.


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