Tens of thousands of junior doctors across England have gone on strike Tuesday over government plans to change their work contracts in a way that medics claim will leave them worse off.
The action, the first such for over 40 years, is the latest twist in a chronic financing crisis at the state-funded National Health Service, and comes after weeks of increasingly bitter recriminations between the doctors and Health Secretary Jeremy Hunt.
Across much of England, patients received only emergency care, while planned over 3,500 operations and many more consultations were postponed. It’s the first of the first of three planned days of strike action. The BBC reported that over a third of the doctors involved had reported for work as normal, but that’s because they were due to perform the pared-down emergency services, rather than because they were strike-breaking.
Junior doctors (a phrase that covers those who have just graduated from med school to those with as much as 10 years of experience in practise) routinely work 100 hours a week due to staff shortages, according to the British Medical Association, on starting salaries of as little as $36,000. Their working conditions are regularly paraded as proof of how it has become impossible to square the commitment to a universal, taxpayer-funded health-care system with the finite resources at government’s disposal. Britain spends less per capita on health than most advanced nations, but the bill for the NHS in England alone still comes to over £106 billion ($154 billion) this year – over 9% of GDP.
Given the acuteness and breadth of the systemic crisis facing the NHS, the direct cause of today’s strike is bizarrely arcane. It revolves around government plans for a new contract that would raise basic pay by 11%, but reduce the number of evening and weekend hours that qualify as “antisocial”, and thus subject to top-up payments (the top-up rates themselves are also being cut to a maximum of 150% of the basic rate, from 200% at present). In essence, it boils down to an attempt to make Saturday count as a regular weekday, consistent with the government’s efforts to make more NHS services, such as consultations and scheduled operations, available at weekends.
The new contract will also scrap guaranteed pay increases linked to time in the job, replacing them with a new scale linked to the completion of certain training stages.
The future of the NHS has become the most reliably divisive issue in British politics over the last decades, with Conservative governments tending towards reining in constantly rising costs, and Labour governments prioritizing service levels, even at the cost of much wider budget deficits.