The incoming Labour government’s health secretary, Wes Streeting, called in the leaders of the British Medical Association (BMA) junior doctors committee (JDC) for talks today to end the long-running dispute over the demand for pay restoration—a 35 percent rise to reverse fifteen-years of below inflation awards.

The determination to restore pay for frontline medics who constitute around a half of the National Health Service (NHS) workforce in England has been at the centre of a battle with the Conservative government since March 2023. The 40,000 junior doctors in the BMA voted to renew their industrial action two months ago on a mandate of 98 percent, and staged their eleventh round of strike action in the run up to the general election with a five-day stoppage between June 27 and July 2.

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Labour is no less hostile to restoring pay to pre-austerity levels. Party leader Sir Keir Starmer has echoed the Conservative mantra of unaffordability after promising business representatives to keep corporation tax to 25 percent—levels lower than the Thatcher years—and that the incoming Labour government will honour Tory Prime Minister Sunak’s pledge to hike up military spending to 2.5 percent of GDP.

From day one, Streeting has made clear Labour’s refusal to meet the junior doctors’ demands if elected to government. He announced last Friday that the policy of the Labour Party was that “the NHS is broken,” adding, “That is the experience of patients who are not receiving the care they deserve, and of the staff working in the NHS who can see that—despite giving their best—this is not good enough.”

This is a declaration of war on the 1.4 million NHS staff and the entire working class. They are being scapegoated for the health service’s longest running spending squeeze in history and its overwhelming thanks to the government’s criminal COVID policy of placing profits before lives—leading to more than 230,000 deaths and a waiting list of more than 7 million patients.

Labour’s sole election “pledge” on the gutting of patient care in the NHS was to reduce waiting lists by providing 40,000 extra appointment per week in England. This is a Trojan horse for piling extra pressure on overstretched NHS staff to work “out of hours” and expanding the use of private sector outsourcing. Labour’s paltry additional £1.3 billion for the NHS is tied to these measures.

Streeting has built himself a reputation as a Blairite ideologue with a series of appearances in the right-wing media, sneering, “the NHS is a service not a shrine”, denouncing its “something for nothing culture” and promising, “We will go further than New Labour ever did. I want the NHS to form partnerships with the private sector that goes beyond just hospitals.”

An article in the Telegraph on July 6 headlined, “Why Wes Streeting is at war with the NHS,” quoted an advisor stating, “Labour can get away with a lot more than a Conservative government can, including private providers. If the Tories do it people cry ‘evil baby killers’.”

To underline the pro-market pedigree of the Labour government, Streeting has brought in Tony Blair’s health secretary Alan Milburn as an advisor. Millburn oversaw the roll out of the Private Finance Initiative (PFI) for hospitals which has saddled them with crippling debts while providing a cash cow for private consortia. He introduced Foundation Trusts to put hospitals on a competitive footing and establish joint ventures with for-profit companies.

Directly prior to the pay talks with the BMA, Streeting participated in Tony Blair’s “future of Britain” conference, where he indicated a readiness to charge for healthcare when asked about maintaining the principle of healthcare free at the point of use, something he once lyingly claimed he would “die in a ditch” for. According to the Spectator, Streeting “did not give his usual, straightforward answer… rather than ruling out charges completely, Streeting has left open the idea that perhaps some people would be able to afford a small bill”.

This makes all the more unconscionable the BMA leaders’ portrayal of Streeting as an honest broker in their pay dispute. JDC co-chairs Dr. Robert Laurenson and Dr. Vivek Trivedi stated, “We were pleased to speak to the new health secretary, Wes Streeting, today, as he made good on his commitment made during the election campaign for JDC (junior doctors’ committee) to be his first call and get the ball rolling on negotiating a solution to the junior doctors’ dispute.”

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Laurenson and Trivedi repeated their earlier call for “a credible offer”, leaving the door open to a climbdown far below 35 percent. Their opposition to the Sunak government was primarily based on its inflexible approach standing in the way of the type of sellout agreement they were always willing to accept.

The 2023/4 BMA agreement with the Scottish National Party government of just 12.3 percent was nowhere near pay restoration (28.5 percent). This was in exchange for yearly negotiations “to make credible progress”. The deal has been cited favourably by JDC officials.

Settling in Scotland was part of a divisive union strategy splitting UK workers along national lines. At the same time junior doctors were taking their latest strike action in England, the JDC announced on June 28 it had ended the pay dispute in Wales, recommending the Labour-run Assembly’s offer. This was for an overall 12.4 percent uplift, well short of pay restoration (29.1 percent).

In welcoming talks with Streeting, Laurenson and Trivedi are not only signalling a preparedness to sellout the pay demand. They are setting the template for collusion with the most right-wing Labour government in history based on its declared agenda of privatisation, further cost-cutting under the guise of “efficiencies” and increased workloads. Any revised offer will be in return for services rendered by the JDC in policing opposition to the government.

An article in The Times published July 6 headlined, “Wes Streeting could offer pay promise to avert strikes,” reported that the health secretary would be open to a “symbolic promise” to restore pay to 2008 levels, but “as a journey not an event”. Laurenson said coming out of the meeting with Streeting, “This was definitely a collaborative talk, and I think it’s fair to say we have no plans at the moment to call for strike action.”

As the Socialist Equality Party explained in its general election campaign, Labour’s defence of the genocide in Gaza, threatening a regional war in the Middle East, and commitment to the escalation of NATO’s proxy war with Russia in Ukraine is necessarily accompanied by a war on the social position and rights of the working class at home:

“War on this scale demands an escalation of the savage austerity that has already left young people and working-class families struggling to survive. The ruling class is demanding an ‘end to the peace dividend’, which means a final death blow must be delivered to the National Health Service, social care, and all essential services to pay for war.”

The defence of the NHS against further privatisation and cuts and the fight for pay restoration cannot be conducted without challenging the domination of health workers’ struggles by the BMA and their bureaucratic counterparts in the other health unions. This is the lesson of the rout they engineered of the powerful strike wave during 2022-3, agreeing to a series of de facto pay cuts under the Tories.

Nothing will change under an equally pro-business, warmongering Labour government. The mantra of “unaffordability” must be answered by development of a rank-and-file movement prepared to challenge the corporate and financial oligarchy and the prioritisation of profit and war over the needs of society, in a fight against capitalism and for socialism.