The resident doctors’ national strike in England planned for November 14–19 must become a rallying point for all National Health Service (NHS) workers against the Starmer government.

50,000 resident doctors in the British Medical Association (BMA) have waged a two-year battle for pay restoration. They have now added the fight to end widespread unemployment facing doctors in the NHS.

This struggle pits them against Labour Health Secretary Wes Streeting, frontman for Starmer’s cuts and drive for corporate control and privatisation of the NHS.

The NHS workforce and the entire working class must defeat this assault to defend public healthcare, defeat plans to curtail the right to strike, resist jobs cuts and reverse decades of pay erosion and crushing and unsafe workloads.

This is a situation confronting millions of workers in the public and private sectors facing a Starmer government representing the interests of big business and the oligarchy.

The resident doctors action is the first national strike the Starmer government has faced since it took office last July. Streeting has accused them of “holding the country to ransom,” echoing Thatcher’s denunciations of “the enemy within” against the 1984-85 miners’ strike. During the last round of walks out in July, he claimed resident doctors were waging a “war” against the government they could not win.

The Labour government fears this action is the tip of the iceberg, as Streeting warned of a “contagion” of strikes. Imposing a defeat on resident doctors is seen as a deterrent against every other struggle the Starmer government anticipates against its austerity agenda. For months the Starmer government has backed its flagship Labour council in Birmingham conducting a strike breaking operation against 400 bin workers resisting vicious pay cuts of up to a quarter of their wages and slashing jobs as part of a £300 million cuts package.

Streeting is a paid representative of the private health lobby from whom he has pocketed £372,000 since 2015. Labour’s pledge to cut patient waiting lists has been used to launch a new wave of outsourcing: private providers already treat one in ten NHS patients. In January Labour promised £2.5 billion for another million outsourced procedures.

In March, Labour announced the planned abolition of NHS England, cutting 12,000 jobs overnight. This was the first instalment in a jobs cull based on axing 100,000 more across 42 Integrated Care Boards and hospitals with the latter ordered to slash services and staff to avoid a £6.6 billion deficit.

Resistance vs BMA leadership’s surrender

The BMA leadership suspended strikes over summer, vetoing a 90 percent mandate. This retreat allowed Streeting to deepen his attack. He ruled out any additional pay, insisting the 5.4 percent pay award for 2025/6 was final leaving resident doctors 21 percent poorer in real terms than in 2008.

When thousands of newly qualified doctors were shut out of training or jobs, the BMA combined the jobs and pay disputes. In a ballot, 97 percent of first-year doctors voted to strike. Yet instead of escalating, the BMA pleaded for further talks which broke down after a meeting on October 13. Streeting offered just 1,000 training places over three years, when 20,000 have already been shut out this year and made no shift on pay. Yet BMA resident doctors committee chair Dr. Jack Fletcher continues to plead with Streeting to return to negotiations on an agenda to “gradually reverse the cuts” based on a proposals of giving resident doctors as little as “a pound an hour for the next for years.”

The Starmer government is determined to impose mass austerity to satisfy the banks and corporations. The Treasury and the corporate media are demanding “fiscal discipline” in the November budget—code for deep cuts to welfare, local services, and the NHS.

Streeting’s praise for “other NHS staff working constructively with us” is a compliment directed to the bureaucratic leadership of all the health unions, the RCN, Unison, Unite, and GMB, which have used consultative, non-binding ballots to block action against this year’s 3.6 percent real-terms pay cut after hundreds of thousands of nurses, paramedics and support staff voted to throw it out in large majorities.

The health unions are also isolating and demobilising the fight against back door NHS privatisation through the for-profit subsidiary companies (“Subcos”) set up by hospital Trusts to outsource support staff based on a fire-and-rehire mechanism removing them from national pay, pensions, terms and conditions. NHS England’s announced “pause” in August of a further roll out of the Subcos was declared a “victory” by Unison to halt a mandated strike by 1,700 Dorset staff, as 150 staff in Airedale, west Yorkshire were striking against inferior terms imposed by the AGH Solutions subco. The GMB also claimed Streeting had “listened” to workers.

The “constructive” partnership between Streeting and the union bureaucracy must be opposed if defeat is to be prevented. Between 2023 and 2024, resident doctors staged 44 strike days for pay restoration. But when Labour came to power, the BMA rushed to declare a 22.3 percent two-year deal a “journey to pay restoration,” even though it fell far short of the 35 percent needed to recover lost earnings. Streeting’s latest 5.4 percent offer can only be hailed by the media as “generous” because the health unions have forced through even worse deals elsewhere.

Build rank-and-file power against bureaucratic sell outs

NHS FightBack calls on all health workers to defend the resident doctors and take the fight into their own hands. We call for the building of a network of rank-and-file committees across every hospital, trust, and department, independent of the union apparatus, democratically controlled by workers and committed to the defence of pay, conditions, and patient care.

These committees must link up across sectors and internationally as part of the International Workers Alliance of Rank-and-File Committees (IWA-RFC), to coordinate action against austerity, privatisation, and war.

Billions for healthcare, not the privateers and military spending

The cost of restoring resident doctors’ pay—around £1.7 billion—is a fraction of the billions squandered on outsourcing and war. There is always money for war, the City of London, and private profit, but not for health, education, or housing.

The defence of the NHS cannot be achieved within capitalism. Every government—Tory, Labour, or coalition—has pursued pro-market restructuring incompatible with universal, high-quality healthcare. The only way forward is to fight for socialism:

• End all the profit racketeering in the NHS—No more PFIs and Subcos—to restore a universal high quality public health service

• Bring the private health corporations, pharmaceutical giants into public ownership and under workers control

• Redirect the billions spent on war and corporate subsidies to healthcare and social services

The struggle of resident doctors is part of an international fight by healthcare workers facing the same conditions—from strikes in Germany, New Zealand, Australia and Sri Lanka to the United States. The global assault by governments and corporations can only be met with a unified, international counter-offensive by the working class.

NHS FightBack, established by the Socialist Equality Party, and the IWA-RFC is fighting to build this new leadership. We urge all NHS workers, doctors, nurses, and staff in every grade, to contact us and join the fight for a public health service based on socialist foundations.