Today and yesterday’s junior doctors’ strike marks a serious escalation in the fight over the future of the NHS. You can tell this not just from the strength of the picket lines, but from the proliferation of doctor-bashing headlines and editorials, as the right wing press lines up to blame the strikers for every death in A&E. And yet, for all the vilification in the press, public support for the strike remains high, as does the mood of NHS campaigners. By the time that at least 5,000 doctors and teachers marched through central London last night, a national strike turnout as high as 80% was being reported.
For everyone in Labour, supporting this strike should be the easiest political calculation imaginable. Not only is it a popular piece of action, it is also a vital point of resistance against the government’s wider agenda for the NHS. If the contract succeeds, far more will follow, both for further layers NHS workers and the structure of the NHS itself. The presence of the Labour leadership at the demonstration outside Downing Street last night boosted morale, but it is also part of a vital strategy to widen the support and terrain of the dispute, and present the reality of the situation – that NHS workers may well be the only force standing between the government and the wholesale privatisation of the service.
One of the most puzzling aspects of the strike so far, then, has been the actively lukewarm attitude of Labour’s official health spokesperson. Heidi Alexander has remained far away from the picket lines, and in the past has even successfully demanded that John McDonnell stay away from them. In the heat of the dispute, what is being drawn out is a sharp set of differences within Labour, both about how to handle strikes, but also, on deeper level, about how far to go in opposing private involvement in the NHS.
Over the weekend, that difference in approach reached a new height, when Alexander announced a cross-party initiative to demand that the government run an independently assessed pilot of its new junior doctors contract, in return for a suspension of strike action. On the one hand, this could be recorded as a shrewd tactical move – a calculated attempt to make the Tories look unreasonable. But from another perspective, it was dangerous: barely a day before the biggest and arguably most important strike in the NHS’s recent history, Labour’s Shadow Health Secretary – rather than backing the strike – was backing a move that gave ground to the very contract that it was opposing.
On a number of levels, Labour’s official stance on the NHS is still at odds with the radical new mood in the party membership. On 11th March, the NHS Bill – a private members’ bill which would reverse much of the privatisation that the NHS has undergone in recent years – had its second reading. To the frustration of NHS campaigners – who had made the Bill a subject of significant mobilisation – Labour’s Shadow Health team did not bring out Labour MPs to carry it forward.
The outright reversal of privatisation in the NHS is not just a popular policy amongst Labour members. Over the past few years, there has been a shift among the wider public, with increasing numbers opposing the involvement of private providers. Private Finance Initiatives (PFI), which accounted for 90% of all hospital constructions between 1997 and 2008, are now widely recognised as financially ruinous for the health service. The internal problem for Labour is that taking these issues on in a convincing way will require the new leadership to openly oppose and contradict Labour’s own record while in government.
Doing so will be a familiar and comfortable activity for Corbyn. But in order to radicalise Labour’s NHS policy, to bring it into line with the radical mood on the subject that exists both in the party and the country, Labour’s grassroots will have to flex its muscles. That means pushing for a formal policy debate at this year’s party conference, and continuing the campaign within the party for a new health platform: a universal, wholly public service, democratically accountable and free from any internal or external market. We will need to be bold about the health service we want to see, not just about the cuts and restructurings we need to reverse; and we should roll back the restrictions on migrants’ access to NHS service which have been introduced in recent years.
Jeremy Corbyn and John McDonnell’s support for the junior doctors’ strike this week marks a significant shift in Labour’s position on the issue, recognising the legitimacy and potential of NHS workers in opposing the Conservative agenda in the health service. But in order to really save the NHS, Labour will need consistency: that means bringing our policy into line with our sentiment.
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