Around 3,000 junior doctors in Wales began a 96-hour strike on Monday against the 5 percent pay award for 2023-4, a de facto pay cut implemented by the Labour-run Welsh Assembly last August.

The four days of consecutive action by junior doctors from 7 a.m. on March 25-29 is the third round of strikes and the most extensive to date by members of the British Medical Association (BMA) in Wales since January. It follows 72-hour strikes in January and February based on a 96 percent mandate.

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The junior doctors in Wales have suffered a real term decline in wages since 2008 of 29.6 percent, part of a general levelling down of junior doctors’ pay across the National Health Service (NHS) in the UK. The starting rate for a newly qualified doctor in Wales is just £13.65 per hour and £14 in England.

Junior doctors are determined to reverse decades of low pay and overwork which has led to a drain of frontline medics that has accelerated the collapse of patient care. However, the BMA offers no perspective to advance this fight after three months of struggle. Rather, it presents the Labour-controlled Welsh Assembly as a supposed ally in a fight against the Sunak Conservative government in Westminster.

The BMA has seized on the replacement of First Minister of Wales Mark Drayford by Vaughan Gething, sworn in last Wednesday, as offering a “fresh approach.” BMA Wales acting chairman Dr. Phil White wrote to the new First Minister stating, “Your vision for a healthy Wales mirrors the ethos and vision of doctors across the country who strive to deliver this daily. However, as an association, we are clear that this future cannot be achieved without the appropriate funding.”

White does not attempt to square Labour’s asserted affinity with the NHS with the decline it has presided over. Nothing has in fact changed since the 5 percent “first and final offer” was imposed last August. Health Secretary Eluned Morgan, reinstated to the position by the incoming first minister, said, “While we wish to address pay restoration ambitions, our offer is at the limits of the finances available to us at present and reflects the position reached with the other health unions for this year.”

The Labour-run Assembly, like the Sunak government, has used as its trump card against the junior doctors the raft of below-inflation deals imposed through the division and sellout of last year’s strike wave among the million-plus NHS workforce by all other major health unions.

In response the BMA Junior Doctors Committee (JDC), despite militant rhetoric, has downgraded the call for pay restoration to an appeal for a “credible offer” to end the dispute. In a March 25 press release on the strike action this week, Dr. Oba Babs-Osibodu and Dr. Peter Fahey, co-chairs of BMA Wales JDC stated, “We want to reiterate that the strikes can be called off at any time if the Welsh Government put forward a credible pay offer to form the basis of talks.”

The impasse into which the dispute has been led by the BMA JDC can only be prevented from becoming a rout if rank-and-file junior doctors take ownership of their fight.

From day one the BMA has sown divisions across the UK. In Scotland a 12.3 percent agreement for 2023/4 was reached with the Scottish National Party government last August in return for calling off strike action. While comparing favourably with the pay awards in England and Wales, this was nowhere near covering the 28.5 percent wage decline and was in favour of yearly negotiations to “make credible progress.”

In Northern Ireland junior doctors were only balloted in January and walked out on March 6 for 24 hours, rejecting a 10.7 percent offer in their first strike in 75 years. The forestalling of any action was summed up by JDC chair for Northern Ireland Fiona Griffin who stated, “We couldn’t leave it until our pay eroded by 50 percent.”

Last Wednesday over 30,000 junior doctors in the BMA in England returned a 98 percent majority to renew their strike action, on a 62 percent turnout. This is after 41 days of strike action since last March. Junior doctors in Wales walked out for three days from February 24, which ended just as the five days of action started in England.

Junior doctors in England have suffered a similar catastrophic decline in wages as in Wales, and are demanding a 35 percent rise to restore real-terms pay. The response of the BMA JDC has been to delay naming further strike dates and pursue talks with Health Secretary Victoria Atkins, who had only offered an additional 3 percent to the 8.8 percent imposed last year.

In a March 20 statement JDC co-chairs Dr. Robert Laurenson and Dr. Vivek Trivedi noted that the Conservative government had spent £3 billion to cover for the strike action since it began last year, more than double the amount estimated to fund the pay restoration settlement in full. This underscores the fraud of the “unaffordability” mantra by the Sunak government. Money is no object when it comes to breaking the resistance of junior doctors and setting an example to all NHS workers. Yet in the face of the warfare conducted by the government, Laurenson and Trivedi reiterated the call for a “credible pay offer now” to “make sure not a single further strike day need be called.”

The JDC leaders’ offer to the Tories is in line with the Labour Party’s offer of corporatist collaboration with unions leaders to smoother all industrial action in the build-up to a general election. Sir Keir Starmer’s Shadow Health Secretary Wes Streeting has paraded his hostility towards the junior doctor strikes and stated that a Labour government would not meet the demand to restore pay to pre-austerity levels.

Streeting used an interview with the Financial Times on March 24 to make his latest pitch for the pro-market measures Labour has planned for the NHS. He described how tens of thousands of patient procedures such as hip, knee and eye surgeries would be farmed out to the private sector under Labour as a supposedly “short-term measure.”

Streeting claimed to distance himself from the “ideological” approach of New Labour under Tony Blair that competition in public services drives up standards. But regarding the establishment of independent sector treatment centres (ISTC) and private finance initiatives (PFIs), expanded under the last Labour government, he stated the evidence was “patchy,” in order to conceal the outright looting of NHS resources and hospitals saddled with unserviceable debts by private consortia.

The key message was that any additional funding to the NHS would be conditional on “reform” based on a “single front door approach” for awarding contracts to the private sector, portraying the problem with the NHS as it being wasteful with public funding and its workforce as backward.

The FT positively referenced the “tight fiscal rules” set by Shadow Chancellor Rachel Reeves, who recently pledged to continue the policies of austerity if Labour came to government and dubbed herself the “Iron Chancellor” in a homage to Margaret Thatcher.

The area of public spending not subject to fiscal restraint is military expenditure, with Labour lined up behind the Tory government in backing the genocidal onslaught against Palestinians in Gaza and the escalation of the NATO proxy war against Russia in Ukraine.

The defence of the NHS and a cost-of-living increase for its entire workforce requires a fight against the twin parties of austerity and war. NHS FightBack, established by the Socialist Equality Party and affiliated to the International Workers Alliance of Rank-and-File Committees, seeks to organise workers throughout the healthcare sector. Get involved today.