Labour’s Health Secretary Wes Streeting chose the end of a five-day strike by 50,000 resident doctors in England to declare war against them for seeking pay restoration.

Writing in the July 30 Guardian, Streeting threatened one for the largest groups of medics in the National Health Service (NHS): “It should be clear to the BMA by now that it will lose a war with this government.”

Such language from a government minister has not been heard since Margaret Thatcher’s declaration that the miners were “the enemy within” during the 1984–85 national strike.

This is not just an attack on one section of NHS workers. Keir Starmer’s government is preparing a head-on confrontation with the working class that will spread through the NHS and public sector in response to demands for redress over pay after a decade and a half of austerity. In the first national strike to confront the government since it came into office last July, the resident doctors are in Streeting’s crosshairs because of their intransigence in demanding a 29 percent rise to bring real-terms wages to the pre-austerity levels of 2008.

Streeting denounced resident doctors as “reckless” and “unreasonable” and for using “the suffering of patients as leverage.” He was given a pulpit from which to do so by the Guardian just one day after regular columnist Polly Toynbee had denounced resident doctors for playing into the hands of the right and their demand for pay restoration as a “slap in the face” for the health secretary. This provided a seamless transition from his favoured location for making anti-NHS statements, the right-wing Daily Telegraph.

Labour is the real threat to the NHS

It is the Labour government and its Conservative predecessors whose cuts are the real threat to the NHS. Slashed real-terms pay has led to an exodus of staff that imperils patient care.

As a resident doctor on the picket line told the WSWS, “We’re not working 21 percent less hard than we were in 2008. The patients that we’re seeing are sicker, they’re older, and you can see that in terms of the occupation—the number of beds in hospitals is absolutely at creaking point.”

Unless pay and working conditions were redressed, he warned, “people will continue to leave by the tens of thousands to international markets. And there will be no one here to treat your grandmother, your father, your son, your child.”

Nothing could be further from the truth than Streeting’s claim that the government is “getting the NHS back on its feet.” Labour is pressing ahead with a £2.5 billion privatisation drive based on outsourcing a million NHS treatments annually to private providers—many notorious for botched operations that the NHS must then rectify. It has already announced the dissolution of NHS England, axing 12,000 jobs, with more cuts ahead via the restructuring of services under Integrated Care Boards. Over 100,000 jobs are now under threat.

Streeting is making an example of resident doctors in anticipation of far broader resistance. In the Telegraph, he instead that it was “important these strikes are not pain free for resident doctors,” warning of a “broader contagion” across the NHS and public sector. The Starmer government has supported its flagship Labour authority in Birmingham in a major strikebreaking operation against 400 refuse drivers and loaders opposing job losses and drastic cuts to pay of £8,000 a year.

Streeting has made his hostility to the NHS abundantly clear, declaring that it must not remain a “shrine”. His “reforms” are coded references to rationing care and further outsourcing to private providers, from someone documented as receiving donations from these profiteers.

In April, the Good Law Project reported that Streeting had “bagged another £58,000 from sources connected to the private health sector since taking over at the health department” last July, at “a rate of almost £10,000 a month.” This represented more than 60 percent of all donations accepted by Streeting. “These latest donations bring the total Streeting has accepted from private health-linked interests since 2015 up to £372,000.”

Streeting and Starmer depend entirely upon the health trade union bureaucracies to suppress a tide of opposition among NHS workers, even as the 3.6 percent offer for this year for other NHS staff, including nurses and paramedics, has been roundly rejected.

“Doctors are not the only staff I am responsible for in the NHS,” Streeting told the Guardian, adding:

The Royal College of Nursing will shortly publish a survey of its members and, without having seen the results, I have spent enough time with our nurses to know that they have not felt valued by the previous government and they are looking to Labour to deliver meaningful change to their profession. The GMB union has made similar representations on behalf of paramedics. Unite returned a negative ballot this week. Unison, the largest trade union in the country, knows better than anyone that staff right across the NHS are looking for material improvements to their pay and conditions. Many of them will never earn as much as the lowest-paid doctor. I have committed to work with them through the NHS Staff Council to make sure that we drive real change for their members, too.

Streeting is praising the methods employed by his allies in the union bureaucracy, consultative and indicative ballots, to screen officials from the demand for strike action. The result of the nurses ballot was announced Thursday with nine in 10 of 170,000 participants rejecting the 3.6 percent pay rise. But the RCN has only called on the government to take steps to enter talks to avert strike action, joining the GMB and Unite which saw rejection votes of 67 and 89 percent respectively by their NHS members.

The way forward

The problems health workers sought to resolve through the unprecedented strike wave of 2022–24—low pay and the degradation of the NHS—are now posed at a more malignant level against a Labour government even less restrained in its hostility than its Conservative predecessor.

That strike movement was systematically divided by the health union bureaucracy, which imposed below-inflation deals like the 5 percent given to nurses.

This betrayal was designed to corral NHS workers behind the election of a Starmer government. After 44 days of strike action, the BMA’s Junior (now Resident) Doctors Committee cut a deal with Streeting, demobilising and betraying the fight for 35 percent pay restoration with a two-year settlement of just 22.3 percent. This was packaged as a “journey to pay progression,” echoing Streeting’s own lies. The deal has been used in an attempt to force acceptance of the 5.4 percent pay rise for 2025-6.

Even after Streeting’s latest threats, the co-chairs of the BMA Resident Doctors Committee, Dr. Ross Nieuwoudt and Dr. Melissa Ryan, meekly stated that this was “a moment for the health secretary to reconsider this strategy.”

Streeting confirmed there will be no reopening of the 5.4 percent award in further talks planned for next week. Only surrender terms are acceptable, garnished by a few crumbs such as reimbursement of exam fees, tweaking training and vague promises of job progression.

No trust can be placed in the BMA Resident Doctor Committee. Streeting and his media lynch mob have been able to claim diminished public support for resident doctors only because the BMA aided this narrative. It issued instructions to remove other trade union banners from picket lines and restricted pickets to a few regional locations. Resident doctors were told not to travel outside their hospital.

The BMA, like all trade union leaderships, acts as an industrial policeman for the state and big business. Residential doctors must break free of its stranglehold on their dispute.

Doctors, nurses and allied health professionals should initiate rank-and-file committees, democratically controlled by workers themselves. These committees must unify NHS workers against the Starmer government and its corporate backers. NHS FightBack, established by the Socialist Equality Party and affiliated with the International Workers Alliance of Rank-and-File Committees (IWA-RFC), is fighting to build this leadership across the health sector.