The following report was given by a senior nurse, Ajitha, to an NHS FightBack meeting on Tuesday: “Defeat Starmer-Streeting budget cuts and privatisation! For a united fightback by NHS workers!” The meeting took place as a five day strike by 50,000 resident doctor’s came to an end.

My friends, colleagues, and fellow health workers, welcome.

We meet at a critical moment, not only for resident doctors, but for everyone who works in the National Health Service.

In truth, the struggle unfolding today concerns the entire working class.

Most of us entered this profession because we care deeply about the health and welfare of the public. We do not take strike action lightly. Every walkout and every protest comes with real sacrifice: concerns about patient safety, the collapsing conditions in our hospitals, and the knowledge that the healthcare system is breaking apart around us. Strikes are never casual. They express the desperation and urgency we all feel.

So we must ask: What is the real nature of this struggle? And who exactly are we fighting?

The real opponent is the state and the Labour government.

Our employer is not simply “NHS management.” Despite decades of privatisation and outsourcing, the NHS remains fundamentally a state-run service.

The Labour government of Keir Starmer and his Health Secretary Wes Streeting are the people who declare—openly—that they “cannot and will not” offer a pay rise, that doctors are “unreasonable,” “ungrateful,” even “holding patients to ransom.”

Why this intransigence? This is not a negotiation tactic. It is the language of a government waging a political offensive not only against resident doctors, or even the NHS, but every worker in the UK.

The Labour government was brought to power with a mandate from big business: to impose the cuts, the wage suppression, and the restructuring that the Tory government had become too unstable to deliver.

For them, this is not simply a dispute over doctors’ pay. This is about reshaping British society to prepare for economic war with global rivals, soaring military spending, and the slashing of essential services and workers’ living standards at home to pay for it.

Wes Streeting is, in fact, being groomed as Starmer’s successor precisely because of his ruthlessness toward the NHS. In the eyes of the ruling class, he is proving his worth by attacking us. The NHS has been chosen as the testing ground: if they can break doctors, nurses, and health workers—the most trusted and respected workforce in the country—they can break anyone.

The media echo chambers of the ruling class all repeat the same government script. Even the so-called liberal press joins the chorus. Polly Toynbee, writing a particularly filthy piece in the Guardian, declares: “This week’s doctors’ strike is another test of Wes Streeting’s mettle. He is right not to buckle.” The right-wing outlets, for their part, have gone completely ballistic.

Labour’s record is cuts, privatisation, and attacks on staff. Streeting, a paid representative of private health-care lobby groups, dares to accuse resident doctors of “holding patients to ransom.” But after 15 months in government, Labour’s record exposes the real ransom demands.

Their promise to cut waiting lists has become a justification for mass outsourcing. Private providers now treat one in every ten NHS patients. In January, the Labour government handed private companies £2.5 billion to carry out an extra one million outsourced procedures. In March, they abolished NHS England and slashed 12,000 jobs overnight.

This month, they announced another 18,000 job cuts in Integrated Care Boards—only the first wave of more than 100,000 planned across ICBs and hospitals. The claim that this is about removing “bureaucracy” and “unnecessary management” is a fraud.

In Dorset, for example, under government direction, three major trusts attempted to hive off 1,700 of the lowest-paid staff into a subsidiary company with worse contracts—a sweatshop model they intend to impose nationally. The plan was paused only because of massive opposition.

Meanwhile, corridor care has been normalised. Under a so-called “timely handover” policy, ambulance crews in some trusts leave patients in corridors after 45 minutes in A&E. Staff from already short-staffed wards are then dragged into corridor care. Only three NHS trusts out of 121 in England are meeting cancer treatment targets.

Labour’s 10-Year Plan—sold as making the NHS “fit for the future”—is a blueprint for cuts, soaring workloads, and accelerated privatisation. Behind their buzzwords about a “Neighbourhood Health Service”, “analogue to digital” and “private and public partnership” lies a plan for further devastation.

Streeting is preparing to drown the NHS in debt by reviving the disastrous PFI [Private Finance Initiative] scheme, funnelling tens of billions more into private hands, just as the Blair–Brown government did before they were thrown out in 2010.

And at the centre of Labour’s programme is a demand for “urgent productivity gains”—making workers do more for less. For the next three years they have set a target of a 2 percent productivity increase every single year.

This is why the fight of resident doctors is not simply industrial—it is political.

The BMA says: “Strike a bit more. Protest a little harder. Apply more pressure.” But the government has already told us there is no deal on offer. Their political survival depends on defeating us. They have been told in no uncertain terms to impose vicious austerity, build up the armed forces and step up attacks on migrants that will help devastate the NHS or [Nigel] Farage and Reform UK will be the next government.

The BMA leadership continues to treat this solely as a pay dispute—writing polite letters, requesting meetings, and offering compromises. But what compromise is possible when Starmer, Streeting and Reeves' mission is to prove that the NHS workforce can be crushed?

Wes Streeting says resident doctors are “at war” with the government. For once, he is not lying. It is a war.

Leadership means telling the truth. But the BMA leadership is still selling us the lie that compromise is possible. It feigns ignorance of the government’s intentions while taking part in fraudulent talks that undermine the determined stand we have taken and lead us into a dead end.

A leadership that cannot identify the enemy or the terms of engagement cannot lead a fight.

As for the other health union leaders, Streeting praises “other NHS staff working constructively with us”, which is in truth a pointed compliment to the bureaucratic leadership of the RCN, Unison, Unite, and GMB, who used non-binding ballots to block action against this year’s 3.6 percent real-terms pay cut. Streeting’s 5.4 percent offer to doctors can be hailed as “generous” only because the unions have imposed even worse deals elsewhere.

Who offers a political alternative?

Jeremy Corbyn’s new party has descended into factional chaos for one simple reason: it will not confront big business offering only mealy-mouthed soundbites about “For the many, not the few.”

Well, the “many” is the working class, which must be mobilised in an industrial and political offensive against the “few”, a class of multibillionaire oligarchs who buy governments so they can wage the ruthless war that Streeting insists that we cannot and must not win.

Likewise, the Greens offer no serious programme to defend the NHS or support for this strike. Their silence speaks volumes.

The Labour Party has moved so far to the right in implementing policies once associated with the Tories that it is easily the most right-wing government in decades, the political heir of Margaret Thatcher and Tony Blair. And the entire establishment is aligning behind it.

What does this mean for us? It means the working class—above all, the NHS workforce—must reorient itself. We cannot allow our struggle to be trapped within the limits set by the BMA or any union leadership tied to the political establishment.

We must begin to organise independently. We need rank-and-file committees in every hospital and every department:

Networks of determined, principled, militant workers fighting not only for pay, but for the survival of the NHS itself.

Structures controlled by workers—not union officials whose role is to contain our struggle.

The future of the NHS—its very existence as a universal, free at the point of delivery and publicly funded service—is at stake.

And only the working class can save it.

We will not win with a few more strike days. We will not win with polite requests for meetings by leaders who pretend that reason will persuade a government acting for the banks, the billionaires, the pharmaceutical giants, private health corporations, and the arms manufacturers to change course.

We fight by mobilising the full strength of NHS workers—and by rallying the working class behind us. We fight by telling the truth:

Our enemy is the government of the rich, for the rich, and by the rich.

Our struggle is political.

And only the independent mobilisation of workers, armed with a socialist and internationalist strategy, can wage it.

The fight of resident doctors is part of an international movement of healthcare workers confronting the same austerity measures and the same attacks—from strikes in Germany, New Zealand, Australia and Sri Lanka to the United States.

Everywhere, governments and corporate interests are imposing identical policies of privatisation, intensified workloads, and declining living standards.

A global assault also demands a global response. It can only be confronted through a unified, international counter-offensive of the working class. This is why the development of a new leadership is essential.

NHS FightBack, part of the International Workers Alliance of Rank-and-File Committees (IWA-RFC), is fighting to build that leadership—rooted in the working class, independent of the union bureaucracy and the political establishment, and international in scope.

We must break the union bureaucracy's stranglehold and restore power to healthcare workers. We urge all NHS workers—doctors, nurses, paramedics, healthcare assistants, support staff, and every grade—to contact us, to join this struggle, and to help fight for a truly public health service based on equality, solidarity, and socialist foundations.

It is essential that we win this dispute. We reject Streeting’s message that defeat is inevitable. This is a weak and despised government, and we are fighting to defend a vital service on which tens of millions depend.

The NHS is admired around the world not because of its managers or its ministers, but because of its workforce. You are the backbone of public health in Britain—and you have the power to lead a broader movement against austerity, inequality, and war. This is the beginning of a new stage in our fight. Let us prepare it consciously.

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