Tens of thousands of junior doctors are to strike across England for three-days in a longstanding dispute over pay and conditions. The strike is the latest of a series involving hundreds of thousands of National Health Service (NHS) workers going back to last December.

Called by the British Medical Association (BMA), the stoppage begins Wednesday morning and is the first since a four-day stoppage in April. That followed a three-day walkout in March.

The action at every NHS Trust will have a major impact. The April walkout by junior doctors saw 196,000 hospital appointments and pre-planned operations cancelled and rescheduled. Since December more than 300,000 operations and appointments have been impacted.

Senior doctors and nurses are being drafted in to cover urgent and emergency care work, with a knock-on effect throughout the NHS.

The BMA initially called for a 35 percent increase in pay to address a real terms 15-year fall in pay of over 26 percent up to 2022, and a further collapse since then—with RPI inflation above 13 percent in that year. Despite the BMA leadership stating that it was prepared to accept a lower pay award, the Conservative government has refused to budge. After several rounds of talks, the Tories are offering nothing more than a 5 percent salary increase and a one-off £1,500 payment. The government has refused to enter any further negotiations until the BMA commits to ending all strike action.

The BMA is desperate to call off the action and is seeking a slightly improved pay offer it hopes to sell to its membership without sparking a rebellion like that in the Royal College of Nursing. Speaking on Sky’s Sophie Ridge on Sunday show after being asked to apologise to the population for the upcoming strikes, BMA Junior Doctors committee chair Robert Laurenson replied, “The strikes don’t have to go ahead though, the government can come to the table and the government can give us a credible offer.”

Asked if the BMA was still committed to the 35 percent rise, Laurenson stated only that a 10 percent pay deal would not be sufficient and that a deal spread out over several years would suffice. “We’re happy to look over a range of years but we need to be working with governments to understand where their headspace is and what they think is affordable.”

The junior doctors are part of an NHS workforce over 1 million strong, but beyond a small section of Unite union members no major group of health workers will strike alongside the doctors. Previous strikes by NHS workers, including junior doctors, were kept isolated and limited to 24 or 48 hours while the unions went into backroom talks aimed at a sell-out. This culminated in the NHS Staff Council meeting on May 2 at which 12 unions representing health workers in England—apart from doctors and dentists—voted by majority to accept the government’s below-inflation 5 percent pay award for 2023-24, and two non-consolidated payments for 2022-23 under the Agenda for Change pay framework.

The main nurses’ union, the RCN, with 280,000 members in England, would have accepted the rotten deal at the NHS Staff Council had its members in England not already voted in April to reject the derisory offer in defiance of a recommendation to accept by the leadership under General Secretary Pat Cullen. The Unite union, with around 100,000 members in the NHS including thousands of ambulance crew members, voted against.

Since then the RCN has not sanctioned a single strike and Unite has only called a few token stoppages, with its members at West Midlands Ambulance Service striking on June 12. On Wednesday, for just one day to coincide with the junior doctors walkout, Unite members at the Christie Hospital in Manchester and the City Hospital in Birmingham will take action.

The BMA has divided its members by every means possible. On Tuesday BMA Scotland announced, “Scottish junior doctors have voted conclusively to reject the pay offer made by the Scottish Government.” In a consultative ballot, 71.1 percent of its members voted to reject an equally derisory pay offer to that of the Tories, put forward by the Scottish National Party government. The deal, 14.5 percent over two years, was put by the BMA without a recommendation.

In response to its members throwing the offer out, BMA Scotland had no choice but to announce a strike. But this will not go ahead for nearly a month, over three days from July 12-15. It was announced with the proviso that “the BMA believes action can still be avoided if the Scottish Government comes back to any fresh negotiations with a better offer that convincingly starts to reverse the 15 years of pay erosion Junior Doctors in Scotland have endured.”

A more divisive statement could not have been written just 24 hours before tens of thousands of junior doctors in the same union strike in England. The 767-word text did not contain a single mention of the upcoming strike south of the border.

That strike will itself take place separately from two-day strikes by NHS consultants—the most senior doctors in the health service—and radiographers set for July 20 and 21, provided a ballot set to close on June 27 is successful. A consultative ballot returned an 86 percent majority. A strike by the 17,000 senior doctors would go ahead with only “Christmas Day cover” provided, meaning emergency services with all routine services paused.

Strike after strike has already been sabotaged and quashed by the trade union bureaucracy in the public and private sectors, whether led by right-wingers or self-styled “lefts” as with the junior doctors’ leadership. If junior doctors and their senior colleagues are not to suffer the same fate, the dispute must be taken out of the hands of the BMA.

Health workers in Britain, throughout Europe, and internationally are facing such a ferocious offensive by the ruling elite because a living wage, decent conditions and pensions are seen as an intolerable impediment to governments pursing war against Russia and building up their war machines at staggering expense. All social spending on health, education, housing and welfare must be stripped to the bone, with the full privatisation of the NHS a major aim.

NHS FightBack, an initiative of the Socialist Equality Party, urges doctors to fight for the formation of rank-and-file committees independent of the BMA bureaucracy. Taking control of the dispute, these committees can reach out to nurses and other NHS workers to organise a counter-offensive against the Sunak government and the devolved governments in Scotland and Wales seeking to impose similar attacks on pay and conditions.

We urge nurses and health workers to contact NHS FightBack to take forward this struggle today.